• 대한임상검사과학회지
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• 제51권2호
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• pp.260-264
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• 2019

84세 여성이 항문까지 욕창이 번져 응급실에 내원하였다. 그녀는 근처의 요양기관에서 전원되었고, 입원시 소변 도뇨관을 달고 있었으며 열은 없었다. 그람염색에서 많은 수의 포도상구균과 >25의 호중구 (${\times}1000$배 렌즈)가 관찰되었다. 24시간 배양한 혈액한천배지에서 용혈이 없는 점액성의 집락이 관찰되었으며 배양 48시간에는 점액성이 더욱 확대되었다. India ink로 염색하여 협막의 모습을 관찰하였으며, 카타라제 양성, 라텍스법 혈액응고효소 음성, 시험관법 혈액응고효소 음성소견을 보였다. Vitek-2와 질량분석기인 Vitek MS V-3 IVD에서 S. aureus로 나타났으며, 16S rRNA 유전자 염기서열 분석 및 Multilocus sequencing typing (MLST)에서 S. aureus로 표준균주인 ATCC 29213과 99.9% 일치를 보였다. 본 증례는 용혈성이 없고, 점액성이 강하며, 라텍스법 혈액응고효소 음성, 시험관법 혈액응고효소 음성소견을 보이는 MRSA를 동정하여 이를 보고한다.

• 대한임상검사과학회지
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• 제42권2호
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• pp.86-91
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• 2010

We evaluated the performance of a novel screening test, PBP2a MRSA rapid kit (Dinona Inc., Iksan, Korea), for methicillin-resistant Staphylococcus aureus (MRSA) based on a immunochromatographic assay. The test is able to detect penicillin-binding protein 2a (PBP2a) using the nasal specimens from health care workers. The nasal specimens were obtained from 69 healthcare workers and were incubated in enrichment broth followed eight hours incubatin in BHI with cefoxitin $4{\mu}g/mL$. These broth were tested by PBP2a Rapid Kit. The enrichment broths were also directly tested for tube coagulase using the conventional identification method. 19 of 22 MRSA showed positive results by PBP2a rapid test and direct coagulase test (the sensitivity for detection of MRSA, 86.36%). While, 8 of 47 non-MRSA showed false positive results for the two tests. All of the 8 non-MRSA which showed false positive were co-colonizing isolates with MRCNS and MSSA. In addition, 46 of 49 methicillin-resistant staphylococci (MRS) showed positive results for PBP2a MRSA rapid kit (the sensitivity for detection of MRS, 93.8%), and all of 20 non-MRS showed negative results (specificity, 100%). The combination of PBP2a MRSA rapid kit and direct coagulase test showed the good sensitivity for detection of MRSA from anterior nares but frequently showed false positive results from the co-colonizing carrier with MRCNS and MSSA.

• 한국식품위생안전성학회지
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• 제18권2호
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• pp.79-86
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• 2003

대부분의 식중독은 단체 급식으로부터 발생하는 경우가 많으며, 특히 위생상태와 연관되어 식중독을 야기 시키는 병인 물질 중 포도상 구균은 많은 부분을 차지하고 있다 따라서 본 연구에서는 서부경남지역의 5개 초등학교 급식시설에서 총 98개의 샘플 중 A 급식소의 식수, D 급식소의 손, E 급식소의 냉장고와 앞치마에서 4개의 포도상 구균을 분리하였다. 분리된 균주들은 1개의 메티실린 저항성 혈장응고 효소 음성 황색포도상구균(Methicilline Resistant Coagulase Negative Staphylococcus aureus； MRCPS)과 3개의 메치실린 민감성 혈장응고효소 양성 황색포도상구균 (Methicilline sensitive Coagulase positive Staphylococcus aureus； MSCPS)으로 구분되었다. 한편 포도상 구균은 내열성 내독소로서, 이 중 가장 문제가 되는 내독소 B(enterotoxin B)를 검색하기 위한 PCR을 실시한 결과, A 장소의 식수, D 장소의 손, E 장소의 냉장고와 앞치마에서 분리된 균주로부터 477bp의 생성물을 갖는 sob gene을 확인할 수 있었다. 이들 분리된 황색포도상구균에 대한 항생제 민감성 실험에서는 ampicillin과 penicillin에 대하여 전체적으로 저항성을 가졌으며, 특히 A 식수에서 분리된 균주는 옥사실린 저항성(oxacilline resistant)균주로 나타나 MRSA(methicilline resistant staphylococcus aureus)균주로 확인되었다.

• Pediatric Infection and Vaccine
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• 제3권2호
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• pp.133-138
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• 1996

Purpose : In the treatment of MRSA infection, rapid detection of MRSA is extremely important. The mecA gene codes the new drug resistant polypeptides called PBP2' which mediates the clinically relevant resistance to all beta-lactam antibiotics. The identical mecA gene has been found in coagulase-negative staphylococcus with the methicillin-resistant phenotype. On the other hand, the femA gene was absent from coagulase negative staphylococcus strains with the methicillin resistant phenotype. This study is aimed at early detection and definite diagnosis of MRSA. Methods : A total of 24 MRSA strains were studied. All strains were tested for antimicrobial susceptibility and purified DNA. We amplified both mecA and femA genes by PCR in 24 strains. Results : In MRSA all the 16 strains (100%) carried femA gene and 11 strains (68.7%) carried mecA gene. In contrast, in methicillin sensitive staphylococcus all the 8 strains (100%) carried femA and only 3 strains (37.5%) were detected mecA. Conclusions : As results, there are difference in the phenotype and genotype of methicillin resistance by PCR of mecA and femA. Such disparities between methicillin resistance and the presence of mecA gene suggest the presence of control gene of the mecA.

• 생명과학회지
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• 제11권1호
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• pp.24-34
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• 2001

Methicillin Resistant Staphylococcus aureus (MRSA) was obtained from the clinical specimens at Pusan national university Hospital, Pusan, Korea. The sensitivities against various antibiotics were examined by using disc diffusion test and associated genes such as mecA, mecR1, mecI and femA were detected by polymerase chain reaction. Among Seventy-nine strains of MRSA, 38 strains(48.1%)were sensitive to streptomycin and 32 strains(40.5%) to cefoperazone, while one strain(1.3%) were resistant to vancomycin. In considering the result of this study, 7 strains showed resistance to 9 kinds of different antibiotics, 12 strains were to 8 kinds, 24 strains were to 7,25 strains were to 6, 9 strains were to 5, and 2 strains were to 4 antibiotics. Among 79 strains of MRSA, 67 strains were coagulase positive and 12 were coagulase negative. In the detection of MRSA associated genes by PCR method, mecA, mecR1, mecI, and femA genes were detected in 30 strains(44.8%), 28 strains(41.8%), 23 strains(34.3%) and 15 strains(22.4%), respectively. MecA type that is without femA were found in 21 strains(31.3%), femA type that is without regulator genes were shown in 4 strains(6.0%), while mecA-mecR1-mecI type with regulator genes were shown more to be 17 strains(25.4%). There was little statistical significance between multidrug resistance and MRSA associated genes. Considering these result, it is necessary to include moecular biological studies of related genes to the study drug resistance.

• Archives of Plastic Surgery
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• 제40권5호
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• pp.536-541
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• 2013

Background Pathogens in the nasal cavity during nasal surgery could lead to a systemic infectious condition, such as bacteremia, nosocomial infection, or toxic shock syndrome. However, there is no research about the prevalence of nasal carriage in patients with nasal bone fracture. Methods This was a prospective, double-blind, randomized study about the rate of nasal carriage in 200 patients with nasal bone fracture in Korea. Nasal secretions were taken from both the middle nasal meatus and colonized. All analyses were carried out using SPSS software. Results Pathogens were identified in 178 of the 200 cases. Coagulase-negative staphylococci (CNS) were the most cultured bacteria in 127 (66.84%) of the 190 total patients after excluding 10 cases of contaminated samples, and methicillin-resistant coagulase-negative staphylococci (MRCNS) were found in 48 (25.26%). Staphylococcus aureus was the second most identified pathogen, found in 36 (18.95%), followed by 7 cases (3.68%) of methicillin-resistant Staphylococcus aureus (MRSA). The prevalence rate of MRSA in the females was higher than that in the males (RR=4.70; 95% CI, 1.09-20.18), but other demographic factors had no effect on the prevalence rate of MRSA and MRCNS. Conclusions The prevalence rate of these pathogens in patients with nasal bone fracture in Korea was similar to other reports. However, few studies have addressed the prevalence rate of CNS and MRCNS in accordance with risk factors or the change in prevalence according to specific prophylaxis against infectious complications. Additional research is needed on the potential connections between clinical factors and microbiological data.

• 대한방사선기술학회지:방사선기술과학
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• 제31권3호
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• pp.229-237
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• 2008

목적 : 검사실별 IP카세트와 테이블의 미생물 수와 세균학적 오염도를 알코올과 소독제가 포함된 티슈를 사용 전 후로 나누어 동정한 후 통계적으로 검정을 실시하여 영상의학과내 병원감염관리의 예방과 올바른 소독 지침을 위한 기초자료를 제공하고자 연구하였다. 대상 및 방법 : 본 연구는 대전광역시 소재의 1개 대학병원 영상의학과의 일반촬영실을 대상으로 하였다. 기간은 2007년 4월 5일부터 4월 12일까지 이루어졌으며, 검사실별 IP카세트와 테이블의 미생물 수와 세균학적 오염도를 알코올과 소독제가 포함된 소독용 티슈를 사용 전, 후로 나누어 실시하였으며, 정확한 수집을 위하여 병원내 감염관리 전문 간호사와 함께 시료를 채취하였다. 통계처리는 SPSS V13.0을 사용하였으며, 전 후 비교를 위해 T-검정을 실시하였으며 사후검증을 실시하였다. 결과 : 24개의 대상 중 19개(79.2%)에서 세균이 검출 되었으며 5개(20.8%)에서는 세균이 검출되지 않았다. 분리된 세균의 종류는 7종의 세균이 검출 되었는데 그 중 Methicillin Resistant coagulase-negative Staphylo-cocci(MRCNS)가 15(62.5%)곳으로 가장 많이 검출되었으며, 그 다음으로 Methicillin Resistant Staphylococcus Aureus(MRSA)가 6(16.7%)곳으로 많았으며, Enterococcus Faecium(EFM)이 5(20.8%), Acinetobacter baumannii(ABA) 2(8.3%), Bacillus sp, Coagulase-negative Staphylococci(CNS), Enterococcus sp(ENT)가 각각 1(4.2%)곳에서 검출되었다. 또한 ABA를 제외한 모든 것이 그람양성구균(Gram positive bacilli)이 30(97%) 례에서 검출 되었으며, 1(3%)례에서만 그람음성균(Gram positive bacilli)이 검출되었다. Group별 70% Alchol 사용 전 후 균의 종류 및 군락 수에서는 70% Alchol로 소독을 한 후 세균을 동정한 결과 70% Alchol 소독군에서는 IP Cassette와 Table 그룹 모두에서 100% 세균이 사멸되었다. Group별 Tissue Cleaner 사용 전 후 균의 종류 및 군락 수에서는 Tissue Cleaner 그룹에서의 균의 사멸률은 10그룹(71.2%)에서만 세균이 완전히 사멸되었으며, 4 그룹에서는 많은 감소를 보였으나 여전히 세균이 검출되었다. 전체 균의 사멸률은 91.5%로 나타났는데 다른 균들은 모두 사멸된 반면 MRCNS 균은 사멸률이 가장 낮았(83.6%)으며, 다음으로 MRSA(95%)가 낮았다. 결론 : 70% Alchol과 Tissue Cleaner의 사용전 후 검출되는 세균의 평균을 비교한 결과 모두에서 유의수준5%에서 통계적으로 유의한 것으로 나타났다.

• 대한족부족관절학회지
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• 제13권2호
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• pp.146-149
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• 2009

Purpose: Foot infections are common complications in patients with diabetes. The patients are usually immune-compromised; therefore the pathogens could be resistant to narrow spectrum antibiotics. Those drugs, however, are categorized as specially managed antibiotics, and access are difficult without confirming of the pathogens. Our aim was to analyze the common pathogens in diabetic foot infection and figure out the proper antibiotics. Materials and Methods: We studied 68 patients treated with diabetic foot infection. The pathogens which caused the infection and their sensitivity to initial antibiotics were analyzed. We also investigated the change of the antibiotics after the confirming of the culture result and average time to get the result. Results: Among the 68 patients, 56 (82%) received cephalosporin and beta-lactam antibiotics. Only 12 (18%) who were confirmed the drug resistant pathogens from previous culture, were treated with broad spectrum antibiotics such as vancomycin and tazoperan. Average culture study time was 6 days. Methicillin-resistant staphylococcus aureus (MRSA) was cultured in 19 patients (28%), Methicillin-resistant coagulase negative staphylococcus (MRCNS) in 11 patietns (17%), pseudomonas in 11 patients (17%). Total 44 (65%) including 3 of other antibiotics resistant pathogen needed broad spectrum antibiotics. Thirty two patients (47%) were resistant to initial antibiotics.irt follow up culture, 2 MRSA and 2 MRCNS were found. The antibiotics resistant pathogens were confirmed in 48 (71%) patients at last. Conclusion: Diabetic patients with foot infection need proper antibiotics from initial treatment. The proper broad spectrum antibiotics should assigned to the patients from the first time without the confirming of the culture results.

• Child Health Nursing Research
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• 제22권4호
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• pp.379-389
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• 2016

Purpose: A longitudinal study was conducted to explore flora colonization and oral glucose high-risk newborns during the first 7 days after birth. Methods: Oral secretions of hospitalized newborns were obtained for microbial cultures and glucose test at days 1-7 after birth. Results: Among the total 112 newborns, 40% were girls and 73% were premature. Mean gestational age was $34.4{\pm}3.2$ weeks and weight was $2,266{\pm}697.5$ grams. The most common flora included Streptococcus (28.2%), Methicillin-resistant Staphylococcus aureus (MRSA, 10.9%), Staphylococcus (6.0%) and Coagulase-Negative Staphylococcus (CNS, 4.0%). The average oral glucose level was $29.2{\pm}23.0mg/dL{\sim}58.2{\pm}39.5mg/dL$. Newborns with higher oral glucose than serum (crude odds ratio [ORc] =1.75; 95% confidence interval [CI] =1.03-2.97), phototherapy (ORc=3.30; 95% CI=2.29-4.76) and prone position (ORc= 2.04; 95% CI=1.13-3.69) were more likely to be colonized. Having oral tubes (ORc=0.42; 95% CI=0.29-0.59), parental nutrition (ORc=0.21; 95% CI=0.13-0.32) and antibiotics (ORc=0.51; 95% CI=0.36-0.73) had protective effects. For oral glucose statistical significances existed on time effect among newborns with Streptococcus (F=9.78, p=.024), MRSA (F=7.60, p=.037) or CNS (F=11.15, p=.019) and interaction between time and colonization among newborns with all of four flora (F=2.73, p=.029) or colonization with only Staphylococcus (F=2.91, p=.034). Conclusion: High-risk newborns develop flora colonization at an early period of life. Their clinical features were associated with types and time of oral flora colonization. They need close monitoring and multifaceted intervention to improve oral environment and infection control.

• Journal of Veterinary Science
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• 제23권6호
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• pp.12.01-12.10
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• 2022

Background: Staphylococcus aureus and Streptococcus agalactiae are the main cause of clinical mastitis in dairy cattle in Argentina, whereas coagulase-negative staphylococci (CNS) and environmental streptococci are the main cause of subclinical mastitis. Bacteria isolated from infected animals show increasing antimicrobial resistance. Objectives: This study aims to determine the antimicrobial resistance of staphylococci and streptococci isolated from milk with mastitis, and to genotypically characterize the methicillin-resistant (MR) staphylococci. Methods: Isolation was performed on blood agar and identification was based on biochemical reactions. Antimicrobial susceptibility was according to the Clinical and Laboratory Standards Institute guidelines. The antimicrobial resistance genes, SCCmec type and spa type were detected by the polymerase chain reaction method. Results: We isolated a total of 185 staphylococci and 28 streptococci from 148 milk samples. Among the staphylococcal isolates, 154 were identified as CNS and 31 as S. aureus. Among the 154 CNS, 24.6% (n = 38) were resistant to penicillin, 14.9% (n = 23) to erythromycin, 17.5% (n = 27) to clindamycin, 6.5% (n = 10) to cefoxitin and oxacillin. Among the S. aureus isolates, 16.1% (n = 5) were resistant to penicillin, 3.2% (n = 1) to cefoxitin and oxacillin (MRSA). Six MR isolates (5 CNS and 1 MRSA) were positive to the mecA gene, and presented the SCCmec IVa. The MRSA strain presented the sequence type 83 and the spa type 002. Among the 28 streptococcal isolates, 14.3% (n = 4) were resistant to penicillin, 10.7% (n = 3) to erythromycin and 14.3% (n = 4) to clindamycin. Conclusions: The present findings of this study indicate a development of antimicrobial resistance in main bacteria isolated from cows with mastitis in Argentina.