• 대한임상검사과학회지
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• 제49권3호
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• pp.279-284
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• 2017

본 연구에서는 혈액배양에서 신속한 세균 동정과 항생제 감수성 시험(antibiotic susceptibility test, AST) 결과를 얻기 위해 혈액배양 양성배지에서 계대배양 없이 세균을 VITEK MS와 VITEK 2 시스템에 직접 접종하였으며, 도출된 결과를 표준방법과 비교하여, 그 신뢰도와 정확도를 평가하였다. 혈액배양 양성시료에서 직접 결과는 표준방법 AST 결과와 비교하였을 때, 97.9% (1,936/1,978)의 전체적인 일치율을 보였다. 그람양성 세균은 97.2% (1,051/1,081)의 일치율을 나타냈으며, 매우 중대한 오차율은 0.5% (5/1081), 중대한 오차율은 0.1% (1/1,081), 사소한 오차율은 2.2% (24/1,081)의 결과를 나타냈다. 두 방법 간 불일치의 주요 원인균은 Staphylococcus epidermidis이었고, 그 중 gentamicin (N=9)과 fusidic acid (N=8)에서 높은 오류를 나타냈다. 그람음성 세균 중 전체적인 일치율은 98.6%(885/897)였고, 사소한 오류는 1.4% (12/897)였다. 그람음성세균의 불일치 주요 원인균은 Escherichia coli와 Pseudomonas aeruginosa였으며, 그 중 amoxicillin/clavulanic acid(N=3)에서 높은 오류를 나타냈다. 직접법에 의한 AST 방법은 CLSI 기준을 충족하였고, 결과 보고 시간을 24시간 단축할 수 있었지만, 매우 큰 오류가 있는 항생제에 대해서는 디스크확산법으로 추가적인 검사를 시행한 후 보고해야 한다는 것을 알 수 있었다. 이러한 연구 결과들을 토대로 혈액배양 시료에서 직접 AST를 실시하는 방법은 정확하고 결과를 보고하는데 까지 소요되는 시간을 크게 감소시킬 수 있기 때문에 환자의 정확하고 효율적인 치료에 유용하게 활용될 수 있을 것으로 사료된다.

• 한국임상약학회지
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• 제22권1호
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• pp.47-54
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• 2012

목적: 급성 상기도 감염에 사용되는 항생제 처방유형을 조사하여 항생제 사용을 개선하는데 있다. 방법: 2011년 1월부터 6월까지 경상대학교 병원을 포함한 10개 국립대학병원을 대상으로 급성 상기도 감염에 사용한 항생제 처방율을 조사하고, 경상대학교병원에서 급성 상기도 감염에 사용한 2011년 1월부터 6월까지의 외래환자를 대상으로 항생제 처방 내역을 전자의무기록을 통하여 후향적으로 분석한 후 처방의를 대상으로 항생제 사용 적정성 검토를 위한 그룹미팅 및 교육, 급성 상기도 감염에 항생제 처방 시 경고 안내문을 보여주는 등 중재활동 후 2011년 12월에 처방유형을 조사 하였다. 결과: 경상대학교병원에서 2011년 1월부터 6월까지 급성 상기도 감염에 항생제 사용은 1739명의 상기도 감염 외래환자 중에서 874명 (42.3%)으로 나타났다. 진료과별 급성 상기도 감염에 대한 항생제 처방은 소아과, 이비인후과, 내과, 응급의학과, 호흡기내과, 흉부외과 등에서 처방하였으며 소아과에서 1044명의 상기도 감염환자 중 556건(53.3%)로 가장 빈번하게 사용하였으며 처방율은 이비인후과에서 58.9% (225/382)로 가장 높았다. 사용한 항생제로는 amoxicillin-clavulanic acid가 371례 (36.3%)로 가장 빈번하게 처방된 약제이며, azithromycin이 85례 (9.7%) 처방되었다. 급성 상기도 감염 중 급성 편도염에 항생제 처방율이 가장 높았으며 (70.8%, 80/113), 급성 인두염에 가장 빈번하게 사용되었다 (61.1%, 319/522). 균동정을 위한 혈액배양 의뢰 건수는 1739 상기도 감염 환자 중 15명 (항생제 미사용 4명, 사용 11명)이 의뢰되었으며 모두 음성이었다. 중재활동 후 2011년 12월 상기도 감염에 항생제 처방건수는 소아과에서 1건, 이비인후과에서 2건으로 나타났다. 결론: 처방의를 대상으로 적절한 항생제를 사용을 권장하는 지속적인 교육 및 항생제 처방시 경고 안내문을 띄우는 등의 중재활동과 지속적인 모니터링 및 피드백은 급성 상기도 감염에 있어서 항생제 처방유형에 변화를 보였다.

• 한국축산식품학회지
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• 제40권4호
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• pp.578-587
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• 2020

Clostridioides (Clostridium) difficile is a Gram (+), anaerobic, spore forming, rod shaped bacterium that can produce toxin. The objective of this study is to reveal the presence of C. difficile in meat products, to analyze the ribotype diversity by PCR and to evaluate the antibiotic susceptibility of isolated strains. The organism was isolated in 22 out of 319 (6.9%) examined meat product samples and 9 out of 22 (40.9%) isolates were identified as RT027 and all isolates had the ability of toxin production. In terms of antibiotic susceptibility, all isolates were susceptive to amoxicillin-clavulanic acid, tetracycline and vancomycin and 21 (95.4%) isolates to metronidazole. On the other hand, imipenem and cefotaxim resistance was observed in all. In conclusion, the results of this comprehensive study conducted in Turkey deduced the presence of C. difficile in different meat products. Therefore, these products can be evaluated as a potential contamination source of C. difficile from animals to humans especially for elders, youngsters, long terms wide spectrum antibiotic used and immuno-suppressed individuals.

• 한국임상수의학회지
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• 제21권2호
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• pp.133-139
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• 2004

Bacterial pathogens were isolated from 36 dogs with respiratory signs, that were submitted to Veterinary Clinics in Jeju, including Veterinary Medical Teaching Hospital in Cheju National University. Of 36 isolates, 16 (44.4%) bacterial pathogens were Gram-positive and 20 (55.6%) were Gram-negative. Gram-positive bacteria identified with API Staph were 12 S. intermedius (33.3%), 2 S. aureus (5.6%), 1 S. haemolyticum (2.8%), and 1 S. xylosus (2.8%). Gram-negative organisms identified with API 20E or API NE included 8 Bordetella bronchiseptica (22.2%), 6 Escherichia coli (16.7%), 4 Pasteurella spp. (11.1%), 1 Enterobacter intermedius (2.8%), and 1 Oligella ureolytica (2.8%). Both Staphylococcus spp. isolates and Gram-negative pathogens were resistant to one or more antibiotics, including ampicillin (AM), amoxicillin/clavulanic acid (AMC), chloramphenicol (C), cefazolin (CZ), erythromycin (E), gentamicin (GM), kanamycin (K), lincomycin (L), oxacillin (OX), trimethoprim/sulfamethoxazole (SXT), and tetracycline (TE). All Staphylococcus spp. were susceptible to AMC, OX and VA, while many isolates were highly resistant to L (87.5%), E (68.8%), P (62.5%), and AM (56.3%). Antibiotic-resistant patterns of staphylococcal isolates were shown ranges from single to 9-resistant patterns. Resistant rates to antibiotics of Gram-negative bacteria were usually higher than those of Staphylococcus spp. in this study. Most Gram-negative bacteria were highly resistant to L (90.0%), AM (85.0%), E (85.0%), P (85.0%), OX (80.0%), and CZ (75.0%). B. bronchiseptica isolates showed 5 to 8 antibiotics-resistant patterns and Pasteurella spp., 2 to 8-resistant patterns. In particular, all 6 E. coli isolates were resistant to more than 9 different kinds of antibiotics, including one strain resistant to all antibiotics tested.

• 한국동물위생학회지
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• 제28권1호
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• pp.71-79
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• 2005

In this study, a total of 2,119 samples was taken from bovine feces and carcass from March 2002 to December 2003. And those were examined for the presence of enterohemorrhagic E coli O157:H7. The properties of the isolates were characterized for biochemical features, serotypes, virulence genes and antimicrobial susceptibility. Forty five strains($3.7\%$) of E coli O157:H7 were isolated from 1,208 fecal samples and were not detected in carcass using immunomagnetic separation technique and selective media. In multiplex PCR using stx1, stx2, eaeA and hlyA primers, the amplified bands at 180 bp, 255bp, 384bp and 534bp were observed, respectively. In antimicrobial susceptibility test, all isolates were susceptible to amoxicillin/clavulanic acid and cefazolin. The isolates were most resistant to sulfisoxazole($24.4\%$), followed by streptomycin($22.2\%$), tetracycline($20.0\%$). Eight strains($17.8\%$) of 45 isolates showed the multi-resistant patterns with over 3 drugs.

• 한국동물위생학회지
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• 제32권3호
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• pp.241-249
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• 2009

Shiga toxin (Stx)-producing Escherichia coli (STEC) strains can cause broad spectrum of human disease, including diarrhea, hemorrhagic colitis, and the life-threatening hemolytic uremic colitis (HUS). We examined 868 samples was taken from bovine feces and carcass from January to December 2008 in Seoul. Twenty two (9.5%) shiga toxin -producing Escherichia coli were isolated from the 230 of bovine feces, and two (0.31%) were isolated from the 638 of carcasses. Serotype of E. coli isolates were O157 (10, 41.6%), O26 (10, 41.6%), O111 (1, 4.2%) and UT (3, 12.6%). In PCR, the isolates displayed three different stx gene combination (stx1 [2, 8.4%]), stx2 [3, 12.6%] and stx1 and stx2 [19,87.5%]). The eaeA and hlyA gene were found in 11 (45.8%) of the 24 strains. Saa gene was present only one strains (4.2%). Toxin typing using reverse passive latex agglutination test showed the same result in VT 1. But it showed different result in VT 2. In antimicrobial susceptibility test, all isolates were sensitive to amikacin, amoxicillin/clavulanic acid, ciprofloxacin and colistin. Eighteen strains (75.0%) of 24 isolates showed the multi-resistant patterns with over 3 drugs. PFGE was performed after the genomic DNA of twenty four isolates was digested with Xba I. the 24 isolates showed 7 (A~G) PFGE type.

• 대한수의학회지
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• 제51권1호
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• pp.29-35
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• 2011

Lack of hygiene and puerperal mastitis are common causes of bacterial diseases in nursing neonates. The aim of this study was to isolate microorganisms from milk samples of healthy female Jindo dogs with suckling puppies and to investigate antimicrobial susceptibility against the isolated bacteria. Milk samples were collected from 120 udders of 12 lactating Jindo dogs that were 2~4 years old without any clinical diseases including mastitis. Bacteria were isolated from 64 milk samples (53.3%), either singly (76.6%) or in combination (23.4%). Staphylococcus (S.) spp. was the most common microorganisms (74.7%) isolated from canine milk, followed by Haemophillus spp. (10.9%), Streptococcus spp. (9.6%), Gardnerella spp. (2.4%) and Moraxella spp. (2.4%). The most frequently isolated organism was S. warneri (31.3%). Antimicrobial susceptibility of these bacteria was tested with 17 antimicrobial agents by Kirbyand Bauer standardized disc diffusion method. Results indicated that bacteria isolated from healthy canine milk were mostly susceptible to amoxicillin-clavulanic acid, cephalothin and ceftiofur, but were resistant to erythromycin, neomycin and tetracycline.

• 한국임상수의학회지
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• 제23권2호
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• pp.169-174
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• 2006

This work described 3 infection cases caused by Rhodococcus equi in foals between 3 and 5 months of age. The disease histories were not fully taken from local veterinarians. At least 1 sick foal has been treated with cephalothins followed by penicillins during approximately 1 week, but died without effectiveness and other foals rearing with the animal have been suffering from severe pneumonia which show high fever, laboring respiration, cough and/or nasal discharge. There were many abscessations into lungs of 2 foals in postmortem examination and another 1 sample was pus collected from abscess around the shoulder, indicating the osteomyelitis. Those bacteria were grampositive coryneform and were identified as a R. equi by a polymerase chain reaction (PCR) using primers for R. equi-specific vapA gene. The pathogens were usually resistant to penicillin, ampicillin, amoxycillin/clavulanic acid, cefazolin, clindamycin, sulfamethoxazol/trimethoprim, kanamycin, and tetracycline, while were sensitive to ciprofloxacin, norfloxacin, orfloxacin, gentamicin, erythromycin, neomycin, and vancomycin. Some more foals with respiratory symptoms in 1 horse farm were treated by orally administration with erythromycin during 2 weeks. Because the combination of erythromycin and rifampin has recommended as the treatment for R. equi infections in foals, the local equine veterinarian can choose those antibiotics for the treatment of this disease in future. However, another antimicrobial agent may be necessary if R. equi resistant to both agents is isolated.

• 한국임상수의학회지
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• 제33권6호
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• pp.392-394
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• 2016

A 2-year-old spayed female Persian cat presented to Kangwon National University Veterinary Medical Teaching Hospital with pruritus and erythema on the tips of both ears, around the eyes, and in the caudal abdomen. This patient had previously been prescribed prednisolone, but did not respond positively to the treatment. A skin screening test revealed that there were no fleas or fungi, and that only cocci were present. Blood testing revealed no remarkable findings. The patient was prescribed antibiotics (amoxicillin-clavulanic acid 25 mg/kg for 2 weeks) with no prednisolone. After 2 weeks, clinical signs were alleviated and the skin screening test showed no signs of cocci. However, clinical signs recurred even with the prescription of antibiotics. Four weeks after the steroid-free interval, Malassezia spp. hypersensitivity was detected upon a serum allergy test, and pathological analysis confirmed eosinophilic and mastocytic superficial dermatitis in the caudal abdomen. Based on these results, we suspected allergic dermatitis and prescribed 7 mg/kg cyclosporine A once a day. After 3 weeks, clinical signs were resolved. Seven weeks after the first trial with cyclosporine A, we reduced the cyclosporine A dose to 7 mg/kg every other day. The patient's symptoms have since been well controlled for 6 months. This study suggests that cyclosporine A can be a good choice for treating cats with suspected allergic dermatitis that has not responded positively to steroid treatment.

• 대한수의학회지
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• 제52권2호
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• pp.133-139
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• 2012

Antimicrobial resistance is one of the most concerns in pig industry. Escherichia (E.) coli have been used for the indicator to monitor the antimicrobial resistance. In this study, 321 E. coli from diarrheic and non-diarrheic piglets were tested for antimicrobial resistance and frequency of $Bla_{TEM}$. In non-diarrheic piglets, they were resistant to oxytetracycline (93%), streptomycin (92%) and sulfadiazine (90%) but susceptible to ceftiofur (99%), colistin (97%), and enrofloxacin (82%). The isolates from diarrheic piglets were resistant to enrofloxacin (72.9%), ceftiofur (17.6%), and colistin (11.3%), whereas the resistance was 1%, 18% and 3% in case of non-diarrheic piglets, respectively. The resistance for amoxicillin/clavulanic acid (54.1%) and ceftiofur (22%) was high in isolates from post-weaning piglets. The resistance for colistin was 15.2% in nursery piglets. Seventy-three percent of isolates from diarrheic piglets showed high multidrug resistance profile (more than 13 antimicrobials) compared to those from non-diarrheic pigs in which 71% of isolates showed moderate multidrug resistance profile (7 to 12 antimicrobials). The frequency of $Bla_{TEM}$ in E. coli from non-diarrheic and diarrheic piglets was 57% and 69%, respectively. The results might provide the basic knowledge to establish the strategies for treatment and reduce antibiotic resistance of E. coli in piglets.