• 제목/요약/키워드: Klebsiella pneumonia

검색결과 92건 처리시간 0.025초

세균성 폐렴의 원인균과 그 치료 (Etiologies of Bacterial Pneumonia with Implications for Therapy)

  • 우준희;이재석;권강호;김경호;최창현;박춘식;이위교;최태윤
    • Tuberculosis and Respiratory Diseases
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    • 제42권1호
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    • pp.67-75
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    • 1995
  • 연구배경: 최근 세균성 폐렴을 일으키는 원인균주의 변화양상, 폐렴의 임상상, 균주에 따른 항생제의 감수성 및 치료성적등을 알아보기위해 순천향대학병원에서 세균성 폐렴으로 진단된 190예를 후향적으로 입원기록 검토를 통하여 분석하였다. 방법: 1989년 1월부터 1992년 12월까지 4년간 순천향대학병원에서 폐렴으로 진단된 환자 897예 중 화농성 객담, 호흡곤란, 흉통등의 증상, 이학적 소견, 흉부 X-선에서 새로운 또는 진행하는 폐 병변, 혈액배양 및 의미 있는 객담에서 다수 또는 순수배양 상태로 나온 것을 병원균으로 간주하고, 항균제치료에 대한 반응등으로 세균성 폐렴으로 진단 받은 환자 190예를 대상으로 하였으며, 병원체는 혈액이나 객담 배양검사로 원인균이 확인된 것만을 대상으로 하여 대상 환자의 나이, 성별, 기저절환, X-선소견, 원인균에 대한 항생제 감수성 및 사망률에 대해 후향적으로 검토하였다. 결과: 1) 대상 환자는 모두 190예이었고 성별빈도는 남자가 123예(65%), 여자가 67예(35%)로서, 남녀의 비가 1.8:1이었으며, 평균연령은 61세(17~84세)이고, 60대 이상이 반수(53%)이상을 차지했다. 2) 세균성 폐렴환자의 기저질환은 175예에서 관찰되었으며 기저질환이 없었던 예는 22예 뿐이었다. 기저질환으로는 폐결핵 및 만성폐쇄성폐질환등 호흡기계 질환이 78예(43%)로 가장 많았고, 뇌혈종 및 경색의 뇌혈관계 질환은 33예(20%), 악성종양 29예(16%), 당뇨 19예(12%) 및 만성 신부전증 10예(5%) 순이었다. 3) 객담배양은 173예에서 양성을 보였고, 균주빈도는 그람음성간균이 154예(89%), 그람양성구균은 19예(11%)이었으며, 이중 가장 흔히 동정된 균주는 Pseudomonas 49예(28%), Klebsiella pneumoniae 29예(17%), Enterobacter species 25예(14%), Acinetobacter species 20예(12%) 순이었고, 원내폐렴에서도 Pseudomonas 균주가 13예(34%)로 가장 많았다. 4) 혈액배양은 16예에서 양성을 보였고, 균주빈도는 그람음성간균이 7예(43%), 그람양성구균은 9예(57%), 이중 가장 흔히 동정된 균주는 Staphylococcus aureus 6예(38%)으며, 그 다음 흔한 균주는 Pseudomonas specise 3예(19%)의 순이었다. 5) 항생제 감수성 검사에서 Pseudomonas species는 amikacin(56%), ciprofloxacin(91%), aztreonam(85%), ceftazidime(50%)에 50% 이상의 감수성을 보였고, piperacillin(60%), gentamicin(73%), carbenicillin(79%)에는 60% 이상의 내성을 보였다. Klebsiella species는 chloramphenicol(74%), gentamicin(75%), cefotetan(78%)에 70% 이상의 감수성을 보였고, carbenicillin(73%), ampicillin(81%)에는 70% 이상의 저항성을 보였다. Staphylococcus의 감수성 검사에서는 methicillin에 64%의 감수성을 보였고, Streptococcus pneumoniae의 경우 oxacillin에 94%의 감수성을 보였다. 6) 세균성 폐렴의 치료결과 154명(81%)이 치유되었고 사망 및 가사상태로 퇴원한 경우는 36명(19%)이었으며, 병원획득폐렴 환자의 사망율은 25예(75%)로 높았다. 결론: 항생제의 개발과 더불어 폐렴의 임상상의 변화, 원인균주의 변화 및 새로운 내성균의 출현등을 고려할 때 무분별한 항생제 투여를 지향하고 세균배양 및 감수성검사를 바탕으로 한 적절한 항생제의 투여가 절실히 요구된다.

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In-vitro Antimicrobial Activity Phytochemical and Cytotoxicity of Methanolic Fruits Extract of Capsicum frutescent

  • Elbashir, Habiballah A.;Mubarak, Elnaeim E.;Kabbashi, Ahmed S.;Garbi, Mohamed I.;Elshikh, Ahmed A.
    • 식품보건융합연구
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    • 제4권4호
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    • pp.10-17
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    • 2018
  • Capsicum frutescen is known in Sudan, is one of the most commonly used pepper species in cooking and in Sudanese folk medicine. The present study was conducted to investigate antimicrobial (bacteria and fungi) and cytotoxicity (Brine Shrimp Lethality Test) of methanolic extract of Capsicum frutescen (fruits). The extract have been tested in the present study to investigate the in vitro potential effects against Gram positive, Gram negative bacteria and fungi. The selected organisms were Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumonia and Candida albicans using the cup plate agar diffusion method. The methanol extract of Capsicum frutescen (fruits) exhibited inhibitory effects against Escherichia coli with zone of inhibition (23 mm) and Klebsiella pneumonia with zone of inhibition (17 mm). The phytochemical screening revealed the presence of Tannins, Saponin, Alkaloids, Anthroquinoles and Terpenoids. The Cytotoxicity of methanolic extract of Capsicum frutescens was $LD_{50}$ $64.68{\mu}g/ml$. The activity and presence of compounds known to be biologically active are a validation for the use of Capsicum as a food ingredient and as a therapeutic element of traditional medicine.

Distribution of Microorganisms Isolated from Cellular Phones

  • 김수정
    • 대한의생명과학회지
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    • 제14권4호
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    • pp.257-261
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    • 2008
  • Cellular phones are the most used electronic device everyday in modern life and are always in contact with our hands, Although many studies have revealed microorganisms living on our hands, there are only a few reports on the research about products or places which are in contact with our hands. Therefore, the purpose of this study is to verify microorganisms living in cellular phones. Microorganisms were scraped from cellular phones of students and professors from the clinical laboratory science department in Daegu Health College, and cultured at Brain Heart Infusion agar and MacConkey agar following API kit to identify them. The average colony number was $1.5{\times}10^2$ on BHI agar and $40{\times}10$ on MacConkey agar. There was no difference according to gender. In Gram stain result, Gram(+) Cocci showed the highest frequency. Also in BHI agar plates, Micrococcus spp and Acinetobacter baumannii identified with high frequency. Moreover, S. aureus, which is very well known as strong food poisoning bacteria, was isolated. Klebsiella pneumonia ssp pneumonia was isolated with the highest frequency from the MacConkey agar or S-S agar plate. From these results show, there are as many different microorganisms from cellular phones as from our hands. This is the first report isolating strong food poisoning bacteria in cellular phones. Since infection in hospitals have been an important issue to be aware of, it is equally necessary to investigate cell phones and products which hospital workers touch with their hands.

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In-Vitro, Anti-Bacterial Activities of Aqueous Extracts of Acacia catechu (L.F.)Willd, Castanea sativa, Ephedra sinica stapf and shilajita mumiyo Against Gram Positive and Gram Negative Bacteria

  • Dashtdar, Mehrab;Dashtdar, Mohammad Reza;Dashtdar, Babak;shirazi, Mohammad khabaz;Khan, Saeed Ahmad
    • 대한약침학회지
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    • 제16권2호
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    • pp.15-22
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    • 2013
  • Objective: Evaluations of the in-vitro anti-bacterial activities of aqueous extracts of Acacia catechu (L.F.)Willd, Castanea sativa, Ephedra sinica stapf and Shilajita mumiyo against gram-positive bacteria (Staphylococcus aureus, Streptococcus pneumonia) and gram-negative bacteria (Escherichia coli, klebsiella pneumoniae, Proteus mirabilis, Pseudomonas aeruginosa) are reasonable since these ethnomedicinal plants have been used in Persian folk medicine for treating skin diseases, venereal diseases, respiratory problems and nervous disorders for ages. Methods: The well diffusion method (KB testing) with a concentration of $250{\mu}g/disc$ was used for evaluating the minimal inhibitory concentrations (MIC). Maximum synergistic effects of different combinations of components were also observed. Results: A particular combination of Acacia catechu (L.F.) Willd, Castanea sativa, Ephedra sinica stapf and shilajita mumiyo extracts possesses an outstanding anti-bacterial activity. It's inhibiting effect on microorganisms is significant when compared to the control group (P<0.05). Staphylococcus aureus was the most sensitive microorganism. The highest anti-bacterial activity against gram-positive bacteria (Staphylococcus aureus, Streptococcus pneumonia) or gram-negative bacteria (Escherichia coli, Klebsiella pneumonia, Proteus mirabilis, and Pseudomonas aeruginosa) was exerted by formula number 2 (table 1). Conclusion: The results reveal the presence of anti-bacterial activities of Acacia catechu, Castanea sativa husk, Ephedra sp. and Mumiyo against gram-positive and gram-negative bacteria. Synergistic effects in a combined formula, especially in formula number 2 (ASLAN$^{(R)}$) can lead to potential sources of new antiseptic agents for treatment of acute or chronic skin ulcers. These results considering the significant anti-bacterial effect of the present formulation, support ethnopharmacological uses against diarrheal and venereal diseases and demonstrate use of these plants to treat infectious diseases.

Klebsiella pneumonia로 인해 발생한 감염성 동맥류의 성공적인 혈관 내 치료 (Successful Endovascular Treatment of an Infected Aortic Aneurysm Induced by Klebsiella pneumoniae)

  • 변홍권;김육;이정환;이지선;박길선
    • 대한영상의학회지
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    • 제81권3호
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    • pp.733-738
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    • 2020
  • Klebsiella pneumoniae에 의해 발생하는 감염성 대동맥류는 드문 것으로 알려져 있다. 저자들은 감염성 대동맥류가 발생한 50세 남성에 대해 성공적으로 이루어진 혈관 내 치료를 보고하고자 한다. 진단은 혈액 배양 검사와 전산화단층촬영을 통해 이루어졌다. 시술 전 투여된 항생제로 인해 임상증상과 혈액 배양이 개선되었다. 시술 후 24개월 동안 환자는 안정된 상태였으며 감염성 대동맥류의 감소가 일련의 전산화단층촬영을 통해 확인되었다. 따라서 기저 질환으로 인해 외과적 치료를 할 수 없는 환자에서 혈관 내 치료는 선택적 항생제 사용 후 균혈증과 열이 조절되는 경우 감염성 대동맥류에 대한 치료 방법이 될 수 있다.

마황윤폐양(麻黃潤肺揚)과 Ciprofloxacin의 병용투여(倂用投與)가 Klebsiella pneumoniae 호흡기(呼吸器) 감양(感梁)에 미치는 영향(影響) (Effects of In Vivo Synergism of Mawhangyounpye-tang and Ciprofloxacin against Klebsiella pneumoniae Respiratory Infections)

  • 김종대
    • 대한본초학회지
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    • 제20권2호
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    • pp.171-179
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    • 2005
  • Objectives & Methods : In order to evaluate the in vivo synergic effect of Mawhangyounpye-tang which was a traditional poly-herbal formula has been used in the treatment of respiratory diseases in Korea, with quinolone antibiotic, ciprofloxacin (CPFX), the viable bacterial number and histopathological changes were monitored after experimental respiratory infection with Klebsiella peumoniae NCTC 9632. Results : The obtained results were as follows : 1. In CPFX group, the viable bacterial numbers were significantly decreased compared to that of control group and these were more dramatically decreased compared to that of single treatment with CPFX, respectively in concomitant treated groups with Mawhangyounpye-tang. 2. In control group, severe infiltration of inflammatory cells, hemorrhage and hypertrophy of alveolar linings were demonstrated at microscopical levels. However, these abnormal histopathological changes were significantly decreased compared to that of control group in CPFX group, and these were more dramatically decreased compared to that of single treatment with CPFX, respectively in concomitant treated groups with Mawhangyounpye-tang. 3. In CPFX group, the LSA (luminal surface of alveoli %) were significantly increased compared to that of control group and these were more dramatically decreased compared to that of single treatment with CPFX, respectively in concomitant treated groups with Mawhangyounpye-tang. Conclusions : It is considered that in vivo antibacterial activity of CPFX was dramatically increased by concomitant use of Mawhangyounpye-tang against Kebsiella pneumoniae NCTC 9632 infection of respiratory tract.

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Septic arthritis of the hip joint caused by Klebsiella pneumoniae: a case report

  • Jeong-Bo Moon;Jun-Hwan Lee;Byung-Ju Ryu
    • Journal of Yeungnam Medical Science
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    • 제40권2호
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    • pp.193-197
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    • 2023
  • Klebsiella pneumoniae is an uncommon cause of septic arthritis in adults. However, late detection can cause serious complications, including joint destruction and immobility. The purpose of this study was to report a case of successfully treated septic arthritis of the hip joint (SAHJ) caused by K. pneumoniae. A 49-year-old female patient presented to our hospital with fever and progressive severe pain in the right hip area. Although there was no abnormality on plain radiographs, ultrasonography revealed diffuse swelling of the right hip joint. Under ultrasonography guidance, the hip joint fluid was aspirated, and Gram staining and culturing were performed. The patient's pain was significantly reduced after the joint aspiration. The Gram staining and culturing revealed gram-negative bacilli, which were subsequently identified as K. pneumoniae. According to the results, systemic intravenous antibiotic (ceftriaxone) was administered without complications, and the patient was discharged on oral antibiotic (ciprofloxacin). Clinical cases of septic arthritis of the knee or sacroiliac joint have been occasionally reported in adults, but cases of SAHJ are rare. Moreover, K. pneumonia-induced SAHJ has not been reported to date. Therefore, we report this very rare case and its successful treatment.

구취유발세균에 대한 $NANOVER^{TM}$의 항균효과 검사 1. Nanosilver가 구취 세균의 증식에 미치는 영향 (Antibacterial Activity of $NANOVER^{TM}$ Against Oral Malodor Generating Microorganisms 1. The Effect of Nanosilver on Growth of Oral Malodor Generating Microorganisms)

  • 정영희;모혜원;정지숙;최경호;최재갑;허윤경;이상흔
    • Journal of Oral Medicine and Pain
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    • 제34권1호
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    • pp.39-48
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    • 2009
  • 본 연구는 구취생성의 주요 원인균에 대한 nanosilver의 항균효과를 조사하기 위해서 시행되었으며, 이와 더불어 이들 세균의 증식 조건도 함께 연구하였다. 포항공과대학교 나노기술센터로부터 $NANOVER^{TM}$, WA 1000 현탁액을 제공 받아 희석하여 사용하였으며, 공시균으로는 주요 구취생성균으로 알려진 Fusobacterium nucleatum (KCTC 2640), Prevotella melaninogenica (KCTC 3689), Klebsiella pneumonia (KCTC 1560) 3종의 세균류를 한국생명공학연구원 생명자원센터로부터 구입하여 사용하였다. 공시균의 배양에 혐기성세균 배양에 이용되는 tryptone- yeast extract-ammonium acetate(TYA) 배지와 chopped beef meat(CBM) 배지를 이용하였다. 1. 최적배양조건으로 감압배양, CBM 배지가 적당한 것으로 나타났다. 2. 간균인 K. pneumonia에 Nanover(5 및 10 ppm)를 처리하고 주사형 전자현미경으로 균체의 형태를 관찰한 결과는 세균의 생장점 부근에서 세포벽에 손상을 주어 세포벽을 절단하여 다량의 막상 편린을 생성하고 autolysin을 불활성화 시켜 filament형 균체를 형성하여 균의 증식은 일시적으로 억제시킬 수 있었으나 완전히 사멸시키지는 못하였으며, 구취 세균을 전혀 다른 형태로 변화시키는 것으로 나타났다. 그러나 항균제로서의 역할은 가진 것으로 확인되었다.

농흉의 외과적 치료330 (Surgical Management of Thoracic Empyema.* - 330 cases -)

  • 김치경
    • Journal of Chest Surgery
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    • 제20권1호
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    • pp.65-70
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    • 1987
  • Empyema thoracis following pneumonia, pulmonary tuberculosis, trauma and surgical procedures continues to be a source of major morbidity and mortality. We retrospectively reviewed the hospital records of 330 patients [child:87, adult243] treated for empyema thoracis at Catholic Medical Center between 1964 and 1986. The causes of empyema in these patients were as follows: pneumonia [C***:66%, A***:30%], pulmonary tuberculosis [C:2%, A:20%], lung abscess [C:3%, A:5%], postoperative complication [C:0%, A:13%], trauma [C:1%, A:4%] and unknown origin [C:23%, A:17%]. Three patients in this series died of sepsis from necrotizing pneumonia. Staphylococcus [29.3%], Streptococcus [8.8%], E. coli [8%], Mycobacterium tuberculosis [7.9%], Klebsiella [7.4%], Pseudomonas [6.4%], Bacteroides [3.4%] were the organisms most commonly isolated. Bacterial isolates were single in 68.3%, multiple 7.5% and absent 24.2%. The type of organism did not correlate with severity of disease or eventual requirement for closed thoracotomy drainage, open thoracotomy drainage [Modified Eloesser*s procedure], thoracoplasty, decortication or pleuropneumonectomy. Successful methods of treatment included aspiration in 44%, tube thoracotomy in 66%, open thoracotomy drainage in 98.7%, thoracoplasty in 98%, decortication in 96% and pleuropneumonectomy in 73%. Initial mode of management in empyema thoracis are thoracentesis and closed thoracotomy drainage. If the initial management was failed, we performed another surgical procedures. Before 1973, we manage with Schede`s thoracoplasty in the postpneumonectomy empyema patients. But thoracoplasty, with or without the use of muscle flaps, is a hazardous operation in the poor-risk patients. The permanent, open thoracotomy drainage is a relatively minor operation which is well tolerated even by cachexic, septic patients. It controls infection, and sometimes results in the bronchopleural fistula closing spontaneously.

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인공호흡기연관 폐렴의 경험적 항생제 선택 시 이전 호흡기검체의 유용성 (Role of Microbiologic Culture Results of Specimens Prior to Onset of Ventilator-Associated Pneumonia in the Patients Admitted to Intensive Care Unit)

  • 김지혜;윤성철;이유미;손지웅;최유진;나문준;권선중
    • Tuberculosis and Respiratory Diseases
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    • 제72권1호
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    • pp.30-36
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    • 2012
  • Background: Patients with ventilator-associated pneumonia (VAP) in intensive care unit (ICU) have a high mortality rate. The routine surveillance cultures obtained previously or an ATS guideline for hospital-acquired pneumonia was used in selecting initial antimicrobials. The object of this study was to compare the respiratory samples before VAP and bronchoalveolar lavage (BAL) culture. Methods: 54 patients underwent fiberoptic bronchoscopy to obtain BAL samples. We reviewed microbiologic specimen results of prior respiratory specimens (pre-VAP) and BAL. Results: Among 51 patients with 54 VAP episodes, 52 microorganisms of pre-VAP and 56 BAL samples were isolated. Pre-VAP included 21.2% of MRSA, and 32.6% of multidrug resistant-Acinetobacter baumannii (MDR-AB). BAL samples comprised 25.0% of MRSA, 26.7% of MDR-AB, 14.3% of Stenotrophomonas maltophilia and 3.6% of Klebsiella pneumonia in order. In pre-VAP samples compared to BAL samples, only 35.2% were identical. In BAL samples compared to pre-VAP samples obtained in 5 days before the onset of VAP, only 43.6% were identical. However, among BAL samples compared to pre-VAP samples obtained after more than 5 days, 13.3% were identical (p=0.037). Conclusion: Based on these data, pre-VAP samples obtained prior to 5 day onset of VAP may help to predict the causative microorganisms and to select appropriate initial antimicrobials.