• Tuberculosis and Respiratory Diseases
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• v.60 no.2
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• pp.228-234
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• 2006

Background : Acinetobacter baumannii is an important pathogen associated with nosocomial infections in intensive care units, and is responsible for nosocomial pneumonia, UTI, bacteremia, etc. The main concern is that this pathogen is often resistant to many antimicrobial agents, particularly to carbapenem. This study compared the clinical those of ICU admitted patients with the carbapenem resistant A. baumannii isolated from the sputum with characteristics of patients with carbapenem sensitive A. baumannii. Methods : A total of 49 patients with A. baumannii from a sputum culture who were admitted to the ICU from January to December 2003 were enrolled in this study. This study evaluated the demographic variables, mortality, APACHE II score, comorbidity, antibiotics used, hospital and ICU stay, Clinical Pulmonary Infection Score, and mechanical ventilation. A retrospective analysis was made by a review of the patients' medical records. Results : Carbapenem sensitive and resistant A. baumannii was isolated from 23 patients and 26 patients respectively. Univariate analysis revealed renal disease, the use of carbapenem and aminoglycoside to be statistically significant factors for carbapenem resistance. Multivariate analysis revealed carbapenem use(p=0.024; OR, 8.17; CI 1.32 to 50.68) to be positively associated with carbapenem resistance, and aminoglycoside use(p=0.026; OR, 0.18; CI, 0.04 to 0.82) to be negatively associated with carbapenem resistance. There was no significant difference in mortality between the carbapenem sensitive and resistant group(30 vs 42%. P=0.39). Conclusion : The occurrence of carbapenem resistant A. baumannii is positively associated with carbapenem use and negatively associated with aminoglycoside use. Carbapenem resistance in the sputum culture did not affect the mortality rate.

• Tuberculosis and Respiratory Diseases
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• v.49 no.1
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• pp.72-81
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• 2000

Backgrounds : Authors evaluated the quantitative culture of bronchoalveolar lavage fluid(BALF) in patients who were being treated with antimicrobial agents and the characteristics of isolated microorganism. Method : A prospective study was done with 25 patients under mechanical ventilation and antimicrobial treatment in ICU and NCU of Yongdong Severance Hospital from Apr. to Sep. 1999. Patients were classified into two groups: control group (n=5) and patients with VAP (n=20). The threshold of quantitative culture of BAL fluid in the diagnosis of VAP was $10^4$ cfu/ml. Results : 1) In gram staining of BALF, one patient in the control group and four in the VAP group showed positive results. Quantitative culture of BALF showed no organisms in the patients in the control group and in 9 VAP patients. Therefore the overall sensitivity was 43.8%. 2) Frequency of isolated organisms cultured above diagnostic threshold was in the following order: E. cloaclae, S. aureus, K. pneumoniae, and A. baumani. S. aureus and Staphylococcus coagulase(-) were a11 resistant to oxacillin. Seven out of 10 isolated G (-) organisms were suspected to be organisms producing extended spectrum $\beta$-lactamase (ESBL). 3) The concurrence between gram staining of sputum aspiration and that of BALF was only in 1 case. And the concurrence of culture results was observed in 3 cases. Conclusion : The sensitivity of gram staining and quantitative culture of BALF from patients under antibiotic therapy and the concordance rate between conventional tracheal aspiration and BAL were low, facts which were important in interpretation the data. Since the frequency of drug resistance organisms was not different from that of foreign data, antibiotics must be prudently selected and used.

• Korean Journal of Veterinary Service
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• v.24 no.1
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• pp.31-41
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• 2001

This study was carried out to identify causative agents from california mastitis test(CMT) positive mastitic milk, and to examine the antimicrobial susceptibility of 50 heads in Seongju and Chilgok area of Gyeongbuk province. Sulfadimethoxine sodium(SMS) was intramuscularly administered once to four mastitis Infected dairy cattle at the rate of 10mg/kg body weight. After injection of SMS, the depletion rate of serum and milk from the cattle were periodically measured for five days. The CMT positive number from 50 heads showed 46% and that of 200 quarters was 47(23.5%). From 39 quarters of 47 heads 39 different microorganisms were identified. These organisms were classified into 12 species : Staphylococcus aureus 8(20.5%), Sta hemolyticus 6(15.4%), Streptococcus bovis 4(10.3%), Sta hyicus 3(7.7%), Sta epidemidis. Sta xylosus, Sta sciuri 2(5.1%), Str agalactiae 2(5.1%), Escherichia coli(10.3%), three Enterobacter cloacae(7.7%), two Ent aerogenes(5.1%) and one Salmonella spp(2.6%). As the results of antibiotic susceptibility test, gentamicin(Gm, 11 species 27 strains, 69.5%), cephalotin(Cf, 9 species 24 strains, 61.5%), sulfamethoxazole(Stx, 8 species 14 strains, 43.6%), tetracycline(Tc, 8 species 14 strains, 35.9%), and streptomycin(Sm), lincomycin(Lm), cefoperazon(Cp) and penicillin(Pc) have a highly resistance(7.7% ～5.1%). However, carbenicillin (Cb), amikacin(Ah) have no susceptible for all drugs. The mean residual concentration of SMS in serum according to the time lapsed were showed 33.964 $\pm$ 4.435ppm at the 4 hours after intramuscularly injection(AII). It was significantly(p<.05) decreased to 6.596 $\pm$ 3.402, 0.217 $\pm$ 0.119 and 0.005 $\pm$ 0.004ppm at the 1st, 3rd and 5th day AII. The mean concentration of SMS in milk was significantly(p<.05) decreased from 0.920 $\pm$ 0.42ppm to 0.084 $\pm$ 0.016ppm between 8 hours and 1 day AII. As the results of this experiments, sulfadimethoxine was residued at the level of no less than 0.01ppm in milk on the 2nd day AII. Thus, this results would be able to be used the basic index for prevention of sulfonamides residue in milk after treatment of dairy mastitis.

• Korean Journal of Clinical Laboratory Science
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• v.56 no.1
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• pp.52-58
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• 2024

Photodynamic therapy (PDT) activates intracellular oxygen using a photosensitizer activated by light of a specific wavelength and is a potential means of treating wound infections caused by antibiotic-resistant bacteria. Pseudomonas aeruginosa (P. aeruginosa) is typically non-pathogenic in healthy individuals but can induce severe illnesses like sepsis in the immunocompromised. Antibiotics have been conventionally used to treat P. aeruginosa infections, but increasing antibiotic resistance caused by drug misuse poses a growing challenge to the management of these infections. This study aimed to investigate the ability of PDT using photosensitizers (PhotoMed, Methyl pheophorbide A, or Radachlorin^®) and a diode laser to inhibit P. aeruginosa. Suspensions of P. aeruginosa and a photosensitizer were inoculated into Petri dishes and incubated for 30 minutes. Samples were then irradiated with the laser at 3 J/cm², and after incubation, colony areas were measured. P. aeruginosa killing rates were 79.65% for PhotoMed, 47.36% for Methyl pheophorbide A, and 40.91% for Radachlorin^®. This study shows that PDT using a diode laser and a photosensitizer constitutes an effective practical therapeutic approach for inhibiting P. aeruginosa.

• Tuberculosis and Respiratory Diseases
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• v.64 no.1
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• pp.8-14
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• 2008

Background: Acinetobacter infections are difficult to treat as they often exhibit multiple resistance to the antibiotics that are currently available for the treatment of pneumonia. Colistin is active against gram-negative bacteria, including the multiple drug resistant (MDR) Acinetobacter species. However, intravenous administration of colistin was abandoned because of its nephrotoxicity and neurotoxicity. The aims of this study were to examine the efficacy and safety of colistin administered by aerosol in the treatment of pneumonia caused by MDR Acinetobacter baumannii. Methods: We retrospectively reviewed the medical records of patients admitted to the intensive care unit (ICU) from Dec. 2006 to Aug. 2007 who had been diagnosed as suffering from pneumonia due to MDR Acinetobacter baumannii and had been treated with nebulized colistin. Results: 31 patients received aerosolized colistin. The average duration of the treatment was $14{\pm}7$ days and the daily dose of ranged from 225 mg to 300 mg. All patients received concomitant intravenous antimicrobial agents. The average length of the stay in the ICU was $34{\pm}21$ days and in the hospital $58{\pm}52$ days. The overall microbiological eradication was observed in 25 patients (80.6%). 14 of these (56%) were cured, and 11 (44%) were infected with other microorganisms. The overall crude mortality of the ICU was 48%. Nephrotoxicity and significant bronchial constriction did not occur in any patient during neublized colistin treatment. Conclusion: Nebulized colistin may be a safe and effective option in the treatment of pneumonia due to MDR Acinetobacter baumannii. Its role in therapy warrants further investigation in comparative studies.