• Journal of Microbiology and Biotechnology
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• v.26 no.8
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• pp.1481-1489
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• 2016

The emergence and dissemination of carbapenemase-producing Acinetobacter baumannii isolates have been reported worldwide, and A. baumannii isolates harboring bla_OXA-23 are often resistant to various antimicrobial agents. Antimicrobial resistance can be particularly strong for biofilm-forming A. baumannii isolates. We investigated the genetic basis for carbapenem resistance and biofilm-forming ability of multidrug-resistant (MDR) clinical isolates. Ninety-two MDR A. baumannii isolates were collected from one university hospital located in the Chungcheong area of Korea over a 5-year period. Multiplex PCR and DNA sequencing were performed to characterize carbapenemase and bap genes. Clonal characteristics were analyzed using REP-PCR. In addition, imaging and quantification of biofilms were performed using a crystal violet assay. All 92 MDR A. baumannii isolates involved in our study contained the bla_OXA-23 and bap genes. The average absorbance of biomass in Bap-producing strains was much greater than that in non-Bap-producing strains. In our study, only three REP-PCR types were found, and the isolates showing type A or type B were found more than 60 times among unique patients during the 5 years of surveillance. These results suggest that the isolates have persisted and colonized for 5 years, and biofilm formation ability has been responsible for their persistence and colonization.

• Korean Journal of Clinical Laboratory Science
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• v.52 no.2
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• pp.128-135
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• 2020

Methicillin-resistant Staphylococcus aureus (MRSA) is a bacterium that causes infections in different parts of the body and causes skin and soft tissue infections (SSTI). The present study examined the antimicrobial resistance patterns and molecular epidemiological characteristics of MRSA isolated from nasal swabs in clinical patients. SCCmec type of MRSA isolates from clinical patients were analyzed: 24 cases were SCCmec type-II; two cases were type-II/IVa; one case was type-II/V; one case was type-IVa; 11 cases were not-typeable. The mec complex type of MRSA isolates from clinical patients were analyzed: 29 cases were mec complex type A, and 10 cases were not-typeable, but type B was not found in the present study. In conclusion, SCCmec type-II and mec complex type A were the most dominant MRSA subtypes among the MRSA isolates from a nasal swab of patients, and the results were similar to other studies on hospital-acquired MRSA (HA-MRSA). These results can not only provide basic data for hospital infection management but also be a good guideline for MRSA infections in the Republic of Korea.

• Korean Journal of Clinical Laboratory Science
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• v.47 no.2
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• pp.65-70
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• 2015

Antimicrobial agents or additives have commonly been used in domestic animals for the prevention and treatment of bacterial diseases. Unfortunately, this has resulted in the overgrowth of bacteria that is resistant to antimicrobial agents used by humans, and these might get disseminated to humans via the food. In this study, we investigated the prevalence of integrons, and characterized gene cassette arrays in Proteus mirabilis isolates obtained from chickens in Chungcheong province of Korea. Additionally, the correlation between gene cassette arrays and antimicrobial resistance rate was studied. A total of 26 Proteus mirabilis isolates were recovered from chickens in Chungcheong province in Korea. Antimicrobial susceptibility was determined by disk diffusion method. PCR and DNA sequencing were performed to characterize the gene cassette arrays. In addition, we employed repetitive extragenic palindromic sequence-based PCR (REP-PCR) method for clonality analysis of P. mirabilis strains. Of the 26 P. mirabilis isolates tested, 14 (53.8%) isolates carried class 1 integrons, while class 2 and class 3 integrons were not detected in our study. The class 1 integrons harbored genes encoding resistance to aminoglycosides (aacCA5, aadA2, aadA5 and aadA7), trimethoprim (dfrA17, and dfrA32), lincosamides (linF) and erythromycin (ereA). In particular, the presence of class 1 integron had a significant correlatation to a high resistance rate of aminoglycoside and trimethoprim. We confirmed that class 1 integrons are widely disseminated in P. mirabilis isolates from chickens, contributing to the resistance to diverse antimicrobial agents in Korea. To prevent further spreading of antimicrobial resistant genes among P. mirabilis isolates, constant monitoring and clinical policing will become necessary.

• Biomedical Science Letters
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• v.6 no.3
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• pp.201-208
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• 2000

The vancomycin, one of the family of glycopeptide antibiotics, inhibits the synthesis of bacterial cell wall peptidoglycan and has been widely used against gram-positive bacterial infections, especially for a treatment of methicillin resistant S. aureus infection. However, clinical isolate which was intermediately resistant to vancomycin (Mu50: MIC 8 $\mu\textrm{g}$/ml) was isolated in recent years. In this study we performed vancomycin susceptibility test with the increment method and population analysis with clinical isolates S. aureus. Also we did several kinds of tests with three selected isolates (s129: MIC 7 $\mu\textrm{g}$/ml, s134: MIC 7 $\mu\textrm{g}$/ml, s135: MIC 8 $\mu\textrm{g}$/ml) to find out possible mechanism of vancomycin resistance. As a result, the prevalence of vancomycin resistant S. aureus isolates among S. aureus strains resistant to methicillin was 23.3% (25/107). The vancomycin resistances of isolated strains of S. aureus were between those of Mu5O and Mu3 strains. By PCR analysis, none of the isolates with decreased vancomycin susceptibility contained known vancomycin resistant genes such as vanA, vanB, vanC1, vanC2, and vanH. Major bands of 81 kDa, 58 kDa, 33 kDa, 28 kDa were demonstrable in whole cell lysates by SDS-PAGE from all three isolates as well as reference strains. And especially,45 kDa protein was overproduced in Mu50 strains. Among them increased production of NAD$^{+}$-linked-$_{D}$-lactate dehydrogenase (dnLDH) were detected from one clinical strain (s135) and Mu5O strain. From these data, we suggest that the mechanism of vancomycin resistance in these isolates are distinct from that in enterococci.

• Biomedical Science Letters
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• v.18 no.1
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• pp.79-82
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• 2012

Acinetobacter infections are of great concern in clinical settings because of multi-drug resistance (MDR) and high mortality of the infected patients. The MDR Acinetobacter baumannii has emerged as a significant infectious agent in hospitals worldwide. The purpose of this study was to determine for molecular characterization of MDR A. baumannii clinical isolates obtained from the Wonju Christian Hospital in Gangwon province of Korea. A total of seventy nonduplicate A. baumannii isolates were collected from the Wonju Christian Hospital in Korea from March to April in 2011. All of the MDR A. baumannii isolates were encoded by $bla_{OXA-23-like}$ gene and all isolates with the $bla_{OXA-23-like}$ gene had the upstream element ISAba1 to promote increased gene expression and subsequent resistance to carbapenem. 16S rRNA methylase gene (armA) was detected in 44 clinical isolates which were resistant to amikacin, and phosphotransferase genes encoding aac(3)-Ia and aac(6')-Ib were the most prevalent. A combination of 16S rRNA methylase and aminoglycoside-modifying enzyme genes (armA, aac(3)-Ia, aac(6')-Ib, and aph(3')-Ia) were found in 31 isolates. The sequencing results for the quinolone resistance-determining region (QRDR) of gyrA and parC revealed the presence of Ser (TCA) 83 Leu (TTA) and Ser (TCG) 80 Leu (TTG) substitutions in the respective enzymes for all MDR. Molecular typing for MDR A. baumannii could be helpful in confirming the identification of a common source or cross-contamination. This is an important step in enabling epidemiological tracing of these strains.

• Korean Journal of Microbiology
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• v.43 no.4
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• pp.346-350
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• 2007

We analyzed the phenotypic changes in coagulase serotype of S. aureus isolated from clinical sources and nasal cavities of healthy persons, $1994{\sim}2005$. A total of 715 isolates, 408 methicillin resistant S. aureus (MRSA) from clinical sources and 307 methicillin-susceptible S. aureus (MSSA), were classified into eight coagulase sero-types, I to VIII. The most prevalent serotype in MRSA was type II (54.3%, 222/408) and followed IV (24.7%), III (10.9%), and V (5.2%), whereas the majorities in MSSA were type VII (30.9%, 95/307), IV (22.2%), V (22.2%) and II (7.1%). Among the isolates collected periods, significant changes of coagulase serotypes in both strains were observed. In MRSA strains, the serotype V was not detected until 1997, but rapidly increased to 18.5% (20/108) in 2005, and the serotypes III decreased from 27% (31/115) in 1994 to 0.9% (1/108) in 2005. A similar trend in MSSA strains was observed but serotype II strain was not detected in 2005. The antigenic shift and changes in the coagulase of S. aureus were confirmed.

• BMB Reports
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• v.40 no.6
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• pp.881-887
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• 2007

It is a hot clinical issue whether newly approved antimicrobial agents such as daptomycin, linezolid, quinupristin/dalfopristin (synercid) and tigecycline are active enough to be used for infections caused by vancomycin resistant bacteria. We performed susceptibility tests for mupirocin, which is in widespread clinical use in Korea, and four new antimicrobials, daptomycin, linezolid, quinupristin/dalfopristin and tigecycline, against vancomycin-resistant Enterococcus faecalis and Enterococcus faecium isolated from Korean patients in 1998 and 2005 to evaluate and compare the in vitro activity of these antimicrobials. Among these agents, quinupristin/dalfopristin, which is rarely used in hospitals in Korea, showed relatively high resistance to several vancomycin-resistant enterococci (VRE) isolated in 2005. Likewise, daptomycin, linezolid and tigecycline have not yet been in clinical use in Korea. However, our results showed that most of the 2005 VRE isolates were already resistant to linezolid and daptomycin (highest minimum inhibitory concentration (MIC) value >$100{\mu}g$/ml). Compared with the other four antimicrobial agents tested in this study, tigecycline generally showed the greatest activity against VRE. However, four strains of 2005 isolates exhibited resistance against tigecycline (MIC >$12.5{\mu}g$/ml). Almost all VRE were resistant to mupirocin, whereas all E. faecium isolated in 1998 were inhibited at concentrations between $0.8\sim1.6{\mu}g$/ml. In conclusion, resistances to these new antimicrobial agents were exhibited in most of VRE strains even though these new antibiotics have been rarely used in Korean hospitals.

• Korean Journal of Clinical Laboratory Science
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• v.50 no.4
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• pp.406-413
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• 2018

The emergence of carbapenem resistance among Pseudomonas aeruginosa has become an increasing problem worldwide. In particular, $metallo-{\beta}-lactamases$ (MBLs) are responsible for the high-level resistance to carbapenem. Sequence type 235 (ST235) has been found internationally in a multidrug-resistant clone and is involved in the dissemination of genes encoding IMP-6 and VIM-2. This study examined the prevalence of MBLs and the epidemiological relationship in carbapenem-resistant P. aeruginosa (CRPA) isolates obtained from a tertiary hospital in Daejeon, Korea, between March 2008 and June 2014. The antimicrobial susceptibilities were determined using the disk-diffusion method and PCR and DNA sequencing were used to identify the MBL genes. In addition, an epidemiological relationship was investigated by multilocus sequence typing (MLST). Among the 110 CRPA isolates, 32 isolates (29.1%) were MBL-producers; the major type was IMP-6 (29 isolates, 90.6%). VIM-2 was identified in 3 isolates (9.4%) of ST357. IMP-6-producing isolates were multidrug-resistant (MDR) and belonged to ST235. ST235 (55 isolates, 50.0%) was the clone most frequently detected and has gradually emerged during a seven-year period. To prevent the spread of MDR ST235 P. aeruginosa isolates, the current widespread use of carbapenems needs to be curtailed, and novel continuous monitoring strategies should be developed as soon as possible.

• Korean Journal of Clinical Laboratory Science
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• v.52 no.4
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• pp.342-348
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• 2020

Uropathogenic Escherichia coli (UPEC) is a major cause of urinary tract infections (UTIs), which is one of the most common infectious diseases in humans worldwide. Since UPEC is increasingly gaining resistance to many antimicrobial agents, antibiotic therapy of UTI has recently become a great concern. This study examined the epidemiological relationship, and antimicrobial resistance patterns of 84 UPEC isolates obtained from UTI patients in Daejeon, from March to December 2017. Molecular epidemiology was investigated by multilocus sequence typing (MLST), and an antimicrobial susceptibility test was determined using an E-test. In this study, UTI was more common in females (73.8%) than in males (26.2%), and the highest incidence of UTI was observed in the age group in their 70s. Among the 84 UPEC isolates, 59 isolates (70.2%) were multidrug-resistant (MDR), and the major sequence type was ST131 (44 isolates, 52.4%). Interestingly, the rates of MDR in non-ST131 isolates (72.5%) were higher compared to ST131 isolates (68.2%). These results indicate the possibility of the development and spread of MDR in non-ST131 isolates. Effective surveillance networks and continuous research need to be conducted globally to prevent the emergence and international spread of MDR non-ST131 isolates.

• Mycobiology
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• v.31 no.2
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• pp.95-98
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• 2003

Aantifungal agents were tested against 30 clinical isolates of Cryptococcus neoformans var. neoformans using the NCCLS method(M27-A2). Posaconazole, itraconazole and amphotericin B had lower MIC than the remaining four antifungal agents. The MIC result for posaconazole was over 220-fold lower active than fluconazole. Fluconazole MICs for most isolates fell within the dose-dependant range. The overall MIC ranges and $MIC_{50}s$ were amphotericin B(0.03-0.25; 0.25), fluconazole(0.5-64; 16), itraconazole(0.015-1; 0.125), terbinafine(0.06->2; 1), caspofungin(8-32; 32), voriconazole(0.015-0.5; 0.25), and posaconazole(0.015-0.25; 0.06 ${\mu}g/ml$), respectively. In conclusion, the $MIC_{50}s$ of these drugs did not exhibit any sign of an upward shift with the exception of fluconazole and tendency cross-resistance between the seven drugs was not observed. We conclude that in vitro resistance to antifungal agents has not significantly changed despite the recent wide-spread use of triazoles for long-term treatment of Cryptococcal meningitis.