• Korean Journal of Clinical Pharmacy
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• v.21 no.4
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• pp.394-399
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• 2011

이 증례는 알코올 중독증을 앓은 병력을 가졌으나 간 기능에 특이한 증후가 없던 환자가, 지역 사회 획득성 폐렴으로부터 유발된 중증 패혈증 치료를 받기 위해서 linezolid, moxifloxacin 과 함께 aztreonam을 초회 정맥주사 맞은 후, 아주 높은 수치의 alanine aminotransferase (ALT), aspartate aminotransferase (AST) 혈중 농도가 검출된 경우이다. 후속 치료에서 상기 3가지 항생제 대신 vancomycin과 ceftazidime을 주사했더니, ALT/AST가 빠르게 정상화됨이 관찰되었다. 이 증례 보고는 linzolid, moxifloxacin과 aztreonam을 함께 사용할 경우, 각별한 주의 관찰이 필요하며, 알코올 중독증을 앓은 병력을 가진 환자에게 투여 시 특별한 주의와 함께 AST/ALT혈중 수치를 검사토록 권하기 위한 것이다.

• Journal of Yeungnam Medical Science
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• v.10 no.1
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• pp.28-36
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• 1993

Major pathogenic Gram-negative organisms such as P. aeruginosa, Serratia species, E. coli, Enterobacter species which are isolated from the specimens in large medical centers are greatly resistant to the commonly used antibiotics. Gram-negative bacilli, which had been isolated in Yeungnam University Hospital during the period from December 1992 to April 1993 and turned out to be resistant to the primary antibiotics susceptibility test for chloramphenicol, ampicillin, cephalothin, gentamicin, tetracyclin, amikin and tobramycin, were subjected to the secondary antibiotics susceptibility test for aztreonam, ceftazidime, ciprofioxacine, cefotaxime, cefamandole, piperacillin, ticarcillin and sulfamethoxazole trimethopime. Out of 315 tested organisms, 167 organisms(53%) were resistant to all secondary antibiotics in vitro. Antimicrobial activity of ceftazidime(37.1%), aztreonam(11.%), ciprofioxacine(7.9%) against Gram negative bacilli were slightly more active than other antibiotics tested, while cefamandole was not active to all the Gram-negative bacilli tested. According to the specimens, E. coli was the most frequently resistant organisms to the primary antibiotics from urine, A. baumanii, from respiratory system and wounds, and P. aeruginosa from various specimens. In summary, Gram negative bacilli resistant to the primarily applied antibiotics also were resistant to the secondary antibiotics. Rearrangement of the antibiotics disks for the antibiotic susceptibility test should be considered.

• Journal of Veterinary Clinics
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• v.27 no.1
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• pp.6-10
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• 2010

Bacterial pathogens were isolated from dogs with urinary tract infection (UTI) in local animal hospitals between August 2003 and December 2009. Bacteria were isolated from urine of 47 dogs. The isolated pathogens were Escherichia coli (n = 27), Streptococcus spp. (n = 7), Staphylococcus spp. (n = 5), Enterobacter spp. (n = 3), Proteus spp. (n = 2), other species were 3 strains, respectively. E. coli were susceptible to imimpenem, polymyxin B, amikacin, cephalosporins, aztreonam, amoxicillin clavulate, cephalosporins, tricarcillin, and amoxicillin clavulate, while were resistant bacitracin, erythromycin, lincomycin, oxacillin, penicillin, and novobiocin. Streptococcus spp. were susceptible to bacitracin, imimpenem, and trimethoprime-sulfa, while were highly resistant amikacin, cefotaxim, cefoxitin, cloxacillin, gentamicin, lincomycin, oxacillin, penicillin, streptomycin, and tobramycin. Staphylococcus spp. were susceptible to cefoxitin, doxycycline, enrofloxacin, imimpenem, and tobramycin, but were resistant aztreonam and tetracycline.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.15 no.4
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• pp.2295-2302
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• 2014

The study aims primarily to evaluate the resistance of antibiotics and the prevalence of these enzymes among Escherichia coli the most frequent isolate of Enterobacteriaceae producing Extended-Spectrum ${\beta}$-Lactamase(ESBLs), to differentiate the types of enzymes in these isolates. Total 74(26.2%) Strains of producing ESBLs among the 282 E. coli isolates were isolated from hospitals of Chungcheong area (Daejeon, Chungnam, and Chungbuk) during a 6 month-period from February to July, 2013. 282 E. coli isolates including ESBL shown resistance rates of aztreonam 30.8%, Cefotaxim 30.9%, and Ceftazidime 32.2%, 74 isolates producing ESBLs in E. coli were resistant rates to Aztreonam 58.1%, Cefotaxim 100%, and Ceftazidime 63.5% of ${\beta}$-lactam antibiotics. CTX-M-2 (48 isolates) was the most prevalent type of ESBLs identified. Followed the order of frequency by PER-1 (28 isolates), VEB-1 (26 isolates) and CTX-M-8 (20 isolates), of the 74 isolates, 2 isolates only showed GES-1 in Chungnam province. Accurate identification type of ESBLs would aid in hospital infection control. This would give aid to the physician to prescribe more appropriate antibiotics.

• Korean Journal of Microbiology
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• v.44 no.4
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• pp.339-345
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• 2008

This study was to detect MBL (metallo-${\beta}$-lactamase) among glucose non-fermenting Gram-negative bacilli isolated from clinical specimen and to search antimicrobial combination therapy against MBL producing Pseudomonas aeruginosa. Among fifty one isolates of Gram-negative bacilli with reduced imipenem susceptibility ($MIC{\ge}8{\mu}g/ml$), nine isolates have shown positive results in MBL detection test. They were seven Achromobacter xylosoxidans subsp. xylosoxidans and two P. aeruginosa. The results from EDTA-DDST coin-cided with those of PCR and nucleotide sequence analysis which showed the presence of $bla_{VIM-2}$. The combination of aztreonam (AZT) and piperacillin-tazobactarn (TZP) or AZT and amikacin (AN) screened by one disk synergy test showed no synergistic effect. Triple antibiotic combination therapy with AZT, TZP and AN, however, was shown to be effective and the most synergistic after 8 hrs of exposure. This result strongly suggest that the triple combination therapy of AZT, TZP, and AN could be useful for the treatment of infection caused by MBL producing Gram-negative bacilli.

• Korean Journal of Veterinary Service
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• v.27 no.2
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• pp.153-157
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• 2004

Bacteria isolated from nasal cavity of 50 Thoroughbred horses with respiratory tract infection were examined. There were isolated Pseudomonas aeruginosa(33.5%), Escherichia coli(10.2%), Pseudomonas spp(7.6%), Klebsiella oxytoca(5.9%), Streptococcus equi subsp zooepidemious(6.2%), Klebsiella pneumoniae(3.4%), Acinetobacter spp(5.5%) and coagulase negative staphylococcus(2.1%). The majority of isolates were highly susceptible to amikacin, amoxicillin, aztreonam, cefotaxime, cefepime, cefotetan, ceftazidime, cefuroxime, chloramphenicol, ciprofloxacin, clindamycin, erythromycin, gentamicin, imipenem, tetracyclin and vancomycin. These results can provide basic information for the treatments of respiratory tract infections in Thoroughbred horses.

• Journal of Life Science
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• v.20 no.8
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• pp.1214-1220
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• 2010

Imipenem-resistant bacteria were isolated from clinical specimens taken from hospitalized patients in Suncheon, Korea. Fifty-four isolates were phylogenetically analyzed based on 16S rRNA gene and gyrB gene sequence comparisons. Isolates were affiliated with Pseudomonas aeruginosa (30 strains; 55.6%), Acinetobacter baumannii (21; 38.9%), Enterobacter hormaechei (2) and Pseudomonas putida (2). Twenty-two isolates produced metallo-$\beta$-lactamase (MBL); 12 Acinetobacter baumannii strains, 7 Pseudomonas aeruginosa strains, 2 P. putida strains and 1 Enterobacter hormaechei strain. Antibiotic susceptibility of the isolates was determined using the disc diffusion method and Vitek system. Strains producing metallo-$\beta$-lactamase (type IMP & VIM) were more resistant to antibiotics ceftazidime, aztreonam, amikacin and gentamicin than to strains producing OXA and SHV type of $\beta$-lactamase.

• Korean Journal of Clinical Laboratory Science
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• v.48 no.2
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• pp.94-101
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• 2016

Acinetobacter species isolates are important opportunistic pathogens and commonly implicated in nosocomial infections. The therapeutic options for treatment of the bacterial infections are limited because the bacteria isolates are usually multidrug resistant (MDR). In the current study, we investigated various carbapenemase genes in 68 Acinetobacter species isolates. Antimicrobial susceptibilities were tested using the disk diffusion method. Screening of carbapenemase genes was performed via multiplex PCR. In addition, PCR and DNA sequencing were used to identify the carbapenemase genes. Repetitive extragenic palindromic-PCR (REP-PCR) was also performed to assess the clonality of isolates. In our study, A. baumannii isolates were highly resistant to all agents tested while all non-A. baumannii isolates were susceptible to all agents tested, with the exception of aztreonam and cefotaxime. All 51 A. baumannii isolates contained the $bla_{OXA-51}$ gene and 37 (72.5%) isolates also harbored the $bla_{OXA-23}$ gene. In addition, 39 MDR A. baumannii isolates were identified in our study and 37 isolates contained the $bla_{OXA-23}$ gene. The 37 MDR strains harboring $bla_{OXA-23}$ showed type I (n=22) or type II (n=15) banding patterns on their REP-PCR profiles. Our results suggest clonal relation and horizontal spreading of MDR A. baumannii isolates containing the $bla_{OXA-23}$ gene at the hospital located in Daejeon. Continuous investigation of antimicrobial resistant determinants and monitoring emergence and dissemination of MDR isolates is required to prevent and control infection and colonization of MDR A. baumannii isolates.

• Korean Journal of Clinical Laboratory Science
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• v.38 no.1
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• pp.26-33
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• 2006

Recently, the rapid increase in extended-spectrum ${\beta}$-lactamase (ESBL) producing clinical isolates has become a serious problem. In this study, the epidemiologic features and molecular characteristics of ESBL among clinical isolates of Escherichia coli and Klebsiella pneumoniae, antibiotic susceptibility testing, genotype of the ESBL and patterns of chromosomal DNA from PFGE (pulsed field gel electrophoresis) were observed. A total of 53 ESBL-producing clinical isolates (30 of E. coli and 23 of Klebsiella pneumoniae) were collected from two university hospitals in the period of June to July in 2002 and 2003 respectively. The antibiotic resistance frequency of those 53 strains was tested by the disk agar diffusion method with the result that all the strains were resistant to cephalothin. To other antibiotics, the resistance rates of E. coli (30 isolates) were in order of ceftazidime (90.0%), cefotaxime and aztreonam (respectively 83.3%). Also, the resistance rates of K. pneumoniae (23 isolates) were in order of aztreonam (78.3%), ceftazidime (73.9%) and cefotaxime (65.3%). Also the sensitivity of ceftazidime-clavulanic acid were 100% in E. coli and 95.7% in K. pneumoniae. And the sensitivity of cefotaxime-clavulanic acid was 96.7% in E. coli and 91.3% in K. pneumoniae. The types of the ESBL genes were determined by using polymerase chain reaction (PCR). Among the 30 isolates of ESBL-producing E. coli, 6 (20.0%) have SHV only, 5 (16.7%) have TEM only and, 18 (60.0%) have both of TEM and SHV. Among the 23 isolates of ESBL-producing K. pneumoniae, 7 (30.4%) have SHV only, 2 (8.7%) have TEM only, and 14 (60.9%) have both of TEM and SHV. These results show that 52 strains, with only one exception, were confirmed as either TEM or SHV. The patterns of Xba I-digested chromosomal DNA of ESBL-producing E. coli and K. pneumoniae isolates were analyzed by PFGE. PFGE patterns of E. coli and K. pneumoniae were multiclonal, but many strains were grouped into a few types. Therefore, it seems that there were clonal outbreaks or possible horizontal spread. In conclusion, the TEM and SHV ${\beta}$-lactamase are most widely spread in E. coli and K. pneumoniae in Korea. As these types are usually carried by plasmids, the spread of these ${\beta}$-lactamase genes could compromise the future usefulness of third generation cephalosporins for the treatment of infections caused by E. coli and K. pneumoniae.

• Korean Journal of Microbiology
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• v.46 no.3
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• pp.303-307
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• 2010

Acinetobacter baumannii 1625, a clinical isolate identified by Vitek and 16S rDNA sequence, showed an extended resistance to most ${\beta}$-lactams including imipenem, kanamycin, gentamicin, tobramycin, and cephalosporins of the third and fourth generations, and produced metallo-${\beta}$-lactamase (MBL) of IMP-1 type which is rare in Korea. The isolate contained a class 1 integron of about 2.5 kb in size and the integron included accA4 (aminoglycoside resistance gene), $bla_{IMP-1}$ (carbapenem resistance gene), and $bla_{OXA-2}$ (extended-spectrum ${\beta}$-lactam resistance gene) gene cassettes in order. The coexistence of IMP-1 type and OXA-2 type ${\beta}$-lactamase gene cassettes in an integron has not been reported in Korea. The transformed integron rendered the E. coli transformant resistant more than eight folds against imipenem, ampicilin, piperacillin, cefazolin, cefoperazone, and aztreonam comparing to the reference strain. This study clearly showed that the extended multi-drug resistance of A. baumannii 1625 was mainly due to the integron.