• 한국임상약학회지
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• 제30권2호
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• pp.120-126
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• 2020

Objective: The rising number of carbapenemase-resistant Enterobacteriaceae (CRE) cases has become a concern worldwidely. This study investigated patient characteristics with CRE and analyzed the risk factors associated with its acquisition. Methods: A retrospective review of the electronic medical records of the Kangbuk Samsung Medical Center from May 2016 to April 2019 was performed. The inclusion criterion was hospitalized patients aged ≥18 years with confirmed CRE acquisition. Patients were divided by CRE acquired and non-required patients. CRE acquired patients were those with CRE confirmed by their active surveillance cultures, while non-acquired patients were those with carbapenemase-sensitive Enterobacteriaceae (CSE). If CRE was isolated more than once during hospitalization, only the first isolation was used for data analysis. Patient characteristics, antibiotic used, and the duration of use were compared between two groups using univariate analysis, and the risk factors associated with CRE were analyzed using multiple logistic regression analysis. Results: Among the 73 CRE acquired patients, 44 (60.3%) were positive for carbapenemase-producing Enterobacteriaceae (CPE). Infection from Klebsiella pneumonia (42 cases, 57.5%), Escherichia coli (17 cases, 23.3%), and Enterobacter cloacae (5 cases, 6.8%). The risk of CRE acquisition was significantly increased by 4.99 times [confidence interval (CI), 1.40-17.78; p=0.013] with mechanical ventilation, 3.86 times (CI, 1.59-9.36; p=0.003) with penicillin administration, and 21.19 times (CI, 6.53-68.70; p<0.001) with carbapenem administration. Conclusions: Proper antibiotic use including the selection, frequency, and duration, and patients on mechanical ventilators need close monitoring.

• 약학회지
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• 제41권2호
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• pp.233-240
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• 1997

The in vitro antibacterial activity of DWP20418 (1R, 5S, 6S)-6-[1-(R)-Hydroxyethyl)-l-methyl-2-[(2S,4S)-2-(piperazinylcarbonyl)-1-(R)-hydroxyethyl)pyrrolidine-4-thio]carb apen-2-em-3-carboxylic acid), a new carbapenem antibiotic, was compared with those of imipenem (IPM) and meropenem (MEPM). DWP20418 was comparable or slightly more superior to MEPM against gram-positive bacteria, and it showed more potent activity to IPM against gram-negative bacteria. DWP20418 was particularly active against MRSA, and its $MIC_{90}$ of methicillin-susceptible S. aureus, low methicillin-resistant S. aureus and high methicillin-resistant S. aureus were 0.391, 25 and 50 ${\mu}g/ml$, respectively. With a view of $MIC_{90}$, DWP20418 was comparable than the other carbapenems against P. aeruginosa and E. coli isolates. The activity of DWP20418 was not affected in the presence of $Mg^{2+},\;Ca^{2+}$ or horse serum. But inoculum size and alterations in pH of medium affected its antibacterial activity. DWP20418 showed rapidly bactericidal activity within 1h, and regrowth was not observed even incubation of 24hrs at the concentrations near the MIC.

• 한국미생물·생명공학회지
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• 제49권2호
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• pp.239-248
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• 2021

The emergence of multidrug-resistant Acinetobacter baumannii has partly increased treatment failure and patient mortality. Class D β-lactamases is an important mechanism of resistance to beta-lactam antibiotics in this species. This study aimed to investigate the relationship between the presence oxacillinase gene and genetic fingerprints of A. baumannii isolates from the intensive care unit of an Egyptian tertiary care hospital. One hundred and twenty A. baumannii clinical isolates were collected. Multiplex PCR was performed to detect genes encoding oxacillinases (OXA-23, OXA-24, OXA-51, OXA-58 and OXA-143). Molecular typing of all collected isolates was performed using random amplified polymorphic DNA (RAPD)-PCR assay. Out of 120 examined isolates, 92, 88 and 84% were resistant to ertapenem, imipenem and meropenem, respectively. The species-specific, commonly present OXA-51 gene was found in all isolates while OXA-23 showed a high prevalence of 88% of isolates. OXA-24 and OXA-143 genes were detected in 3% and 1% of isolates, respectively. No OXA-58 gene was detected. Five clusters consisting of 19 genotypes were detected using RAPD-PCR. Genotype A was the most prevalent, it was observed in 62% of the isolates followed by genotype B (12%). These results revealed that genotypes A and B are common in the hospital. Results also demonstrate that RAPD-PCR is a rapid and reliable method for studying the clonal similarity among A. baumannii isolated from different clinical specimens.

• Annals of Clinical Microbiology
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• 제22권1호
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• pp.9-13
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• 2019

배경: 다양한 임상검체에서 카바페넴분해효소 생성 장내세균(carbapenemase-producing Enterobacteriace, CPE)의 분리가 증가하고 있다. CPE 감염증은 치사율이 높고, 집단 발병의 가능성이 높아 지속적인 감시가 필수적이다. 저자들은 CPE 주요 유전자들을 한 번에 검출하기 위한 multiplex PCR을 개발하고 이를 평가하고자 하였다. 방법: 총 7종의 내성 유전자를 동시에 검출하기 위한 시발체를 새롭게 디자인하고 PCR 조건을 설정하였다. 주요 카바페넴분해효소인 KPC, IMP, VIM, NDM-1, GES, OXA-23 및 OXA-48 유전자를 대상으로 하였다. 각 유전자의 증폭 산물은 100 bp 이상의 차이가 나도록 고안하였다. 개발된 multiplex PCR은 총 69주의 CPE 양성 임상분리균주를 이용하여 평가하고, 비특이적 증폭에 의한 위양성 가능성의 배제를 위해 71주의 카바페넴 감수성 균주로 확인하였다. 결과: 본 연구에서 개발한 시발체 및 PCR 조건을 이용하여 실험한 결과 CPE 내성 유전자인 KPC 양성 14주, IMP 양성 13주, OXA-23 양성 12주, OXA-48 양성 11주, VIM 양성 9주, GES 및 NDM 양성 각 5주 등 총 69주 모두에서 CPE 유전자의 검출이 가능함을 확인하였다. 카바페넴 감수성 균주를 이용한 특이성 확인 시험에서 Enterococcus faecalis, Escherichia coli, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa 등을 포함한 총 71주의 다양한 그람양성 및 음성균주 모두에서 음성임을 확인하였다. 결론: 본 연구에서 개발된 multiplex PCR은 총 7종의 CPE 유전형을 한 번에 검출할 수 있어 CPE 확인 시험에 유용할 것으로 생각한다.

• Bulletin of the Korean Chemical Society
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• 제27권5호
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• pp.705-712
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• 2006

The synthesis of a new series of 1 $\beta$-methylcarbapenems having 5-(1,2-disubstituted ethyl)pyrrolidine moiety are described. Their in vitro antibacterial activities against both Gram-positive and Gram-negative bacteria were tested and the effect of substituents on the pyrrolidine ring was investigated. Among them, compound (IIIc) having 1-methoxyimino-2-hydroxyethyl moiety showed the most potent antibacterial activity.

• 한국응용약물학회:학술대회논문집
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• 한국응용약물학회 1996년도 춘계학술대회
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• pp.233-233
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• 1996

배지의 영향에 대하여 검토하기 위하여 SDA, MHA, NA 및 BHIA를 사용하였으며, 시험균주 중 Pseudomonas aeruginosa에 대하여만 NA에서의 MIC 값이 낮게 나타났을 뿐 나머지 균주에 대하여는 배지에 따른 항균력 변화가 관찰되지 않았으며, 배지의 pH를 5.4-8.4까지 변화시켰을 때 pH 변화에 따른 DA-1131의 유의적인 항균력 변화와 접종균량에 따른 항균력 변화가 관찰되지 않았다. Methicillin-resistant Staphylococcus aureus(MRSA)에 대하여는 DA-1131과 vancomycin 간의 상승 및 상가작용이 관찰되었고, P. aeruginosa, Klebsiella pneumoniae, Enterobacter cloacae 및 Serratia marcescens 등의 균종에 대하여는 ciprofloxacin의 상가작용이 확인되었다. Sisomicin은 P. aeruginosa에 대한 상승 및 상가작용이 인정되었으나 ceftazidime은 DA-1131에 의한 길항작용이 관찰되었다.

• 한국응용약물학회:학술대회논문집
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• 한국응용약물학회 1996년도 춘계학술대회
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• pp.236-236
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• 1996

DA-1131은 IPM이 D2 channel 특이적인 세포외막투과성을 나타내는 것과는 달리 D2 channel 이외에 azthreonam 투과경로도 이용하는 것으로 확인되었다. IPM 감수성 및 내성인 P aeruginosa 균주들에 대하여 $\beta$-lactamase의 inducible activity, hydrolytic susceptibility, affinity를 측정한 결과, Inducible activity는 DA-1131, PPM 및 MEPM이 거의 동일하였으며, 3가지 약물 모두 가수분해에 대한 안정성을 나타내었다. 그러나 $\beta$-lactamase에 대한 affinity는 IPM이 가장 컸고, MEPM, DA-1131의 순으로 감소하였다. DA-1131은 P8P2와 PBP3를 동시에 저해하며, IPM은 PBP2의 저해 후 순차적으로 PBP3를 저해하였고 이러한 시험결과는 PBPs blinding pattern과 밀접한 관계가 있는 것으로 알려진 균형태변화로도 확인되었다.

• Bulletin of the Korean Chemical Society
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• 제27권8호
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• pp.1164-1170
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• 2006

The synthesis of a new series of 1$\beta$-methylcarbapenems having 5-($\alpha,\beta$-disubstituted ethyl)pyrrolidine moiety is described. Their in vitro antibacterial activities against both Gram-positive and Gram-negative bacteria were tested and the effect of substituents on the pyrrolidine ring was investigated. A particular compound (VIh) having $\alpha$-hydroxy-$\beta$-piperazinylethyl substituted moiety showed the most potent activity.

• 보건의료산업학회지
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• 제8권4호
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• pp.163-173
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• 2014

This study was performed to investigate the current status of isolation precautions of multidrug resistant organisms(MDROs) in general hospitals with more than 200bed. The questionnaires were mailed from 3rd, April 2013 to 30th, April 2013. Methicillin resistant Staphylococcus aureus:(MRSA), vancomycin resistant Staphylococcus aureus:(VRSA), vancomycin resistant Enterococcus(VRE), multidrug-resistant Acinetobacter baumannii, carbapenem-resistant Enterobacteriaceae multidrug-resistant Pseudomonas aeruginosa were enrolled. MRSA(100.0%) and VRE(98.7%) were isolated respectively. VRE(97.3%) and MRSA(64.0%) were regulated strictly respectively. VRE(91.5%) and VRSA(50.7%) were isolated in a single room respectively. Hospital being located in Seoul(p<0.001), and beds(${\geq}600$)(p=0.008) were different significantly. The isolation space limitation(71.1%) was the highest difficulty. The development of refunding the costs of the extra supplies and other hygienic materials for infection control was discovered as the most urgent strategy.

• Natural Product Sciences
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• 제23권4호
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• pp.286-290
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• 2017

Multidrug-resistant Acinetobacter baumannii and Pseudomonas aeruginosa are highly dangerous nosocomial pathogens, cause the symptoms of skin infections, pressure sores, sepsis, blood stream and wound infections. Unfortunately, these pathogens are immune to the most common antibiotics, such as, carbapenem, aminoglycoside and fluoroquinolone. Therefore, it is imperative that new and effective antibiotics be developed. In the present study, the antimicrobial effects of Aloe vera MAP (modified Aloe polysaccharide) on Staphylococcus aureus and Bacillus subtilis, Escherichia coli and Enterobacter aerogenes, and clinical Pseudomonas aeruginosa and clinical Acinetobacter baumannii were comprehensibly investigated. Prior to the growth inhibition effect measurement and antibiotic disc diffusion assay on gram-positive and gram-negative bacteria and selected multidrug-resistant Pseudomonas aeruginosa and Acinetobacter baumannii, antimicrobial resistance screening was performed for the multidrug-resistant bacteria obtained from clinical isolates. The results for showed the Aloe vera MAP had a concentration-dependent effect on all of examined bacteria, particularly on Pseudomonas aeruginosa. Anti-inflammatory and anti-oxidant experiments were also performed dose dependently effects to confirm the beneficial physiological effects of Aloe vera MAP.