This study was undertaken to determine the antimicrobial susceptibilities of 716 bacterial strains among 1,104 microbes which were isolated in blood culture from 13,595 in-patients and out-patients in K hospital during the pe-riod of 1993 to 1996. The results obtained were as follows : The isolation rate of microbes from the blood culture for 3 years was 8.1% (1,104/13,595). Among 716 bacte-rial strains, Escherichia coli and Staphylococcus epidermidis were 29.8% (213) and 19.5% (140) respectively. The bacterial isolation frequency according to ages was high at fifties, sixties and two or less years old groups, especially the isolation rate of S. epidermidis was 47% at two or less years old group and that of Salmonella typhi was 36% at thirties years old group. The seasonal isolation rate of the bacterial species except E. coli was high during May to September. Gram positive cocci were resistant to penicillin-G except Enterococcus faecalis, but susceptible to vanco-mycin and teicoplanin. Gram negative bacilli were susceptible to amikacin, ciprofloxacin, and imipenem, but resistant to ampicillin except S. typhi. These results indicate that bacterial strains isolated from bacteremia patients were resis-tant to penicillins, but susceptible to vancomycin, teicoplanin, amikacin, ciprofloxacin and imipenem.
This paper was attemped to analize 55 cases of fiberoptic bronchoscopy during period of 3 years from Feb. 1978 till Feb. 1981 in Chung Ang University hospital. The results were as follow; 1) In age distribution; Most common age group was 5th decade (15 cases, 27.2%) and the other age groups showed relatively even distribution. 2) The ratio of male to female was 3 to 1. 3) The chief complaints were presented in following order; cough (52%), hemoptysis(25%), dyspnea(23.6%), chest pain(18%), chest disomfort(9%). 4) Direct smear of bronchoscopic aspiration material; Not found 33 cases (60%) were most common finding. In the founded bacteria Gram positive cocci 2 cases (3.6%), Gram negative cocci 2 cases (3.6%), Gram positive bacilli 1 cases (1.8%), Gram negativebacilli 2 cases (3.6%), mixed form 15 cases(27.2%) were presented. 5) Bacterial culture of bronchoscopic aspiration material; No growth 28 cases (50.9%) were most common finding. In the bacterial growth, alpha hemolytic streptococci 10 cases (18.2%), Neisseria group 7cases(12.7%), Klebsiella 2 cases (3.6%), Pseudomonas 2 cases (3.6%), mixed culture 6 cases (10.9%) were presented, 6) The diagnosis of bronchoscopic appearance, laboratory exam., and pathologic exam. of biopsed specimen were 21 cases (38.1%) primary carcinoma of bronchus, 8 cases (14.5%) pulmonary tuberculosis, 7 cases (12.7%) bronchitis in orders.
Kim, Tae-Nyeun;Lee, Young-Hyun;Chung, Jae-Chun;Kim, Chong-Suhl
Journal of Yeungnam Medical Science
/
v.3
no.1
/
pp.87-94
/
1986
Empyema thoracis following pneumonia, intra-abdominal pathology, trauma, and surgical procedure continues to be a source of major morbidity and mortality. Thirty seven adult and eleven pediatric patients with empyema thoracis were treated at the University of Yeungnam Medical Center from May 1983 to November 1986. Age distribution ranged from 6 months to 72 years and showed a double-peaked curve with the highest incidence between 36 and 65 years and below 15 years of age. There were male predominence in patients above 16 years of age. The most common predisposing factors was impaired consciousness due to either alcoholism or head injury. The causes of empyema were as follows: pneumonia 64.6%, lung abscess 6.4%, intraabdominal pathology 6.4%, and surgical procedure 6.4%. The cardinal symptoms were fever, cough, chest pain, dyspnea, sputum, weight loss, anorexia, and night sweat in orders. Culture of empyema fluid were positive in 50% of patients. The isolated organisms were Gram-negative bacilli 33.3%, staphylococcus aureus 25%, and streptococcus 25%. The patients received antibiotics in conjunction with various invasive procedures : chest tube drainage 77.1%, decortication 6.3%, and repeated thoracentesis 10.3%. There were 4 deaths, 1 child and 3 adults, with a overall mortality of 8.3%.
We report the case of a girl with peritoneal tuberculosis (Tb) who presented with mimicking features of ovarian cancer including massive ascites, elevation of CA-125 and ovarian masses. These ovarian masses cannot be ruled out malingnacy with image study. Gram stain, acid-fast stain, bacteriological and mycological culture of centrifuged ascites cells were negative. Tumor markers revealed an elevated CA-125 level of 112 U/mL and adenosine deaminase level were significantly high with 118 U/L. Diagnostic laparoscopy was done. The histology of the peritoneum and the ovary showed multiple granulomatous nodules with epithelioid cells and multi-nucleated giant cells. And there were no evidence of malignancy. Furthermore acid-fast bacilli (AFB) was identified in this specimen. Peritoneal Tb was difficult to diagnosis in our patient because it mimicked ovarian cancer. And this is the first case of abdominal Tb mimicking ovarian cancer in children in Korea.
Kim, Shin Moo;Song, Kye Min;Kim, Seung A;Choi, Su Youn;Im, Hyo Bin;Seong, Chi Nam
Korean Journal of Clinical Laboratory Science
/
v.36
no.2
/
pp.69-75
/
2004
Vibrio vulnificus is a halophilic bacterium frequently involved in human infection of seafood-associated primary septicemia and primary wound infection, mostly in men with over 40-years of age with underlying liver disease. The primary septicemia, which is the most common form of V. vulnificus infection in Korea, is defined as a systemic illness presenting fever or hypotension with recovery of V. vulnificus from blood or tissue without the apparent primary focus of infection. V. vulnificus typically do not produce acid from sucrose, but a case of primary septisemia was found in a patient at Chonnam K hospital in 1993 from whose blood a sucrose-fermenting strain was isolated. The patient was a 62-year-old man, heavy drinker, with underlying liver disease. He consumed a raw seafood dish two days before onset of the present illness. His symptoms were tenderness and swelling on the right foot. He rapidly developed septicemia, resulting in sudden death. V. vulnificus was isolated from the venous blood culture of the patient. On subculture, the isolate formed yellow colonies on TCBS and produced acid from sucrose. Because of these characteristics, species identification was not achieved by the API 20E and was delayed. Other characteristics of the isolate were identical to those of typical V. vulnificus. The isolate was common serotype O4A and possession of V. vulnificus-specific cytolysin gene was detected by PCR. The isolate was susceptible to all the antimicrobial agents tested including tetracycline, but was intermediate to colistin. In conclusion, it is important that microbiologists be aware of the presence of sucrose-positive V. vulnificus when he or she identifies gram-negative bacilli, which is isolated from the blood of patients with a recent history of raw seafood dish consumption.
Proceedings of the Korean Society for Applied Microbiology Conference
/
2000.04a
/
pp.3-6
/
2000
Antimicrobial resistance has been a well-recognized problem ever since the introduction of penicillin into clinical use. History of antimicrobial development can be categorized based on the major antibiotics that had been developed against emerging resistant $pathogens^1$. In the first period from 1940 to 1960, penicillin was a dominating antibiotic called as a "magic bullet", although S.aureus armed with penicillinase led antimicrobial era to the second period in 1960s and 1970s. The second stage was characterized by broad-spectrum penicillins and early generation cephalosporins. During this period, nosocomial infections due to gram-negative bacilli became more prevalent, while those caused by S.aureus declined. A variety of new antimicrobial agents with distinct mechanism of action including new generation cephalosporins, monobactams, carbapenems, ${\beta}$-lactamase inhibitors, and quinolones characterized the third period from 1980s to 1990s. However, extensive use of wide variety of antibiotics in the community and hospitals has fueled the crisis in emerging antimicrobial resistance. Newly appeared drug-resistant Streptococcus pneumoniae (DRSP), vancomycin-resistant enterococci (VRE), extended-spectrum ${\beta}$-lactamase-producing Klebsiella, and VRSA have posed a serious threat in many parts of the world. Given the recent epidemiology of antimicrobial resistance and its clinical impact, there is no greater challenge related to emerging infections than the emergence of antibiotic resistance. Problems of antimicrobial resistance can be amplified by the fact that resistant clones or genes can spread within or between the species as well as to geographically distant areas which leads to a global concern$^2$. Antimicrobial resistance is primarily generated and promoted by increased use of antimicrobial agents. Unfortunately, as many as 50 % of prescriptions for antibiotics are reported to be inappropriate$^3$. Injudicious use of antibiotics even for viral upper respiratory infections is a universal phenomenon in every part of the world. The use of large quantities of antibiotics in the animal health industry and farming is another major factor contributing to selection of antibiotic resistance. In addition to these background factors, the tremendous increase in the immunocompromised hosts, popular use of invasive medical interventions, and increase in travel and mixing of human populations are contributing to the resurgence and spread of antimicrobial resistance$^4$. Antimicrobial resistance has critical impact on modem medicine both in clinical and economic aspect. Patients with previously treatable infections may have fatal outcome due to therapeutic failure that is unusual event no more. The potential economic impact of antimicrobial resistance is actually uncountable. With the increase in the problems of resistant organisms in the 21st century, however, additional health care costs for this problem must be enormously increasing.
Kim, Beom-Kyu;Jeon, Beong-Sam;Cha, Jae-Young;Park, Jeong-Won;Kim, Sam-Woong;Kim, Ji-Yoon;Park, Yong-Lark;Cho, Young-Su;Song, Jae-Young
Journal of Life Science
/
v.13
no.6
/
pp.871-878
/
2003
A marine bacterium (strain BKl) that produces extracellular enzymes capable of decomposing complex polysac-charides, such as agar, chitin, carboxymethylcellulose, xylan and mannan, was isolated from the marine red alga Porphyra dentata. Strain BKl was gram-negative, aerobic, catalase- and oxidase-positive, polarly flagellated bacilli that produce gelatinase and urease, but not decarboxylases. The G+C content of the DNA was 51.6 mol%. The major isoprenoid quinone component was identified as an ubiquinone-8, and the major cellular fatty acids were C16:0, C16:1 w6c and C18:1 w7c. Comparative 16S rRNA sequence analysis placed strain BK1 with members of the genus Pseudomonas. On the basis of phenotypic and genotypic data, the strain BK1 was shown to be a member of the subgroup of Pseudomonas, and named as Pseudomonas sp. BK1.
Kim, Kyung-Ah;Shin, Son-Moon;Moon, Han-Ku;Park, Young-Hoon
Journal of Yeungnam Medical Science
/
v.16
no.1
/
pp.60-68
/
1999
A nationwide survey was conducted to investigate the annual occurrence rate of neonatal sepsis, maternal risk factors in neonatal sepsis, localized infection in neonates, causative organisms in nosocomial infection and the most common causative organism for neonatal sepsis in Korea. Clinical and bacteriological data wele collected from 37 neonatal units to perform retrospective review of the medical records of the newborn infants who were confirmed as having neonatal sepsis and whose blood culture was collected to isolate organisms for one year study period from January to December in 1997. 78,463 neonates were born at 37 hospital in 1997, and 20,869 neonates were admitted to the neonatal units, During this period, 772 episodes of neonatal sepsis were recorded in 517 neonates. The occurrence rate of neonatal sepsis was 0.73%(0~2.95%). Male to female ratio was 1.15:1, and 303 cases(42.1%) were born prematurely. The main pathogens of early onset of sepsis were S. aureus(20%), S. epidermidis(14.4%) and coagulase negative staphylococcus(14. 4%). Gram negative bacilli including Enterobacter spp (7.2%), E. coli(5.1%), Klepstella(4.5%), Pseudomonas(3.7%) and Enterobacter faectum(3.6%) accounted for 24.1% of sepsis. Group B beta-hemolytic streptococcus were isolated only in two cases. Common obstetric factors were PROM(21.1%), difficulty delivery(18.7%), fetal tachycardia(5.3%), chorioamnionitis(4.9%), and maternal fever(4.7%). The main pathogens of late-onset sepsis were S. aureus(22.3%), S. epidermidis(20.4%) and CONS(9.9%). There were 6 cases(1.0%) of Candida sepsis, Frequent focal infections accompanying sepsis were pneumonia(26.1%), urinary tract infection(10.5%), meningitis(8.2%), and arthritis(3.6%), S. epidermidis(22.0%) and s. aureus(21.7%) were also the most common pathogens in 373 nosocomial infection.
Lee Jung-Won;Shin Jee-Sun;Seo Jeong-Wan;Lee Mi-Ae;Lee Seung-Joo
Childhood Kidney Diseases
/
v.8
no.2
/
pp.214-222
/
2004
Purpose: Appropriate antibiotic therapy is important in childhood urinary tract infection and the selection of anibiotics is based on antimicrobial sensitivity of Escherichia coli. Extended-Spectrum ${\beta}-Lactamase(ESBL)$ is an enzyme produced by gram-negative bacilli that has the ability to hydrolyse penicillins, broad-spectrum cephalosporin and monobactam. There have been many reports of outbreaks of hospital infection by ESBL-producing organism. However, community-acquired infection with ESBL-producing organism are rare. This study was performed to retrospectively identify the incidence, characteristics and risk factors of ESBL (+) E. coli in community-acquired childhood UTI. Methods: In 288 children admitted in Ewha Womans University Hospital with E. coli UTI from Mar 2001 to February 2003, ESBL was isolated. ESBL was confirmed by the utilization of an automatized machine(Vitek GNS 433 card) using liquid medium dilution method according to National Committee for Clinical Laboratory Standard. The clinical characteristics, risk factors, antimicrobial resistance and treatment effectiveness were compared with ESBL(-) E. coli UTI. Results: Of 288 E. coli isolates, 31(10.8%) produced ESBL and 93.5%(29/31) occurred in infants younger than 6 month of age(P<0.01). No significant differences were noted in prior antibiotic use, prior admission history and underlying urogenital anomaly. Antimicrobial resistance was significantly higher in ESBL(+) E. coli compared with control patients (P<0.05). Although ceftriaxone showed 100% resistance in ESBL(+) E. coli, bacteriologic sterilization rate after ceftriaxone therapy was higher(96.8%). However, the recurrence rate of febrile UTI within 6 months was higher(25.8%) than control patients(6.6%). Conclusion: Epidemiologic study is required to find out any new risk factors of community-acquired ESBL(+) E. coli UTI and changes in selection of empirical antibiotics should be considered.
The purpose of this study was to investigate the distribution of microorganisms and the degree of contamination in the air of the dental clinics and to offer basic data as to the contamination of medical equipment and the prevention of the clinics. With this in mind, the researcher gathered air samples from the waiting rooms and medical offices of nine dental clinics in the city of J, South Korea with the use of a method of natural inattention and an air sampler and cultivated the samples on the plain table and drew from it bacteria falling and separated and sorted out the colony with the help of ATB and detected the distribution of the germs. The results are following, The number of bacteria falling in the air of the dental clinics was less than 10(CFU/Plate) with the exception of one dental clinic. This implies that they fit in with standards for hygiene. The number of bacteria falling in the air of the medical offices was less than 10(CFU/Plate) with the exception of one dental clinic. This implies that they fit in with standards for hygiene. The survey on the detection of staph. aureus reveals that all the dental clinics with the exception of B dental clinic proving to be positive had non-pathogenic staphylococci detected. The survey on the detection of pathogenic gram negative bacilli indicates that all the dental clinics but one were none detected. The survey on the distribution of germs shows that germs in 7 out of 9 dental clinics were none detected, and that they in four out of 9 waiting rooms were none detected. All the germs detected in the others were mostly non-pathogenic. The study shows that all the subject dental clinics but one were hygienically controlled and that there was a difference in accordance with cleaning and sterilization. This means that dental clinics should be equipped with systematic programs for cleaning and sterilization designed to prevent infection.
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