• Childhood Kidney Diseases
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• 제23권1호
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• pp.29-35
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• 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.

• 한국산학기술학회논문지
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• 제22권6호
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• pp.413-419
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• 2021

본 연구의 목적은 확장 스펙트럼 𝛽-락타마제(ESBL) 항생제가 그람 음성 세균에 의한 감염을 치료하고 예방하는데 사용하고 있으며 임상에서 심각한 감염을 치료하는데 선택하는 마지막 옵션 역할을 한다. 미생물의 확장 스펙트럼 𝛽-락타마제(ESBL) 및/또는 카르바페네마제(Carbapenemase) 내성에 대한 보고는 전 세계적으로 확산되는 것으로 보고되며 항생제 치료에 많은 제한을 주는 요인으로 다약재 내성과 관련이 있기 때문에 보건 서비스에 큰 관심을 가지고 있다. 본 연구는 국내 시장에서 구매하여 분리한 육류로부터 세균을 분리 동정하여 항생제 저항성 테스트인 디스크 확산법을 사용하여 내성균을 분리 실험하였고, PCR과 DNA 시퀜싱방법을 수행아였다. 결과는 PCR을 수행하여 항생제 내성유전자와 유전자를 생산하는 ESBL의 존재를 검출하고 결과를 얻었다. 총 36개의 샘플 육류로부터 181개의 각각 분리된 세균을 추출하여 실험결과을 얻었다. 결과는 PCR과 DNA 염기서열을 분석하여 항생제내성 유전자로 blaVIM, blaBIC, blaKPC, blaSIM으로 나타났다. 분리한 육류 속의 박테리아는 별도 유전자 서열분석으로 4개의 다른 박테리아가 확인되었다. 이러한 결과는 소매되는 육류에서 발견되는 박테리아에 ESBL 내성유전자인 blaVIM, blaBIC, blaKPC, blaSIM를 가진 박테리아 균주가 있을 수 있으며 이는 특수 확장 스펙트럼 𝛽-락타마제(ESBL) 및/또는 카르바페네마제(Carbapenemase) 내성유전자가 확산될 수 있다는 것을 시사한다.

• 미생물학회지
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• 제42권2호
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• pp.125-130
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• 2006

본 연구에서는 도축장과 도축물에서 plasmid 매개성 광범위 ${\beta}$-lactam (extended spectrum ${\beta}$-lactamase) 분해효소를 생성하는 Klebsiella pneumoniae와Escherichia coli가 분리됨으로서 한국에서는 이들 균주가 임상범위를 넘어 자연계까지 확산되었음을 확인하였다. 디스크 확산 시험, 등전점 수치, 접합시험 등을 통하여 돼지의 분변으로부터 최종 10균주의 접합자를 얻었고 이들의 형별결정은 아미노산서열분석과 기준주와 대조등을 BCM Search Laucncher 및 NCBI blast를 통해 이루어졌다. 광범위 ${\beta}$-lactam 유형은 Klebsiella pneumoniae 8균주가 TEM-52형이었고 2균주 Escherichia coli가 SHV-12형이었다. CMY-1형은 본 연구에서 분리되지 않았다.

• 디지털융복합연구
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• 제14권10호
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• pp.349-354
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• 2016

다양한 extended-spectrum ${\beta}$-lactamase (ESBL)를 생성하는 폐렴막대균의 출현 및 확산은 세균에 의한 감염증 치료에 어려움을 가중시키고 있다. 본 연구에서는 충청지역에서 분리된 폐렴막대균을 대상으로 ESBL 유전자를 검출하고 항균제 감수성 양상을 조사하였다. 또한 같은 클론에서 유래하였는지를 확인하기 위해 repetitive element sequence-based (REP)-PCR을 수행하였다. 충청지역에서 분리된 폐렴막대균 102균주 중 21균주가 CTX-M-14 및/또는 CTX-M-15를 생성하는 것으로 나타났으며 이 균주들은 3세대 cephalosporin 계열 항균제에 대해 70% 이상의 높은 내성율을 보였다. 본 연구에서 분리된 CTX-M형 ESBL생성 폐렴막대균은 다양한 클론으로부터 유래되었으며 그 중 일부는 지역사회에 확산되어 있음이 확인되었다. 이러한 폐렴막대균의 감염 및 확산을 방지하기 위해서는 감염관리의 강화가 필요하다. 아울러 좀 더 효과적인 내성세균의 관리를 위해서는 내성유전자의 생물학적 조사와 통계학적 분석을 통해 통합적으로 구축된 데이터베이스를 모니터링 할 필요가 있을 것으로 사료된다.

• Biomolecules & Therapeutics
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• 제7권1호
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• pp.44-53
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• 1999

The resistant strains due to the extended-spectrum $\beta$-lactamase (ESBL) were susceptible to cefatrizine combined with clavulanic acid. The purpose of this study was to evaluate the in vitro and in vivo antibacterial activities of cefatrizine/clavulanic acid (CTRZ/CV) combination at a ratio of 2 : 1 in comparison with cefaclor (CCLO), cefuroxime (CRXM), cefuroxime axetil (CRXMA) and amoxicillin/clavulanic acid (AMXCCV). CTRZ/CV showed good activity against laboratory strains of gram-positive and gram-negative bacteria and exhibited excellent antibacterial activity against $\beta$-lactamase-producing strains. The bactericidal activity of CTRZ/CV was superior to that of CCLO and CRXM, and almost equal to that of AMXCCV against the $\beta$-lactamase-producing strains. The in vitro results were substantiated. by in vivo mouse experimental infection studies with $\beta$-lactamase-producing and non-producing strains. In mixed experimental infection due to $\beta$-lactamase-producing and non-producing strains, the therapeutic efficacy of CTRZ/CV was superior to that of CTRZ, CCLO, CRXMA and AMXCCV. In respiratory tract infection in mice due to Klebsiella pneumoniae EB4O, CTRZ/CV was more erective than CCLO, CRXMA and AMXCCV and also more efficacious than CCLO, CRXMA and AMXCCV in urinary tract infection in mice due to Escherichia coli EB13. These results indicate that CTRZ/CV is a useful drug for the treatment of infection caused by $\beta$-1actamase-producing strains including ESBL-producing strains.

• 디지털융복합연구
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• 제13권12호
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• pp.313-318
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• 2015

본 연구에서는 세균의 항균제 내성기전을 연구하기 위해 일개의 대학병원에서 분리된 Enterobacter cloacae를 대상으로 extended spectrum ${\beta}$-lactamase (ESBL) 및 16S rRNA methyltransferase 유전자를 검출하고 항균제 감수성 양상을 조사하였다. 대상균주 중 총 8 균주가 CTX-M-15형 ESBL을 생성하는 것으로 확인되었으며 이 균주들 중 3 균주는 16S rRNA methyltransferase의 한 종류인 armA 유전자도 동시에 가지고 있는 것으로 나타났다. CTX-M-15형 ESBL 유전자와 armA 유전자를 동시에 가지고 있는 E. cloacae는 3세대 cephalosporin 계열 및 aminoglycoside 계열의 항균제 뿐 만 아니라 fluoroquinolone 계열의 항균제에도 내성을 보였다. 더구나 이러한 항균제 내성 유전자들은 플라스미드를 통해 다른 세균으로 전달 될 수 있어 다제내성 세균의 출현 및 확산을 촉진 할 수 있다. 따라서 E. cloacae를 대상으로 지속적인 항균제 내성 유전자를 모니터링 하는 것은 항균제 내성 확산방지를 위해 중요할 것으로 사료된다.

• 환경생물
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• 제29권4호
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• pp.286-295
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• 2011

Bacteria resistant to various antibiotics have recently become an issue of the utmost importance. Resistant strains are not uncommon, even in municipal drinking water sources. The health threat posed by resistant, pathogenic bacteria has serious ramifications for both public health and agriculture. In this study, we isolated antibiotic resistant bacteria from water samples from the Han River, Korea, which is contaminated by the wastewater from many industrial complexes, hospitals, agricultural and animal husbandry estates, and from wastewater treatment facilities. We determined the degrees of resistance to various antibiotics exhibited by the isolated strains. The similarities between the isolated $E.$ $coli$ strains were examined, using the pulsed field gel electrophoresis and multilocus sequence typing, in order to trace their origins and to explore the syntechnic adaptations and pathogenicity of the various strains and relate these to their genetic sequence. A total of 25 $E.$ $coli$ strains were isolated from six stations along the Han River. All the 25 strains exhibited resistance to ampicillin. We also investigated resistance to amoxicillin, clavulanic acid, cefazolin, cofoxitin, cefotaxime, cefpodoxime, ceftriaxone, cefepime, nalidixic acid, aztreonam, ciprofloxacin, streptomycin, gentamicin, chloramphenicol and imipenem. Based on the ESBL detection, 14 strains belonged to the ESBL producing strains. The number of the clonal complex producing strains was 5 among the 14 isolated strains. The 5 strains were included in the 168, 23, 38, 469, 156 clonal complex, respectively. The rest 9 strains were not included in the clonal complex, but showed independent STs.

• 한국동물위생학회지
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• 제37권1호
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• pp.19-27
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• 2014

This study was conducted to investigate the antimicrobial resistance, presence of ${\beta}$-lactamase genes and integrons in 83 ESBL-producing Escherichia coli isolated from Nakdong river and Geumho river in Daegu. Among the ${\beta}$-lactam antimicrobials, all isolates were resistant to ampicillin, cephalothin, cefamandole and cefotaxime, followed by piperacillin (98.8%), ampicillin/sulbactam (86.7%), aztreonam (60.2%) and cefepime (59.0%), whereas resistance to piperacillin/tazobacram, ticarcillin/clavulanic acid and cefoxitin was less than 30%. Many of the ESBL-producing Escherichia coli were also resistant to non-${\beta}$-lactams antimicrobials such as nalidixic acid (83.1%), sulfonamides (72.3%), ciprofloxacin (62.7%) and gentamicin (38.6%). All isolates showed resistance to seven or more antimicrobial agents. The most frequently detected gene was $bla_{TEM+CTX-M}$ (49.4%), followed by $bla_{CTX-M}$ (27.7%), $bla_{TEM}$ (6.0%) and $bla_{OXA}$ (1.2%). But $bla_{SHV}$ was not found. Class 1 integrons were found in 61.4% (51 isolates) of isolates, however, class 2 and 3 integrons were not detected. The results showed water from Nakdong river and Geumho river is contaminated with ESBL-producing E. coli isolates. These results suggest the need for further investigation of antibiotic resistant bacteria to prevent public health impacts in the water environment.

• 대한미생물학회지
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• 제35권5_6호
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• pp.337-339
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• 2000

MRSA, erythromycin-resistant S. pyogenes, penicillin non-susceptible pneumococci, PPNG, ESBL-producing E. coli and K. pneumoniae, class C ${\beta}$-lactamase-producing E. coli, fluoroquinolone-resistant E. coli, aminoglycoside-resistant A. baumannii and P. aeruginosa are all prevalent in Korea, which suggest the presence of high levels of antimicrobial selective pressure and nosocomial spread of resistant bacteria. Rapid increase of VRE and emergence of fluoroquinolone-resistant gonococci and VIM-2 metallo-${\beta}$-lactamase-producing P. aeruginosa are recently observed new threats in Korea.

• 한국동물위생학회지
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• 제37권4호
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• pp.225-231
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• 2014

In this study, 185 cefotaxime-resistant Escherichia coli were isolated from different stages of a wastewater treatment plant (WWTP) in Daegu in Korea. Among them, 99.5% (184 isolates) originated from raw sewage and 0.5% (1 isolates) from the final effluent. Cefotaxime-resistant E. coli were high resistant to ampicillin, piperacillin, cefazolin, cephalothin, cefachlor and cefamandole (99.5~100%). About 93% of the cefotaxime-resistant E. coli were extended-spectrum ${\beta}$-lactamases (ESBL)-producing E. coli. The $bla_{TEM+CTX}$ gene was the most predominant of the ESBL genes (72.5%), followed by $bla_{CTX-M}$ (16.2%), $bla_{TEM}$ (8.7%), $bla_{TEM+CTX+SHV}$ (1.1%), $bla_{TEM+SHV}$, $bla_{TEM+OXA}$, and $bla_{TEM+CTX+SHV}$ (respectvely 0.5%). Class 1 and 2 integron were found in 49.7% and class 3 integron was not found. All of integron positive isolates were multiresistant (i.e. resistant to four or more antibiotics). Our findings showed WWTP is contaminated with antibiotic resistant bacteria with resistance genes.