• Title/Summary/Keyword: Antimicrobial therapy

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Detection Rate of Extended-Spectrum ${\beta}$-Lactamase Producers in Klebsiella pneumoniae and Escherichia coli Isolated at Yeungnam University Medical Center (영남대학교 의과대학 부속병원에서 동정된 Klebsiella pneumoniae와 Escherichia coli의 Extended-Spectrum ${\beta}$-Lactamase생성 빈도)

  • Lee, Chae-Hoon;Lee, Ho-Chan;Kim, Kyung-Dong;Lee, Tae-Su
    • Journal of Yeungnam Medical Science
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    • v.16 no.2
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    • pp.270-276
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    • 1999
  • Background: Extended-spectrum ${\beta}$-lactamases(ESBL) are enzymes that confer resistance to oxyimino-${\beta}$-lactams as well as to penicillins and cephalosporins. Strains of Klebsiella pneumoniae and Escherichia coli that produce ESBL have been increasingly prevalent in many countries. The purpose of this study was to investigate the ESBL production rate of K. pneumoniae and E. coli at the in Yeungnam University Medical Center. Materials and Methods: Thirty-one isolates of K pneumoniae and twenty-five isolates of E. coli were examined for ESBL by double disk synergy test, using 20/$10{\mu}g$ ticarcillin/clavulanic acid and $30{\mu}g$ oxyimino-${\beta}$-lactam(ceftazidime, ceftaxime, ceftriaxone and aztreonam) disks. Results: Fifty-two percent of K. pneumoniae and sixteen percent of E. coli isolates revealed double disk synergism. Majority of ESBL-producing strains(fifty-five percent) were isolated from patients in the intensive care unit. Conclusion: ESBL production of K. pneumoniae and E. coli were also common at the Yeungnam University Medical Center and pose a serious problem for antimicrobial therapy.

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The Clinical Effect of Sparfloxacin for the Treatment of Acute Respiratory Infection (호흡기 감염 질환에서 Sparfloxacin의 임상효과)

  • Lee, Hak-Jun;Park, Hye-Jung;Shin, Chang-Jin;Shin, Kyeong-Cheol;Chung, Jin-Hong;Lee, Kwan-Ho;Lee, Hyun-Woo
    • Journal of Yeungnam Medical Science
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    • v.15 no.2
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    • pp.246-253
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    • 1998
  • Sparfloxacin is a new synthetic quinolone antimicrobial developed at the Research Laboratories of Dainippon Pharmaceutical Co, Ltd. To evaluate the efficacy and safety of sparfloxacin in acute pulmonary infection, we administered sparfloxacina(100mg) twice in a day to 30 patients who had signs and symptoms of acute pulmonary infectious diseases regardless of their underlying lung disease for 7 days. The results were as follows: 1) A total 30 patients were enrolled in the trial. Among them, 24 cases(80%) had underlying lung problems such as chronic obstructive pulmonary disease(36.4%), bronchiectasis(36.4%), bronchial asthma(3.3%), or lung cancer(3.3%). 2) In 26 cases(86.6%), we observed effective improvement, and 4 cases(13.4%) show mildly effective improvement of symptoms and signs of respiratory infection. 3) In 23 cases(73.4%), we observed bacteriological eradication in culture or decreased the number of bacteria by Gram stain which found dominantly in previous Gram stain. 4) The significant side effect was not noted. The above results suggested that sparfloxacin was effective as a first line therapy in patients with acute respiratory infection.

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Evaluation of Ascorbic Acid Treatment in Clinical and Subclinical Mastitis of Indian Dairy Cows

  • Naresh, Ram;Dwivedi, S.K.;Swarup, D.;Patra, R.C.
    • Asian-Australasian Journal of Animal Sciences
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    • v.15 no.6
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    • pp.905-911
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    • 2002
  • A study was carried out to assess the therapeutic effect of ascorbic acid in mastitis of dairy cows. The herd with a population of 250-275 lactating cows was screened for clinical and subclinical mastitis for a period of 5 months. Based on inclusion and exclusion criteria, eighteen animals each with clinical and subclinical mastitis in one quarter only were selected as study population. Twelve cows (group A) with normal udder and health were also selected as a healthy control. Clinical mastitis cows were grouped as B (n=12) and C (n=6). Cows of group B were treated with ascorbic acid at 25 mg/kg, subcutaneously for 5 consecutive days and intramammary infusion (Ampicillin sodium 75 mg and Cloxacillin sodium 200 mg/infusion) based on antibiotic sensitivity test, till complete recovery. Group C cows received only intramammary infusion till the complete recovery. Eighteen subclinical mastitis cows were divided in group D (n=12) and E (n=6). Cows of group D were treated with ascorbic acid at 25 mg/kg subcutaneously for 5 consecutive days while group E did not receive any treatment. California mastitis test (CMT), somatic cell count (SCC), physical changes of udder and milk were used to diagnose and classify the mastitis. Evaluation of the therapy was based on CMT score and physical changes of udder and milk. Sample size calculation was also performed but was not followed for control groups due to scarcity of cases. Adequate blinding was done when and where required to avoid the biases. Confounding variables like herd, age of the cow, stage of the lactation, season and geographical region were duly considered and adequate blocking was followed. Ascorbic acid was administered in clinical and subclinical cases even after cure considering its immunostimulatory and healing inducing effects. The recovery rate was faster in cases of clinical mastitis treated with ascorbic acid along with an intramammary infusion (group B) than the quarters of group C cows. Quarter wise the average duration/number (3.16${\pm}$0.11 days) of antimicrobial intramammary infusion was significantly (p<0.01) less in group B than that of average duration/number (5.33${\pm}$0.20 days) of group C. Subclinical mastitis cows treated with ascorbic acid showed 83.33% recovery while 16.77% did not respond to treatment till last day of study. Cows of group E (untreated) did not recovered from the mastitis. Subjective parameters viz. swelling, pain reflex of udder and physical changes in milk from quarter of ascorbic acid treated cows (group B) disappeared earlier than that of group C cows. It is concluded from this study that the ascorbic acid might be useful as an adjunct in case of clinical mastitis to get quick recovery with less number of intramammary infusions. High recovery rate in subclinical mastitis quarters of group D cows is appreciable and opens a new avenue to conduct further trials in a larger population in various field conditions. However, the pharmacology of ascorbic acid with particular reference to health of mammary gland needs to be investigated.

Isolation of Anaerobic Bacteria from Clinical Specimens in Veterinary Medical Teaching Hospital (대학 동물병원 임상 검체로부터 분리된 혐기성 세균과 항생제 감수성 양상)

  • Park, Se-won;Chung, Jin-young;Hwang, Cheol-yong;Youn, Hwa-young;Han, Hong-ryul
    • Journal of Veterinary Clinics
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    • v.21 no.1
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    • pp.15-19
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    • 2004
  • The emergence of bacterial resistance to antibiotics during therapy is a matter of great problem in clinical medicine. This may be because many veterinarians have used inappropriate antibiotics without bacteriological culture. Therefore, the purpose of this study is to determine isolation of anaerobic bacteria as pathogens from veterinary clinical specimens as well as susceptibility pattern for choosing antibiotics. Various anaerobic bacteria were isolated from clinical specimens of dogs, cats, rabbits at Veterinary Medical Teaching Hospital of Seoul National University from May 2001 to October 2002. The total number of isolated anaerobic bacteria was 13 isolates; Bacteroides spp. (3 isolates), Fusobacterium spp. (2 isolates), Peptostreptococcus spp. (2 isolates), Porphyromonas gingivalis (2 isolates), Prevotella spp. (3 isolates), and Propionibacterium acnes (1 isolate). For evaluating the antibiotic susceptibility patterns of the isolates disk diffusion method was used. All isolates were susceptable to all tested antibiotics except only one Fusobacterium varium was resistant to norfloxacin.

Evaluation of Bactericidal Capacity of Silver Ion against Bovine Mastitis Pathogens (소 유방염 원인균에 대한 은이온의 향균력 평가)

  • Seol, Jae-Won;Hur, Tai-Young;Jung, Young-Hun;Park, Sang-Youel;Kang, Seog-Jin
    • Journal of Veterinary Clinics
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    • v.27 no.3
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    • pp.252-256
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    • 2010
  • Bovine mastitis, defined as an inflammation of the mammary gland, is usually associated with bacterial infection. Thus, treatment and control of mastitis relies primarily on antimicrobial therapy. This study investigated the bactericidal actions of silver ion against causing various bovine mastitis pathogens. Minimal inhibitory concentrations (MICs), minimum bactericidal concentrations (MBCs) and bactericidal activity times and concentrations of silver ion against pathogens were determined. The effect of silver ion on bacterial morphology was studied by scanning electron microscopy (SEM). The MICs and MBCs of silver ion for various bacteria strains ranged from 1.9-15.6 ${\mu}g$/ml. SEM images indicated formation of a pit, distortion and disruption of cell walls in silver treated Staphylococcus aureus and Escherichia coli. The results demonstrate that silver ion has a bactericidal capacity against causing various pathogens of bovine mastitis and suggest that silver ions may be exploitable as a therapeutic/preventative tool of bovine mastitis.

Phototoxic effect of blue light on the planktonic and biofilm state of anaerobic periodontal pathogens

  • Song, Hyun-Hwa;Lee, Jae-Kwan;Um, Heung-Sik;Chang, Beom-Seok;Lee, Si-Young;Lee, Min-Ku
    • Journal of Periodontal and Implant Science
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    • v.43 no.2
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    • pp.72-78
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    • 2013
  • Purpose: The purpose of this study was to compare the phototoxic effects of blue light exposure on periodontal pathogens in both planktonic and biofilm cultures. Methods: Strains of Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, and Porphyromonas gingivalis, in planktonic or biofilm states, were exposed to visible light at wavelengths of 400.520 nm. A quartz-tungsten-halogen lamp at a power density of $500mW/cm^2$ was used for the light source. Each sample was exposed to 15, 30, 60, 90, or 120 seconds of each bacterial strain in the planktonic or biofilm state. Confocal scanning laser microscopy (CSLM) was used to observe the distribution of live/dead bacterial cells in biofilms. After light exposure, the bacterial killing rates were calculated from colony forming unit (CFU) counts. Results: CLSM images that were obtained from biofilms showed a mixture of dead and live bacterial cells extending to a depth of $30-45{\mu}m$. Obvious differences in the live-to-dead bacterial cell ratio were found in P. gingivalis biofilm according to light exposure time. In the planktonic state, almost all bacteria were killed with 60 seconds of light exposure to F. nucleatum (99.1%) and with 15 seconds to P. gingivalis (100%). In the biofilm state, however, only the CFU of P. gingivalis demonstrated a decreasing tendency with increasing light exposure time, and there was a lower efficacy of phototoxicity to P. gingivalis as biofilm than in the planktonic state. Conclusions: Blue light exposure using a dental halogen curing unit is effective in reducing periodontal pathogens in the planktonic state. It is recommended that an adjunctive exogenous photosensitizer be used and that pathogens be exposed to visible light for clinical antimicrobial periodontal therapy.

Inhibitory Effect of Stephanniae Tetrandrae Radix Extract on $TNF-{\alpha}$, $IL-1{\beta}$, IL-6 and Nitric Oxide Production in Lipopolysaccharide - Activated RAW 264.7 Cells (방기(防己) 추출물이 LPS로 유도된 Raw 264.7 cell에서의 $TNF-{\alpha}$, $IL-1{\beta}$, IL-6 및 Nitric Oxide Production에 미치는 영향)

  • Kim, Dae-Hee;Lee, Jong-Rok;Byun, Sung-Hui;Shin, Sang-Woo;Kwon, Young-Kyu;Kim, Sang-Chan
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.20 no.4
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    • pp.902-908
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    • 2006
  • Tetrandra is the root of Stephania tetrandra 5. Moore (family Menispermaceae), or of Aristolochia frangchi Wu (family Aristolochiaceae). It is a Differ-flavored and cold-property herb acting on the urinary bladder, kidney and spleen meridiands. Known biological effects of this herb are expelling wind to relieve pain and inducing diuresis to alleviate edema. This herb also has anti-inflammatory and anti-hypersensitivity actions. Recent studies have shown that Stephanniae Tetrandrae Radix has antimicrobial effects, namely, a protective effect on acute renal failure induce by gentamicin sulfate and a suppressive effect against clostridium perfringes. However, there is a lack of studies concerning the immunological activities of this herb. The present study was conducted to evaluate the immunological activities of Stephanniae Tetrandrae Radix on the regulatory mechanisms of cytokines and nitric oxide (NO) in Raw 264.7 cells. Cell viability was measured by MTT assay after the treatment of Stephanniae Tetrandrae Radix extract (STRE) and NO production was monitored by measuring the nitrite content in culture medium. COX-2 and iNOS were determined by immunoblot analysis, and levels of cytokine were analyzed by sandwich immunoassays. Results provided evidences that STRE inhibited the production of nitrite and nitrate (NO), inducible nitric oxide synthase (iNOS), cyclooxygenase-2 (COX-2) tumor necrosis $factor-{\alpha}\;(TNF-{\alpha})$, $interleukin-1{\beta}(IL-1{\beta})$ and interleukin-6 (IL-6) in Raw 264.7 cells activated with lipopolysaccharide (LPS). These findings showed that STRE could produce some anti-inflammatory effects which might play a role in adjunctive therapy in Gram-negative bacterial infections.

Elevation of Procalcitonin in an Adolescent Acetaminophen Intoxication (아세트아미노펜 중독 청소년에서의 프로칼시토닌 상승)

  • Kim, So Eun;Lee, Jae Baek;Jin, Young Ho;Yoon, Jae Chol;Jo, Si On;Jeong, Tae Oh
    • Journal of The Korean Society of Clinical Toxicology
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    • v.17 no.1
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    • pp.38-41
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    • 2019
  • Procalcitonin (PCT) is commonly employed in medical practice as a diagnostic biomarker of bacterial infection and also as a monitoring biomarker for antimicrobial therapy. There have been a few published reports concerning elevated PCT levels in people with acute liver injury caused by an overdose of acetaminophen. We report here on a case of PCT elevation in an adolescent with acute acetaminophen poisoning without any bacterial infection or liver injury. A 15-year-old girl had deliberately ingested 20 tablets of 650 mg acetaminophen (13 g) and she presented to our emergency department. The PCT level on admission was elevated to 65.64 ng/mL (reference range: 0-0.5 ng/mL). Her PCT level on the second day peaked up to 100 ng/mL and then it gradually decreased. There was no evidence of liver injury or infection on the computed tomography examination and other lab tests. The patient regained her good health and was discharged on the sixth day of hospitalization.

Effects of Aerosol Colistin Treatment of Pneumonia Caused by Multi-drug Resistant Acinetobacter baumannii (다약제 내성 Acinetobacter baumannii 에 의한 폐렴에서 Colistin 분무치료의 효과)

  • Choi, Hye Sook;Hwang, Yeon Hee;Park, Myung Jae;Kang, Hong Mo
    • 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.

Bacteremia in Pediatric Cancer Patients : Causative Organisms and Antibiotic Sensitivities (소아 암 환자에서 발생한 균혈증 : 원인균과 항생제 감수성)

  • Kim, Yong-Han;Lee, Hyun-Dong;Hah, Jeong-Ok
    • Clinical and Experimental Pediatrics
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    • v.48 no.6
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    • pp.619-623
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    • 2005
  • Purpose : Bacteremia in immunocompromised pediatric cancer patients can lead to high morbidity and mortality, if not treated early and properly. The incidence and antibiotic sensitivities to common pathogens of bacteremia in pediatric cancer patients are liable to change, according to region and time. We investigated the causative organisms and antibiotic sensitivities of bacteremia in pediatric cancer patients to assess the adequacy of empiric antimicrobial therapy. Methods : From September 1995 to August 2003, we retrospectively evaluated 58 episodes in 39 pediatric cancer patients with bacteremia treated at the Pediatric Department of Yeungnam University Hospital. We investigated and analyzed the causative organisms and the antibiotic sensitivity test results by reviewing the records of the microbiologically proven positive blood culture results. Results : The incidence of bacteremia in pediatric cancer patients in this study was 5.7 percent (58 episodes out of 1,022 occasions of blood cultures). Gram-positive organisms were isolated more often than gram-negative organisms (63.8 percent vs 36.2 percent) in the following order : Staphylococcus epidermidis (37.9 percent), Staphylococcus aureus (17.3 percent), Escherichia coli (12 percent), Streptococcus (8.6 percent), Enterobacter (6.9 percent), Klesiella (6.9 percent), Serratia (3.5 percent), Acinetobacter (3.5 percent), Proteus (1.7 percent) and Morganella morganii (1.7 percent). In antibiotic sensitivity tests, only six of 37 isolates (16 percent) of gram positive bacteria were sensitive to penicillin and 15 of 37 isolates (40 percent) were sensitive to oxacillin. All except one Staphylococcus aureus were sensitive to vancomycin and all except one Staphylococcus epidermidis were sensitive to teicoplanin among 37 isolates of gram positive bacteria. In the case of gram negative bacteria, two of 21 isolates (10 percent) and four of 21 isolates (19 percent) were sensitive to cefotaxime and ceftazidime, respectively. Only six of 21 isolates (29 percent) were sensitive to aminoglycoside, but all 21 isolates (100 percent) were sensitive to imipenem. All seven isolates tested after the year 2000 were sensitive to meropenem. Conclusion : In conclusion, we should choose the proper antimicrobials in treating pediatric cancer patients with suspected bacteremia, reflecting the increasing episodes of gram positive bacteremia and polymicrobial resistance of gram positive and negative organisms.