• Maxillofacial Plastic and Reconstructive Surgery
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• 제22권3호
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• pp.330-336
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• 2000

A large number of streptococci that do not fit readily into any of the established classification schemes have been relegated to a large heterogeneous group called the Streptococcus viridans, which are members of the normal flora of the mucous membranes of the body, including the oral cavity, the nasopharynx, and genitourinary tract. This group includes S. mitis, S. oralis, S. sanguis, S. salivarius, S. milleri, etc. Surveying on the literature, it has been reported that infective endocarditis, meningitis, rhabdomyolysis, cholangitis, appendicitis caused by Streptococcus viridans, which were the most important pathogen in children with malignant hematologic disease. Various antibiotics has been chosen for treatment or prophylaxis for these infections, but were generally lower antimicrobial susceptibilities because of an abuse of antibiotics and advent of resistant group. Therefore, surveillant culture must be performed to evaluate personal antimicrobial susceptibilities of intraoral microbes for proper antimicrobial choice for dental procedures. This study examined sampling from subgingival plaque of 60 chidren's microbes. The cultured bacterial isolates, Streptococcus viridans were examined 10 antimicrobial drugs with the Kirby-Bauer agar disk diffusion method. The used drugs were Penicillin, Ampicillin, Oxacillin, Cephalothin, Imipenem, Gentamicin, Erythromycin, Vancomycin, Ciprofloxacin, Clindamycin. The results were as follows : 1. Sampling Streptococcus viridans were S. mitis(65%), S. oralis(22%), S. sanguis(5%), S. intermedius(3%), S. salivarius(2%), S acidominimus(2%), Unidentified streptococcus(2%). 2. The antimicrobial susceptibility of total Streptococcus viridans : Oxacillin< Erythromycin< Pencillin=Ciprofloxacin< Cephalothin< Ampicillin< Clindamycin< Gentamicin< Imipenem=Vancomycin. 3. The antimicrobial susceptibility of S. mitis : Oxacillin=Erythromycin< Ciprofloxacin< Cephalothin< Penicillin=Ampicillin< Gentamicin< Clidamycin< Imipenem=Vancomycin. 4. The antimicrobial susceptibility of S. oralis : Oxacillin< Erythromycin< Penicillin=Ciprofloxacin=Clindamycin< Cephalothin=Gentamicin< Ampicillin< Imipenem=Vancomycin. 5. There was no significant difference in the antimicrobial susceptibility among each Streptococcus viridans group.

• Clinical and Experimental Pediatrics
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• 제56권8호
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• pp.332-337
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• 2013

Purpose: To identify the frequency of bacterial isolates in early-onset neonatal sepsis (EONS) and their antimicrobial resistance pattern. Methods: A retrospective study of EONS was conducted at the Beni Suef University Hospital from September 2008 to September 2012. A case of EONS was defined as an infant who had clinical signs of infection or who was born to a mother with risk factors for infection, and in whom blood culture obtained within 72 hours of life grew a bacterial pathogen. Results: Of 673 neonates screened, there were 138 positive blood cultures (20.5%) (confirmed EONS). Of the recovered isolates, 86.2% were gram-negative pathogens. Klebsiella pneumoniae (42.8%), Enterobacter cloacae (22.5%), and Escherichia coli (13.8%) were the commonest isolated organisms. The most common gram-positive microorganism was Staphylococcus aureus accounting for only 12 isolates (8.7%). All Klebsiella isolates and 93% of Enterobacter isolates were resistant to ampicillin. Gram-negative pathogens had the maximum overall sensitivity to imipenem, cefepime, and ciprofloxacin; whereas, gram-positive isolates were most susceptible to vancomycin, imipenem, and piperacillin. Conclusion: K. pneumoniae was the predominant causative bacteria of EONS followed by E. cloacae and E. coli. There was a high resistance to ampicillin. Imipenem had the maximum overall activity against the causative bacteria. Continuous surveillance is needed to monitor the changing epidemiology of pathogens and antibiotic sensitivity.

• Journal of Microbiology and Biotechnology
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• 제16권1호
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• pp.158-162
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• 2006

Cyclic dipeptides isolated from Streptomyces sp. have been shown to have antimicrobial activity as well as other potentially useful biological activities. The purpose of this study was to compare the in vitro activity of two cyclic dipeptides combined against anaerobic bacteria with the activity of other antimicrobial agents. Specifically, the in vitro activity of the combination of two cyclic dipeptides was investigated against 140 clinical isolates of anaerobic bacteria by the agar dilution method and was compared with that of erythromycin, cefoxitin, imipenem, clindamycin, and metronidazole. The cyclic dipeptide combination and imipenem were the most active antimicrobial agents tested. In addition, the cyclic dipeptide combination had a radioprotective effect on five normal human lung fibroblast cells, showing survival rates higher $(>90\%)$ than either of the two cyclic dipeptides alone $(<80\%)$.

• 대한간호학회지
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• 제36권7호
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• pp.1204-1214
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• 2006

Purpose: This retrospective study was done to evaluate the status of nosocomial urinary tract infections and to determine the risk factors and transmission route of causal IRPA through molecular epidemiology. Method: Two hundred ninety-nine of 423 patients admitted to the internal medicine and surgery ICU at a university hospital incity B had a positiveurine culture. Twelve of the 299 patients who had a urinary tract infection had IRPA strains. The data was collected from November 1, 2004 to January 31, 2005. The following results were obtained after the data was analyzed using percentile and UPGMA. Result: The rate of nosocomial urinary tract infections in the ICU was 10.8%. Therewere 16.8 cases of infection based on the period of hospitalization. There were 16.9 cases of infection based on the use of a foley catheter. The rate of nosocomial urinary tract infection in the ICU and urinary tract infections related to IRPA were higher in patients with the following characteristics: men, old age, admission through the emergency room, longer than seven days admission, severity of admitting causes, disturbance of consciousness, hydration less than 300cc in 24hours, a long course of antibiotics, a long period of foley catheterization and perineal care. Most of the microorganisms that caused the urinary tract infection were gram negative bacilli, among which P. aeruginosa was found in 70 patients (18.5%) and IRPA in 12 (4.0%). Among the 12 IRPA strains that were tested with PFGE, eight showed a dice coefficient higher than 80%, suggesting a genetic relationship. They were related with the period of hospitalization in the same ICU. These patients all received direct care for a urinary tract infection. Conclusion: Through these results, IRPA can be consideredas a contributing factors to urinary tract infections thus, active preventative measures are needed by the medical staff.

• 한국임상약학회지
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• 제22권3호
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• pp.234-238
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• 2012

Background: Valproic acid is widely used in the treatment of generalized tonic-clonic and partial seizures. The carbapenem class is the most potent and widest spectrum of antimicrobial activity. Concomitant administration of carbapenems and valproic acid has been reported to decrease the serum concentration of valproic acid, which is sometimes associated with seizures. The purpose of this study is to evaluate the changes in valproic acid concentration and half life and the frequency of seizure during concomitant administration of valproic acid and carbapenems. Method: This study was performed retrospectively on total 40 cases with identified valproic acid concentration during concomitant administration of valproic acid and carbapenems at Kangbuk Samsung Hospital from February 1st, 2006 to October 31st, 2011. Patients were classified into 3 groups: ertapenem group (n=14), imipenem group (n=12), meropenem group (n=14). Results: The mean serum concentrations in each group during combined treatment were $9.50{\pm}8.84$, $21.88{\pm}8.17$ and $10.62{\pm}8.67$ mg/L, respectively (p < 0.001). The mean half-lives in each group during concurrent use of valproic acid and carbapenems were $3.18{\pm}0.81$, $4.63{\pm}1.97$ and $2.67{\pm}1.69$ hr, respectively (p < 0.001). The valproic acid serum concentration decreased by 75.5%, 54.1% and 84.1% and the half-life of valporoic acid decreased by 65.6%, 35.7% and 73.5%, respectively. Total cases with seizure were 12(30%) with 5(35.7%) in the ertapenem group, 3 (25.0%) in the imipenem group and 4(28.6%) in the meropenem group (p=0.911). There were no specific factors to influence on seizure development during combined treatment. Conclusion: Concurrent use of carbapenems and valproic acid should be avoided. If concomitant administration is essential, very close serum concentration monitoring and clinical observation are necessary.

• 대한의생명과학회지
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• 제17권2호
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• pp.135-140
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• 2011

We compared three EDTA-based phenotypic screening methods for detecting IMP-1 and VIM-2 type metallo-${\beta}$- lactamase (MBL)-producing isolates of Acinetobacter and Pseudomonas spp., EDTA-double disk synergy test (EDTADDST), Etest MBL, and imipenem (IPM)-EDTA disk test. A total of 183 isolates (65 Acinetobacter spp. and 118 Pseudomonas spp. showing IPM resistance), confirmed to MBL genes by PCR, were used. The criteria for MBL production were (i) presence of a synergistic zone between IPM and EDTA disks in EDTA-DDST, (ii) reduction of IPM minimal inhibitory concentration by ${\geq}$ 3 twofold dilutions in the presence of EDTA in the Etest MBL, and (iii) ${\geq}$ 7 mm increase in the inhibition zone around the IPM plus EDTA disks compared with a sole IPM disk in the IPM-EDTA disk test. In this study using 87 MBL-producing and 96 MBL-nonproducing isolates, the sensitivities/specificities of EDTA-DDST, Etest MBL and IPM-EDTA disk tests were 94.3/78.1%, 89.7/91.7%, and 97.7/95.8%, respectively. When the threshold for the increase of the inhibition zone around the IPM plus EDTA disk over a sole IPM disk was altered to ${\geq}$ 5 mm and ${\geq}$ 8 mm for Acinetobacter spp. and Pseudomonas spp., respectively, the sensitivity and specificity of the test were 98.9% and 96.9%, respectively. Of the three EDTA-based phenotypic tests, the IMP-EDTA disk test was superior for detection of MBL-producing isolates.

• 생명과학회지
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• 제8권6호
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• pp.711-722
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• 1998

본 연구는 혈액에서 분리되는 세균의 항균제 감수성 양상을 파악하기 위하여 1993년 10월 1일부터 1996년 9월 30일 사이에 K대학 부속병원의 입원 및 외래환자 13,595명을 대상으로 혈액배양에서 분리된 1,104균주중 716균주를 세균의 균종별, 연령별, 계절별 분리빈도와 항균제 감수성 검사를 실시하여 다음과 같은 결과를 얻었다. 1. 최근 3년간 균분리 양성은 1,104명으로 8.1%의 양성률을 보였다. 연구대상 716균주의 균종별 분리빈도는 E. coli가 29.8% (213주)로 분리율이 가장 높았다. 2. 대부분의 균종은 50세, 60세군 및 2세 이하군에서 분리율이 높았고, S. typhi는 30세군에서 분리율이 높았다. 3. 계절별 분리율은 대부분의 균종이 여름철에 분리율이 높았고, E. coli는 계절에 관계없이 분리되었다. 4. 항균제 감수성은 그람양성 구균의 경우 penicillin계 항균제인penicillin-G에 E. faecalis를 제외한 균에서 높은 내성률을 보였으며, vancomycin과 teicoplanin에는 감수성이 높았다. 그람음성 간균은 amikacin, ciprofloxacin, 및 imipenem에는 감수성이 높았고, ampicillin에는 내성을 보였다. S. typhi는 cephalothin을 제외한 모든 항균제에 100%의 감수성이었다. 이상의 결과에서 균혈증 환자로부터 분리된 세균에는 penicillin계 항균제에 내성인 균주가 많으며 glycopeptide계 항균제와 amikacin, ciprofloxacin 및 imipenem에는 아직 내성이 낮다는 결론을 얻었다.

• Journal of Korean Biological Nursing Science
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• 제3권2호
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• pp.1-20
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• 2001

본 연구는 기관절개술을 받은 환자의 기관절개부위에서 발견되는 포도상구균에 대해 povidon의 살균효과와 소독제 사용 횟수, 경과일수에 따른 변화를 관찰하는 것을 목표로 하고 있다. 연구대상은 2001년 1월 16일부터 2001년 2월 26일까지 D시내에 소재한 2개 종합병원의 신경외과 중환자실에 입원한 35명의 기관절개환자였으며, 수집된 자료는 SAS를 이용하여 백분율, t-test로 분석하였다. 연구결과는 다음과 같다. 포도상구균에 대한 povidone의 살균효과는 농도와 시간에 관계없이 강하게 나타났다. 1일 1회 소독 후 3일째부터 Staphylococcus aureus균이 검출되었고, 6일째에 가장 많이 검출되었다. Coagulase negative Staphylococcus균은 1일부터 3일까지는 거의 검출되지 않았으나, 4일째에 가장 많이 검출되었다. 소독횟수에 따른 균집락화 양상은 1일 1회 소독할 때보다 2회 소독시 황색포도상구균이 현저히 감소하였다. 항생제에 대한 Staphylococcus aureus와 Coagulase negative Staphylococcus의 내성검사를 한결과 Staphylococcus aureus는 Methicillin에서 72.7%, Imipenem에서 63.6%가 내성을 나타냈으며, Coagulase negative Staphylococcus는 Methicillin에서 37.5%, Imipenem에서 12.5%가 내성을 나타내었고, Vancomycin에는 모두 내성을 나타내지 않았다. 이상의 본 연구결과로써 기관절개환자의 절개부위에 대한 철저한 소독을 통해 병원감염을 예방할 수 있는 기초자료가 될 수 있는 것으로 사료되며, 다음과 같은 제언을 하고자 한다. 앞으로 더 많은 소독제와 다양한 균종과의 관계에 대한 연구가 시행되어야 할 것이며, 모든 의료인은 철저한 병원감염예방에 힘써야 할 것이다. 또한, 병원감염 예방과 간호 발전을 위한 소독전문인력을 양성하여 활성화시키는 것이 필요할 것으로 사료된다.

• 미생물학회지
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• 제46권3호
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• pp.303-307
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• 2010

임상분리 균주인 A. baumannii 1625는 imipenem (carbapenem 계열)을 포함한 대부분의 ${\beta}$-lactam계열의 항생제들과 kanamycin, gentamicin, tobramycin 및 제 3세대와 4세대 cephalosporin 계열의 항생제들에 광범위한 내성을 나타내었고, 한국에서는 드문 IMP-1형 metallo-${\beta}$-lactamase (MBL)를 생성하는 균주임이 확인되었다. A. baumannii 1625는 약 2.5 kb 크기의 class 1 integron을 갖고 있었으며, 이 integron내에 aminoglycoside계열 내성 유전자인 accA4, carbapenem 계열 내성 유전자인 $bla_{IMP-1}$, 광범위한 ${\beta}$-lactam 내성 유전자인 $bla_{OXA-2}$ 유전자 cassette들이 차례대로 위치해 있음을 확인하였는데, 이것은 IMP-1형과 OXA-2형 ${\beta}$-lactamase의 유전자를 같은 integron내에 동시에 갖는 새로운 배열 및 구조로서 이전에 국내에서 보고된 바 없는 것이다. 이 2.5 kb 크기의 integron을 항생제 내성이 없는 E. coli에 형질전환 시켰을 때, imipenem, ampicillin, piperacillin, cefazolin, cefoperazone, aztreonam 등의 항생제들에 대하여 8배 이상 증가된 내성정도를 보였다. 이는 A. baumannii 1625의 integron이 다제내성을 부여하는 기능을 하고 있음을 보여준다.

• 미생물학회지
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• 제44권4호
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• pp.339-345
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• 2008

국내 대학병원에서 분리되어 imipenem 에 대한 최소억제농도가 $8{\mu}g/ml$ 이상인 51개의 포도당비발효 그람음성 간균들 중 metallo-${\beta}$-lactamase (MBL)을 생성하는 균주들을 분리하고, 그들 중에서 내성이 강한 Pseudomonas aeruginosa에 대한 항균제 병합요법의 효과를 알아보기 위하여 상승효과를 보이는 항균제 조합을 찾아보았다. 9개의 균주(Pseudomonas aeruginosa 2주 및 Achromobacter xylosoxidans subsp. xylosoxidans 7주)가 MBL 양성을 나타냈으며, PCR 결과 9주 모두에서 $bla_{VIM-2}$ 유전자가 관찰되었다. 이들 중에서 P. aeruginosa DK569는 aztreonam (MIC; $8{\mu}g/ml$)을 제외하고 실험한 모든 ${\beta}$-lactam 항균제, aminoglycoside, ciprofloxacin에 내성을 보여 aztreonam 함유 배지를 이용하여 상승효과률 보이는 항균제를 찾고자 하였다. One disk synergy test 에서 선별된 항균제 조합을 이용하여 생존률 검사 실험을 한 결과, aztreonam (AZT)와 piperacillin-tazobactam (TZP)의 병합은 항균제 노출 6시간 후에 AZT 또는 TZP의 단독 항균제 노출시 보다 균수가 1/18.7로 감소하였다. 그리고 AZT와 amikacin (AN)의 병합에서도 항균제 노출 6 시간 후에 AZT 또는 AN의 단독항균제의 투여보다 균수가 1/17.1 로 감소하였다. 결국 위 두 조합은 의미있는 상승효과를 보이지 못하여 위 세 항균제를 조합하여 실험하였다. 위의 세 항균제를 병합하였을 때 항균제 노출 8시간 후에 AZT, TZP 및 AN의 단독 투여에 비하여 병합요법에 의해 균수가 1/183.3 로 감소하여 의미있는 상승효과를 보였다. 이 결과는 치료가 쉽지 앓은 MBL 생성균에 의한 감염에 대한 치료에 AZT, TZP 및 AN의 세 가지 항균제 병합요법이 유용할 것이라는 것을 의미한다.