• Pediatric Infection and Vaccine
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• 제16권1호
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• pp.6-12
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• 2009

There are relatively few novel antimicrobial agents despite the dramatic increase in antimicrobial resistance and multiple drug resistance of clinical isolates worldwide. Vancomycin is still the most widely used antibiotic for treating resistant Gram-positive coccal infections in children, especially for methicillin-resistant Staphylococcus aureus. For children with Gram-positive coccal infections where vancomycin is not effective or older therapeutic agents cannot be tolerated, linezolid, quinupristin-dalfopristin or daptomycin may be useful in the appropriate clinical setting. For Gram-negative bacterial infections, new carbapenems await clinical application. Tebipenem pivoxil is a novel oral carbapenem undergoing clinical trials for acute otitis media in pediatric patients. Antiviral drug development is now progressing at the pace of antibiotic development 30 years ago. Newer antiviral agents used for the treatment of herpes viruses and hepatitis C virus infections in children are included in this review.

• 한국임상수의학회지
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• 제14권2호
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• pp.215-222
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• 1997

Enrofloxacin-colistin combination, widely used in Gram negative infections in veterinary sector, was investigated in terms of MIC and initial killing rate using E coli k 88ab, Salmonella typhimurium, Pasteurella multocida type A, Bordetella bronchiseptica and Staphylococcus aureus as test organisms. On the basis of MICs of enrofloxacin-colistin combination against the above bacteria, killing rates of the combination of enrofloxacin and colistin at the ratio of 5:0, 4:1, 3:2, 1:1, 2:3, 1:4 and 0:5, indicated high and rapid antibacterial acitivities against all but Staphylococcus aureus R-209, with the number of bacteria reducing to less than one percent within two hours. At the MIC of enrofloxacin or colistin, both antibacterials showed the highest killing rates during 2-4 hours against Gram negatives such as E coli K88ab,Pasteurella multocida type A and Bodetella bronchiseptica but allowed the regrowth of the same pathogens thereafter. On the while, the combination of two antibacterials at a fourth MIC resulted in high killing rate without bacterial regrowth during 24 hours, suggesting the synergistic antivacterial effects. The combination, however, did not show favourable activity against Gram negatime S typhimurium and Gram positive S aureus ergistic antibacterial activity against Gram negatime pathogens but also colistin showed LPS-neutraization, we could suggest the combination should provide clinically positive therapeutic armarium in Gram negative infections.

• 한국의료질향상학회지
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• 제3권2호
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• pp.26-35
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• 1997

Background : Glycopeptide antibiotics are the only drugs for treatment of infections due to beta-lactam-resistant Gram-positive bacteria. As the incidence of infection and colonization with vancomycin-resistant enterococci(VRE) rapidly increases, the hospital infection control practices advisory committee(HICPAC) recommends prudent vancomycin use to detect, prevent and control infection and colonization with VRE. Methods : The inpatients admitted from September to December, 1996 in Pusan National University Hospital, with Gram-positive bacterial infections were evaluated retrospectively to see whether the administrations of glycopeptide antibiotics were appropriate or not, upon comparison with the recommendations for preventing the spread of vancomycin resistance by HICPAC. Results : Teicoplanin has been chosen more frequently than vancomycin of the glycopeptide antibiotics. The indications of administration of glycopeptides in patients with pneumonia, wound infections, sepsis, and in febrile or neutropenic patients with malignancies were appropriate, but the use of glycopeptides for elimination of merely colonized bacteria in the oral cavity could not be excluded. Inappropriate use of glycopeptides was 10.6%, and inappropriately long-term use without positive culture for beta-lactam-resistant Gram-positive organisms was about 40% of total days of drug use. Conclusion : It seems essential for the quality assurance committee to make a plan in teaching the HICPAC recommendations to the medical practitioners who prescribed the glycopeptides inappropriately or used for irrelevantly long to his patient, monitor and survey their use of glycopeptides prospectively and periodically, and if there are repeated inappropriate prescriptions, a certain penalty would be given to the practitioners.

• Asian Pacific Journal of Cancer Prevention
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• 제16권14호
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• pp.5691-5695
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• 2015

Background: Continuous surveillance of pattern of blood stream infection is necessary in febrile neutropenia (FN)especially with the recent escalating trend in the management of pediatric cancer patients towards intensified regimens and with the increase in infections caused by resistant organisms limiting the choice of antibiotics. Aim: To monitor change in pattern of blood stream infections (BSI) in FN pediatric cancer patients. Materials and Methods: Surveillance of FN episodes with positive BSI was prospectively monitored and compared to a previous surveillance in the same pediatric oncology unit. Results: A total of 232 BSI positive episodes were documented in 192 patients during a 6 months period. The results of recent surveillance analysis showed an increase in intensified regimens of chemotherapy, antimicrobial resistance, fungal infections, and prolonged duration of episodes when compared to previous surveillance, with p value sof <0.001, 0.005, 0.021, and <0.001, respectively. There was an apparent decrease in the crude mortality but this was not statistically significant, to 6% in 2011 from 10 % in 2006. Conclusions: The pattern of BSI at our institution is still inclining towards gram positive organisms but is showing a shift towards more antibiotic resistance and fungal infections.

• 한국응용약물학회:학술대회논문집
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• 한국응용약물학회 1997년도 춘계학술대회
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• pp.12-12
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• 1997

CFC-222 is a novel fluoroqinolone antibacterial agent synthesized and under development by the Cheil Jedang Corporation, Korea. CFC-222 exerts the antibacterial activity by inhibition of bacterial DNA gyrase leading to bactericidal action. In in vitro and in vivo preclinical testing, CFC-222 has been shown to possess a broad spectrum of antibacterial activity. In particular CFC-222 is very potent against Gram-positive bacteria such as Staphylococcus spp., Streptocuccus spp. (in particular penicillin G-resistant and -susceptible S. pneumoniae) and Enterococcus spp. when compared to other quinolones (ciprofloxacin, ofloxacin or lomefloxacin). CFC-222 also showed potent activity against the methicillin resistant clinical isolates of S. aureus (MRSA). Against Gram-negative bacteria (E. coli, Pseudomonas and Sarcina) the activity of CFC-222 was slightly weaker than that of ciprofloxacin, but was more potent than that of ofloxacin or lomefloxacin. In urinary systemic infections caused by both Gram-positive and -negative bacteria, CFC-222 demonstrated a potent therapeutic efficacy in particular against Cram-positive bacteria S. aureus, S. pyrogen 203 and S. pneumonia TypeIII.

• 청정기술
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• 제29권2호
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• pp.135-144
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• 2023

Pseudomonas aeruginosa와 Staphylococcus aureus는 만성 창상 감염의 원인이 되는 주요 병원체이며 상처부위에서 공존한다. 이러한 감염은 단일 감염에 비해 독성이 높아 환자에게 바람직하지 않은 결과를 초래한다. 복합미생물 감염내에서 미생물 간의 상호작용은 질병 진행을 악화시키는 것으로 알려져 있다. 호흡기, 상처, 당뇨병 발과 같은 질병 내 복합 미생물 감염은 다양한 미생물들을 포함하나, 녹농균과 황색포도상구균이 가장 일반적으로 확인된다. 본 연구는 그람음성균 P. aeruginosa와 그람양성균 S. aureus를 중심으로 독성화학물질의 농도구배에 따른 성장양상을 비교하고자 하였다. 세균 성장이 억제되는 농도를 의미하는 최소 억제 농도(MIC)는 특정화학물을 함유한 배지를 연속적으로 희석하여 성장 곡선을 평가하여 결정한다. 두 균주 모두 상기 방법을 통해 성장곡선을 확인하였고, 지수성장기를 적용하여 세균의 배가시간을 계산하였다. 각 독성 물질에 대한 MIC 결과로부터 그람양성균과 그람음성균 사이의 성장 속도 차이와 각 독성 물질에 대한 내성 차이를 식별하였다. 우리는 이 접근 방식이 세균 관련 감염의 혁신적인 치료법 개발에 대한 강력한 잠재력을 가지고 있다고 기대한다.

• Clinical and Experimental Pediatrics
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• 제54권9호
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• pp.363-367
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• 2011

Central venous catheters (CVCs) are regularly used in intensive care units, and catheter-related bloodstream infection (CRBSI) remains a leading cause of healthcare-associated infections, particularly in preterm infants. Increased survival rate of extremely-low-birth-weight infants can be partly attributed to routine practice of CVC placement. The most common types of CVCs used in neonatal intensive care units (NICUs) include umbilical venous catheters, peripherally inserted central catheters, and tunneled catheters. CRBSI is defined as a laboratory-confirmed bloodstream infection (BSI) with either a positive catheter tip culture or a positive blood culture drawn from the CVC. BSIs most frequently result from pathogens such as gram-positive cocci, coagulase-negative staphylococci, and sometimes gram-negative organisms. CRBSIs are usually associated with several risk factors, including prolonged catheter placement, femoral access, low birth weight, and young gestational age. Most NICUs have a strategy for catheter insertion and maintenance designed to decrease CRBSIs. Specific interventions slightly differ between NICUs, particularly with regard to the types of disinfectants used for hand hygiene and appropriate skin care for the infant. In conclusion, infection rates can be reduced by the application of strict protocols for the placement and maintenance of CVCs and the education of NICU physicians and nurses.

• Natural Product Sciences
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• 제23권4호
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• pp.286-290
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• 2017

Multidrug-resistant Acinetobacter baumannii and Pseudomonas aeruginosa are highly dangerous nosocomial pathogens, cause the symptoms of skin infections, pressure sores, sepsis, blood stream and wound infections. Unfortunately, these pathogens are immune to the most common antibiotics, such as, carbapenem, aminoglycoside and fluoroquinolone. Therefore, it is imperative that new and effective antibiotics be developed. In the present study, the antimicrobial effects of Aloe vera MAP (modified Aloe polysaccharide) on Staphylococcus aureus and Bacillus subtilis, Escherichia coli and Enterobacter aerogenes, and clinical Pseudomonas aeruginosa and clinical Acinetobacter baumannii were comprehensibly investigated. Prior to the growth inhibition effect measurement and antibiotic disc diffusion assay on gram-positive and gram-negative bacteria and selected multidrug-resistant Pseudomonas aeruginosa and Acinetobacter baumannii, antimicrobial resistance screening was performed for the multidrug-resistant bacteria obtained from clinical isolates. The results for showed the Aloe vera MAP had a concentration-dependent effect on all of examined bacteria, particularly on Pseudomonas aeruginosa. Anti-inflammatory and anti-oxidant experiments were also performed dose dependently effects to confirm the beneficial physiological effects of Aloe vera MAP.

• Clinical and Experimental Pediatrics
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• 제50권1호
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• pp.56-64
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• 2007

목 적 : 소아 종양 환자에서 발열이 있는 경우, 즉각적인 경험적 항생제 치료가 필요하기 때문에, 지역이나 병원 내에서 발생한 균혈증의 흔한 원인균과 항생제 감수성에 대한 최근 경향에 대한 정보가 필요하다. 본 연구에서는 4년간 소아 종양 환자에서 분리된 균혈증의 원인균 분포와 이들의 항생제 감수성에 대하여 분석하고자 하였다. 방 법 : 2002년 1월부터 2005년 12월까지 서울대학교 어린이병원 소아 종양 환자 128명 환아에서 발생한 197례의 균혈증과 이들에서 분리된 214균주에 대하여 분석하였다. 결 과 : 총 214균주 중 그람음성균이 64.0%, 그람양성균이 31.3%였으며 진균은 4.7%이었다. 균혈증을 일으킨 가장 흔한 균은 Klebsiella species(21%)와 E. coli(16.8%)였으며, CNS와 viridans streptococci도 7.9%와 7.5%로 분리율이 높았다. 호중구 감소증이 있는 환자군에서 그람음성균이 차지하는 비율이 감소증이 없는 환자군에 비해 높았고(67.5% vs. 51.1%, P=0.018), 균혈증 발생 당시 중심 정맥관을 가진 경우에 CNS(12.7% vs. 2.1%, P=0.004)와 viridans streptococci(11.0% vs. 3.1%, P=0.036)가 차지하는 비율이 더 높았다. 항생제 감수성 검사에서 그람양성균에서는 penicillin, oxacillin 및 vancomycin 내성률이 각각 83.3%, 48.5% 및 0.5%였으며, 그람음성균에서는 cefotaxime, piperacillin/tazobactam, imipenem, gentamicin 및 amikacin 내성률이 24.1%, 17.2%. 6.6%, 21.6% 및 14.2%이었다. 균혈증의 경과를 알 수 있었던 179례 중 42례(23.5%)가 중환자실 치료를 받았으며, 20례(11.2%)가 사망하였으며, 그람 음성균 감염의 경우 그람 양성균 감염에 비해 중환자실 치료율이 높았으며(26.5% vs. 10.3%, P=0.016), 중심 정맥관을 가진 경우에 중환자실 치료 빈도(34.4% vs. 10.8%, P<0.001)와 사망률(16.7 % vs. 4.8%, P=0.012)이 높았다. 결 론 : 최근 4년간 소아 종양 환자에서의 균혈증 분석 결과, 아직 그람음성균이 차지하는 빈도가 높으며 특히 호중구 감소증이 동반되었을 때 그람음성균에 대한 적절한 치료가 우선 시행되어야 하겠다. 하지만 그람양성균이 차지하는 비율이 증가하고 있는 것도 경험적 항생제 결정시 고려하여야 할 것으로 판단된다.

• 한국미생물·생명공학회지
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• 제50권1호
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• pp.147-156
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• 2022

Urinary tract infections (UTIs) are one of the most common infections in different age groups, including children. Bacteria are the main etiological agents of UTIs. The aim of the present study was to isolate, identify, and determine the antibiotic susceptibility of bacteria isolated from children with UTIs from Baghdad, Iraq. Three hundred and two urine samples were collected from children aged 6 months to 12 years. The samples were cultured on blood agar and MacConkey agar. The selected colonies were subjected to biochemical tests and antibiotic susceptibility analysis using the Vitek^® 2 Compact automated microbial identification system. In this sample, 299 bacteria were identified, of which, 267 were gram-negative bacteria, and 32 were gram-positive bacteria. Escherichia coli (56%) was the most commonly isolated gram-negative bacteria, followed by Pseudomonas aeruginosa (14%), Enterobacter spp. (10.48%), Klebsiella pneumoniae (9.36%), Proteus spp. (7.8%), Acinetobacter baumannii (1.5%), and Morganella morganii (0.37%). Enterococcus faecalis (62.5%) was the most commonly detected gram-positive bacteria, followed by Staphylococcus aureus (37.5%). E. coli and P. aeruginosa were the most antibiotic-resistant bacteria. Among the tested antibiotics, meropenem showed 100% sensitivity, followed by imipenem (97.4%), amikacin (91.8%), and tobramycin (83.5%). In contrast, the high frequencies of resistance were observed with cefixime (93.2%), cefotaxime (78.7%), and ceftriaxone/cefotaxime (71.2%). In conclusion, carbapenems and aminoglycosides are highly recommended for the empirical treatment of UTIs, while, Quinolones, penicillins, and cephalosporins are not suggested. Frequent antibiotics susceptibility testing are warranted to determine the resistance pattern of UTI bacteria.