Ochrobactrum anthropi, previously known as Achromobacter species biotypes 1 and 2 (CDC groups Vd-1, Vd-2), belong to the groups of non-Enterobacteriaceae- nonfermentative Gram negative bacilli. Achromobacter is not presently a recognized genus. Achromobacter xylosoxidans has been transferred to genus Alcaligenes as A. xylosoxidans subsp. xylosoxidans, and "Achromobacter" sp. group Vd has been named Ochrobactrum anthropi. O. anthropi was isolated from a blood culture. Organisms were identified as O. anthropi by use of the biochemical test and the VITEK 2(bioMerieux, USA). The Organism was susceptible only to colistin, imipenem, meropenem, and tetracycline, but were resistant to amikacin, aztreonam, cefepime, ceftazidime, cefpirome, ciprofloxacin, gentamicin, isepamcin, netilmicin, pefloxacin, piperacillin, piperacillin/tazobactam, ticarcillin, ticarcillin/clavulanic acid, tobramycin, and trimethoprim/sulfamethoxazole. We report the clinical and microbiologic characteristics of O. anthropi infection in the patient. This is the first case of O. anthropi infection after using a plant as medicine at Chosun University Hospital.
To overcome the problems of the resistance to clavulanic acid, many researchers are developing novel inhibitors that are not sensitive to new mutant ${\beta}$-lactamases. In order to evaluate newly synthesized compound CH2150 (Sodium (3S.5R)-6(Z)-[1-{1-(2-{2-benzoxazoly}thioethyl)-l.2,3-txiazol-4-yl}methylene] penicillanate-1,1-dioxide) as a ${\beta}$-lactamase inhibitor, we examined inhibitory activity of CH2150 against ${\beta}$-lactamases of clinical isolates resistant to ampicillin/sulbactam(12 strains of Escherichia coli and 13 strains of Staphylococcus aureus), and compared with that of sulbactam. Nitrocefin was used as substrate for ${\beta}$-lactamases, and the increase of absorbance was measured spectrophotometerically at 482 nm. ${\beta}$-Lactarnase inhibition of CH2150 against ${\beta}$-lactamases was 73 ~ 96% in E. coli and 76 ~ 79% in S. aureus. Comparatively, that of sulbactam was 96 ~ 100% and 96 ~ 100%, respectively. The inhibitory activity of CH2150 was slightly lower than that of sulbactam. The MIC values of ampicillin combined with CH2150 (2:1) for the clinical isolates were 4~512 ${\mu}$g/ml for E. coli and 1.0 ~ 64 ${\mu}$g/ml for S. aureus, whereas 0.5~16 ${\mu}$g/ml for E. coli and 0.25~8 ${\mu}$g/ml for S. aureus when combined with sulbactam (2:1).
This study aimed to investigate the prescription of antibiotics in clinics, and evaluate their usage appropriateness after the 2000 Korean separation of dispensary from medical practice. A retrospective study was performed on the antibiotic use for 4 years from August 2000 to July 2004 in three clinics (general, internal medicine and ear-nose-and-throat (ENT) clinics). Moreover, prescription of antibiotics for acute upper respiratory infection (AURI), concomitant drugs, duplicate antibiotics and patient adherence were assessed for 260 patients experienced AURI in a pharmacy. The prescription rates of antibiotics amongst the whole prescription decreased annually during the study period, but those in ENT clinic still constituted more than 90%. The usage of penicillins declined, but that of broad spectrum antibiotics such as amoxicillin/clavulanic acid and 1st/2nd generation cephalosporins increased. Moreover, the categories of antibiotics for the same indication were different among the clinics. For patients with AURI, the more antibiotics were prescribed as its missing days and days under its therapeutic dose increased. The drug interactions with concomitant drugs decreased annually, but the use of duplicate antibiotics was similar across the period. Potential inappropriate antibiotic use was common after the Korean policy, so the observation of pharmacists needs in addition to the patients and practitioners' attention.
Kim, Yong Min;Kim, Jae-Jin;Kim, Mija;Park, Soon-Nang;Kim, Hwa-Sook;Kook, Joong-Ki;Kim, Hak Kyun
International Journal of Oral Biology
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제39권2호
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pp.87-95
/
2014
The purpose of this study was to isolate and identify bacteria from the 4 patients with non-odontogenic infectious lesions (mucormycosis, chronic inflammation from wound infection, and two actinomycosis) and determine their antimicrobial susceptibility against eight antibiotics. Bacterial culture was performed under three culture conditions (anaerobic, $CO_2$, and aerobic incubator). The bacterial strains were identified by 16S rRNA gene (16S rDNA) sequence comparison analysis method. For investigating the antimicrobial susceptibility of the bacteria against eight antibiotics, penicillin G, amoxicillin, tetracycline, cefuroxime, erythromycin, clindamycin, vancomycin, and Augmentin$^{(R)}$ (amoxicillin + clavulanic acid), minimum inhibitory concentration (MIC) measurement was performed using broth microdilution assay. Nosocomial pathogens such as Enterococcus faecalis, Klebsiella pneumoniae, Bacillus subtilis, and Neisseria flavescens were isolated from mucormycosis. Veillonella parvula, Enterobacter hormaechei, and Acinetobacter calcoaceticus were isolated from chronic inflammatory lesion. Actinomyces massiliensis was isolated from actinomycosis in parotid gland. Capnocytophaga ochracea was isolated from actinomycosis in buccal region in anaerobic condition. There was no susceptible antibiotic to all bacteria in mucormycosis. Tetracycline was susceptible to all bacteria in chronic inflammation. C. ochracea was resistant to vancomycin and penicillin G; and other antibiotics showed susceptibility to all bacteria in actinomycosis. The results indicated that the combined treatment of two or more antibiotics is better than single antibiotic treatment in mucormycosis, and penicillin is the first recommended antibiotic to treat actinomycosis.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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제41권4호
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pp.176-180
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2015
Objectives: The increased prevalence of antibiotic resistance is an outcome of evolution. Most patients presenting with odontogenic space infections also have associated systemic co-morbidities such as diabetes mellitus resulting in impaired host defense. The present study aims to compare the odontogenic spaces involved, antibiotic susceptibility of microorganisms, length of hospital stay, and the influence of systemic comorbidities on treatment outcome in diabetic patients. Materials and Methods: A 2-year prospective study from January 2012 to January 2014 was conducted on patients with odontogenic maxillofacial space infections. The patients were divided into two groups based on their glycemic levels. The data were compiled and statistically analyzed. Results: A total of 188 patients were included in the study that underwent surgical incision and drainage, removal of infection source, specimen collection for culture-sensitivity, and evaluation of diabetic status. Sixty-one out of 188 patients were found to be diabetic. The submandibular space was the most commonly involved space, and the most prevalent microorganism was Klebsiella pneumoniae in diabetics and group D Streptococcus in the nondiabetic group. Conclusion: The submandibular space was found to be the most commonly involved space, irrespective of glycemic control. Empiric antibiotic therapy with amoxicillin plus clavulanic acid combined with metronidazole with optimal glycemic control and surgical drainage of infection led to resolution of infection in diabetic as well as nondiabetic patients. The average length of hospital stay was found to be relatively longer in diabetic individuals.
This study focused on the involvement of the unusual nucleotide (p)ppGpp, a stringent factor, during the morphological and physiological differentiation of Streptomyces coelicolor. Two genes, relA and rshA, were disrupted to demonstrate the roles of the stringent factor in the differentiation. The intracellular concentration of (p)ppGpp in the wild-type (M600) and disrupted mutants was measured in relation to the intentional starvation of a specific nutrient, such as carbon, nitrogen, and phosphate or the in situ depletion of nutrients in a batch culture. As a result, it was found that the morphological characteristic of the ${\Delta}relA$ mutant was a bld phenotype forming condensed mycelia, whereas the ${\Delta}rshA$ mutant grew fast-forming spores and straightforward mycelia. In both mutants, the production of actinorhodin (Act) was completely abolished, yet the undecylprodigiosin (Red) production was increased. Intracellular (p)ppGpp was detected in the ${\Delta}relA$ mutant in the case of limited phosphate, yet not with limited carbon or nitrogen sources. In contrast, (p)ppGpp was produced in the ${\Delta}rshA$ mutant under limited carbon and nitrogen conditions. Therefore, (p)ppGpp in S. coelicolor was found to be selectively regulated by either the RelA or RshA protein, which was differentially expressed in response to the specific nutrient limitation. These results were also supported by the in situ ppGpp production during a batch culture. Furthermore, it is suggested that RelA and RshA are bifunctional proteins that possess the ability to both synthesize and hydrolyze (p)ppGpp.
Augmentin is a formulation of amoxycillin trihydrate and potassium clavulanate, a fused beta-lactam molecule produced by the fermentation of Streptomyces clavuligerus. Most clinically important resistance is due to the production by bacteria of antibiotic destroying enzymes. In the case of penicillins and cephalosporins these enzymes are termed beta-lactamase as they destroy the beta-lectern ring of these antibiotics, completely inactivating them. The presence of clavulanic acid extends the spectrum of amoxycillin to include bet On clinical study of the intravenous Augmentin in the field of thoracic and cardiovascular surgical cases, we selected randomly 30 patients, 21 male and 9 female, age from 13 to 72, in the period from April to December 1985. Among the total 30 patients, 22 were preoperatively infected [11 thoracic empyema, 5 lobar pneumonia, 2 lung abscess, 2 bronchiectasis, one acute pyelonephritis with ureter stone and one rheumatic carditis], and 8 were not infected preoperatively [Table 1, 2]. Of the preoperatively infected group, 11 cases [50%] were culture positive [4 staphylococcus, 3 pseudomonas, 2 Serratia group, and one E. coli], and preoperatively non-infected group [8 cases] revealed expectedly negative findings on bacterial culture. All of the culture positive bacteria were sensitive to Augmentin on disc culture sensitivity test except one case of E. coli. Daily doses of intravenous Augmentin were 2.-1-6.0gm divided in 2-5 injections. Every injection administered [1.2gm at Augmentin dissolved in 20ml distilled water] slowly for more than 20 minutes. Duration of injection was variable according to the clinical conditions from minimum 5 to maximum 31 days. The results of antibiotic treatment with Augmentin and some other antibiotic combinations pre- and postoperatively were subgrouped as EXCELLENT, EFFECTIVE, and FAILURE. Clinical criteria of the therapeutic result were symptomatic, objective and laboratory improvement. 8 cases were excellent, 13 effective, and one failure among the preoperatively infected group, and all 8 cases of the preoperatively non-infected group were effective as pro;hylactive antibiotic therapy. Overall effective ratio was 97% in both subgroup. There was no side effect clinically and laboratory study including liver and kidney function test during and after the I.V. administration of Augmentin. Oral swallow tablets which were administered after discharge from hospital also revealed good effects with some degree of gastrointestinal trouble.
Fecal contamination levels of discharge water from inland pollution sources were investigated in Iwon-myeon (Taean-gun), South Korea. Gram-negative bacteria were isolated during the investigation and the antimicrobial resistance patterns of the isolates were examined to estimate their impact on the coastal environment. The ranges of total coliform and fecal coliform of 12 samples from four major inland pollution sources were 79-490,000 MPN/100 mL and 2.0-490,000 MPN/100 mL, respectively, with the highest level of fecal contamination at Station No. 3. A total of 137 strains (14 genus) were isolated, of which 86 strains (62.8%) were Enterobacteriaceae. The identified isolates were as follows: Pseudomonas spp. (35 strains), Klebsiella spp. (20 strains), Serratia spp. (20 strains), and Escherichia spp. (19 strains). The isolated Gram-negative bacteria showed the highest antimicrobial resistance to ampicillin (81.8%), followed by amoxicillin/clavulanic acid (64.2%), ceftiofur (61.3%), and cefoxitin (59.1%). Antimicrobials in which less than 10% of isolates showed antimicrobial resistance were ciprofloxacin (3.6%) and gentamicin (2.2%). Resistance to one or more antimicrobials was observed in 121 strains (88.3%) and 84 strains (61.3%) showed a tendency for multiple antimicrobial resistance.
Yoo, Yeong Myong;Park, Byeong Sub;Lee, Shin Young;Park, Kyu Jung;Jung, Hyun Joo;Pai, Ki Soo
Childhood Kidney Diseases
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제23권1호
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pp.29-35
/
2019
Purpose: We aimed to determine characteristics of host, causative organisms, and antibiotic susceptibility of bacteria in pediatric patients with UTI living in metropolitan area of Korea. Methods: Retrospective investigation was done for the causative organisms of UTI in 683 pediatric cases treated at Ajou University Hospital from 2012 to 2017. Patients were classified into Escherichia coli and non-E. coli group, where E. coli group was subdivided into ESBL(+) and ESBL(-) groups based on whether the bacteria could produce extended spectrum beta-lactamase (ESBL). Antibiotic susceptibility of the causative organism was also determined. Results: A total of 683 UTIs occurred in 550 patients, of which 463 (67.8%) were first-time infection and 87 (32.2%) were recurrent ones (2-7 recurrences, 2.52 average), and 64.9% were male and 35.1% were female. The most common causative organism was E. coli (77.2%) and ESBL(+) E. coli was found in 126 cases. The susceptibility of E. coli to 3rd or 4th generation cephalosporin was relatively higher than that to ampicillin or amoxicillin/clavulanic acid. ESBL(+) E. coli showed higher resistance rate to 3rd or 4th generation cephalosporin than ESBL(-) E. coli. Conclusion: New treatment guideline should be considered due to the incidence of ESBL(+) E. coli increased up to one quarter of UTI cases.
Ha, Minjong;Ahmed, Sohail;Lee, Do Na;Han, Janghee;Yoon, Junghee;Yeon, Seong-Chan
한국임상수의학회지
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제39권3호
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pp.131-137
/
2022
Osteomyelitis typically occurs because of the direct inoculation of bacteria or fungi after penetrating trauma or surgical contamination or, by extension, from soft tissue infection. Osteomyelitis is rarely reported in wildlife animals, though severe chronic osteomyelitis cases do exist in wildlife owing to the scarcity of medical support in the wild environment. This report describes three cases of chronic osteomyelitis in wild raccoon dogs related to trauma. The typical symptoms of three reported cases were ataxia, stiffness, muscle atrophy, and lethargy. All three cases were relevant to traumatic or severe external injury, and skin infestation caused by ectoparasites was apparent on an ocular inspection. In the radiographic examination, diffuse sites of osteolytic lesions and remarkable periosteal responses were demonstrated around the injured limb in all three cases. Apparent neutrophilia with a left shift, lymphocytosis, and monocytosis in hematological examinations generally indicated chronic infection as shown in case 1 and 3. Treatment was attempted with broad-spectrum antibiotics and non-steroidal anti-inflammatory drugs, such as amoxicillin/clavulanic acid, enrofloxacin, clindamycin, and meloxicam. These treatment options helped improve the overall prognosis of chronic osteomyelitis, but the outcomes did not meet the treatment goal entirely. Osteomyelitis can be extremely challenging to treat, particularly in wild animals, because of their distinctive traits, such as masking phenomenon and uncontrolled exposure to ectoparasites. Earlier diagnosis with a radiographic examination, hematological examinations, and careful patient monitoring, followed by prolonged antibiotic therapy and restricted exercise, are the key factors leading to a better prognosis.
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