Sun Woo Park;Ji Young Park;Hyoung Soo Choi;Hyunju Lee
Pediatric Infection and Vaccine
/
v.31
no.1
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pp.46-54
/
2024
Purpose: This study aimed to identify the pathogens of bloodstream infection in children with underlying hemato-oncologic diseases, analyze susceptibility patterns, compare temporal trends with those of previous studies, and assess empirical antimicrobial therapy. Methods: Retrospective review study of children bacteremia in hemato-oncologic diseases was conducted at Seoul National University Bundang Hospital from January 2013 to July 2023. Results: Overall, 98 episodes of bacteremia were observed in 74 patients. Among pathogens isolated, 57.1% (n=56) were Gram-positive bacteria, 38.8% (n=38) were Gram-negative bacteria, and 4.1% (n=4) were Candida spp. The most common Gram-positive bacteria were coagulase-negative staphylococci (n=21, 21.4%) and Staphylococcus aureus, (n=14, 14.3%) whereas the most common Gram-negative bacteria were Klebsiella pneumoniae (n=16, 16.3%) and Escherichia coli (n=10, 10.2%). The susceptibility of Gram-positive bacteria to penicillin, oxacillin, and vancomycin was 11.5%, 32.7%, and 94.2%, respectively and the susceptibility of Gram-negative bacteria to cefotaxime, piperacillin/tazobactam, imipenem, gentamicin, and amikacin was 68.6%, 80%, 97.1%, 82.9%, and 91.4%, respectively. Methicillin-resistant S. aureus was detected in 1 strain and among Gram-negative strains, extended spectrum β-lactamase accounted for 28.9% (12/38). When analyzing the antibiotic susceptibility and empirical antibiotics, the mismatch rate was 25.5% (n=25). The mortality rate of children within 30 days of bacteremia was 7.1% (n=7). Conclusions: Empirical antibiotic therapy for bacteremia in children with hemato-oncologic diseases should be based on the local antibiogram in each institution and continuous monitoring is necessary.
The chemical compositions, and antibacterial and antifungal effects of essential oils extracted from three coniferous species, Pinus densiflora, Cryptomeria japonica, and Chamaecyparis obtusa, were investigated. Gas chromatography mass analysis of the essential oils revealed that the major components and the percentage of each essential oil were 16.66% $\beta$-phellandrene and 14.85% $\alpha$-pinene in P. densiflora; 31.45% kaur-16-ene and 11.06% sabinene in C. japonica; and 18.75% bicyclo [2,2,1] heptan-2-ol and 17.41% 2-carene in Ch. obtusa. The antimicrobial assay by agar disc diffusion method showed that $2.2{\mu}g$ of Ch. obtusa oil inhibited most effectively the growth of Escherichia coli ATCC 33312 and Klebsiella oxytoca ATCC 10031, whereas the C. japonica oil gave weak antimicrobial activity. The minimal inhibitory concentration(MIC) values for bacterial strains were in the range of 5.45-21.8 mg/ml depending on essential oils, but most Gram-negative bacteria were resistant even at 21.8 mg oil/ml. P. densiflora oil showed the most effective antifungal activity and the MIC values for Cryptococcus neoformans B42419 and Candida glabrata YFCC 062CCM 11658 were as low as 0.545 and 2.18 mg/ml, respectively. Cryp. neoformans B42419 was the most sensitive to all essential oils in the range of 0.545-2.18 mg/ml. Our data clearly showed that the essential oils from the three conifers had effective antimicrobial activity, especially against fungi.
To understand the formation of initial gut microbiota, three initial fecal samples were collected from two groups of two breast milk-fed (BM1) and seven formula milk-fed (FM1) infants, and the compositional changes in gut microbiota were determined using metagenomics. Compositional change analysis during week one showed that Bifidobacterium increased from the first to the third fecal samples in the BM1 group (1.3% to 35.1%), while Klebsiella and Serratia were detected in the third fecal sample of the FM1 group (4.4% and 34.2%, respectively), suggesting the beneficial effect of breast milk intake. To further understand the compositional changes during progression from infancy to childhood (i.e., from three weeks to five years of age), additional fecal samples were collected from four groups of two breast milk-fed infants (BM2), one formula milk-fed toddler (FM2), three weaning food-fed toddlers (WF), and three solid food-fed children (SF). Subsequent compositional change analysis and principal coordinates analysis (PCoA) revealed that the composition of the gut microbiota changed from an infant-like composition to an adult-like one in conjunction with dietary changes. Interestingly, overall gut microbiota composition analyses during the period of progression from infancy to childhood suggested increasing complexity of gut microbiota as well as emergence of a new species of bacteria capable of digesting complex carbohydrates in WF and SF groups, substantiating that diet type is a key factor in determining the composition of gut microbiota. Consequently, this study may be useful as a guide to understanding the development of initial gut microbiota based on diet.
Compared to the first and second-generation cephalosporins, the third-generation cephalosporins are remarkably stable against hydrolysis by the $\beta$-lactamases produced by aerobic gram-negative bacilli, such as Enterobacteriaceae. Among these bacteria, the most prevalent plasmid-encoded $\beta$-lactamase is TEM-1 $\beta$-lactamase belonging to class A or group 2b. This enzyme is produced constitutively and is principally active against peniciflins and old cephalosporins rather than third-generafion cephalosporins, carbapenems and mmobactams. However, new TEM type $\beta$-lactamases including TEM-9 and TEM-12 evolved through point mutations in a gene encoding $\beta$-lactamase have been discovered from patients during chemotherapy. These $\beta$-lactamases are known to be capable of hydrolyzing most of the third-generatim cephalosporins. To study the prevalence of $\beta$-lactamases from clinical isolates collected in Korea. the minimal inhibitory concentratims(MICs) of several third-generation cephalosporins against 628 clinical isolates were determined by agar dilution methods, and $\beta$-lactamas-producing bacteria were isolated by use of cefinase disc. By polymerase chain reaction (PCR) method, clinical isolates harboring a gene for TEM type $\beta$-lactamase were identified among the $\beta$-lactamase producing strains. Twentiy three percent of the clinical isolates was resistant to the thirdgeneration cephalosporins, and more than 90% of resistant cells produced various $\beta$-lactamases. TFM type $\beta$-lactamases were dominant in gram-negative bacilli, such as Escherichia coli, Klebsiella pneumoniae, Enterobacter species. These results suggest the necessity of the development of new cephalosporins which are stable against $\beta$-lactamases like TEM.
Cutaneous leishmaniasis (CL) is a parasitic disease characterized by single or multiple ulcerations. Secondary bacterial infections are one of the complications that can increase the tissue destruction and the resulting scar. To better determine the incidence of real secondary bacterial infections in CL, we designed the current study. This was a cross-sectional study performed in Skin Diseases and Leishmaniasis Research Centre, Isfahan, Iran. A total of 1,255 patients with confirmed CL enrolled in the study. Sterile swaps were achieved for ulcer exudates and scraping was used for non-ulcerated lesions. All samples were transferred to tryptic soy broth medium. After 24 hr of incubation at $37^{\circ}C$ they were transferred to eosin methylene blue agar (EMB) and blood agar. Laboratory tests were used to determine the species of bacteria. Among 1,255 confirmed CL patients, 274 (21.8%) had positive cultures for secondary bacterial infections. The bacteria isolated from the lesions were Staphylococcus aureus in 190 cases (69.3%), coagulase negative Staphylococcus in 63 cases (23.0%), E. coli in 10 cases (3.6%), Proteus sp. in 6 cases (2.2%), and Klebsiella sp. in 5 cases (1.9%). The results show that the overall incidence of secondary bacterial infections in the lesions of CL was 21.8%, considerably high. The incidence of secondary bacterial infections was significantly higher in ulcerated lesions compared with non-ulcerated lesions.
Suh, Woosuck;Kim, Bi Na;Kang, Hyun Mi;Yang, Eun Ae;Rhim, Jung-Woo;Lee, Kyung-Yil
Clinical and Experimental Pediatrics
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v.64
no.6
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pp.293-300
/
2021
Background: Understanding the epidemiology and prevalence of febrile urinary tract infection (fUTI) in children is important for risk stratification and selecting appropriate urine sample collection candidates to aid in its diagnosis and treatment. Purpose: This study aimed to analyze the epidemiology, etiology, and changes in antibiotic susceptibility patterns of the first fUTI in children. Methods: This retrospective observational cohort study included children younger than 19 years of age who were diagnosed and treated for their first fUTI in 2006-2016. Electronic medical records were analyzed and radiologic images were evaluated. Results: A total of 359 patients (median age, 5.1 months; interquartile range, 3.0-10.5 months) fit the inclusion criteria; of them, 78.0% (n=280) were younger than 12 months old. The male to female ratio was 5.3:1 for patients aged 0-2 months, 2.1:1 for those 3-5 months, and 1.6:1 for those 6-11 months. Beyond 12 months of age, there was a female predominance. Escherichia coli was the leading cause (83.8%), followed by Enterococcus species (6.7%), and Klebsiella pneumoniae (3.6%). Significant yearly increases in the proportions of multidrug-resistant strains (P<0.001) and extended-spectrum beta-lactamase (ESBL) producers (P<0.001) were observed. In patients with vesicoureteral reflux (VUR), the overall recurrence rate was 53.6% (n=15). A significantly higher recurrence rate was observed when the fUTI was caused by an ESBL versus non-ESBL producer (75.0% vs. 30.0%, P=0.03). Conclusion: fUTI was most prevalent in children younger than 12 months of age and showed a female predominance in patients older than 12 months of age. The proportion of ESBL producers causing fUTI is increasing. Carbapenems, rather than noncarbapenems, should be considered for treating fUTI caused by ESBL-producing enteric gram-negative rods to reduce short-term recurrence rates in children with VUR.
This study was conducted to monitor the antibiotics resistance of human-harmful bacteria isolated in the agricultural environment for hot peppers (Capsicum annuum) and tomato (Lycopersicon esculentum). As a result, we isolated 120 bacterial species (34 on fruits, 48 in soil, 21 in water, and 17 in manure), identified them with the 16S rRNA sequence, analyzed minimum inhibitory concentration (MIC) for 26 antibiotics using Sensititre ARIS Hi-Q system and then evaluated whether each bacterial genus acquired resistance for the tested antibiotics or not, according to the CLSI criteria. From difference in MIC between eco-friendly (EFM) and practical (PFM) cultivation farms, Klebsiella spp. isolated from EFM was resistant to ampicillin (AMP) and nalidixic acid (NAL), and that isolated from PFM was resistant to streptomycin (STR) and tetracycline (TET). Enterobacter spp. isolated from EFM was resistant to AMP and azithromycin (AZI), and that isolated from PFM was resistant to AMP, AZI, and STR. Meanwhile, Pseudomonas spp. isolated from EFM and PFM were all resistant to AMP, AZI, cefotaxime (FOT), cefoxitin (FOX), ceftriaxone (AXO), CHL, NAL, and STR. Staphylococcus spp. isolated from EFM and PFM were resistant to gentamycin (GEN), STR, and kanamycin (KAN), and in particular, that from EFM showed resistance for erythromycin (ERY). In conclusion, our study suggested that EFM lead STR antibiotics resistance for human-harmful bacteria to decrease, because only the bacteria isolated from hot pepper and tomato crop with PFM have showed resistance against STR antibiotics, regardless of bacterial genus.
Gwanghee Kim;Yoojin Lee;Jin Sun You;Wontae Hwang;Jeewon Hwang;Hwa Young Kim;Jieun Kim;Ara Jo;In ho Park;Mohammed Ali;Jongsun Kim;Jeon-Soo Shin;Ho-Keun Kwon;Hyun Jik Kim;Sang Sun Yoon
IMMUNE NETWORK
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v.23
no.4
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pp.31.1-31.18
/
2023
Evidence suggests that the human respiratory tract, as with the gastrointestinal tract, has evolved to its current state in association with commensal microbes. However, little is known about how the airway microbiome affects the development of airway immune system. Here, we uncover a previously unidentified mode of interaction between host airway immunity and a unique strain (AIT01) of Staphylococcus epidermidis, a predominant species of the nasal microbiome. Intranasal administration of AIT01 increased the population of neutrophils and monocytes in mouse lungs. The recruitment of these immune cells resulted in the protection of the murine host against infection by Pseudomonas aeruginosa, a pathogenic bacterium. Interestingly, an AIT01-secreted protein identified as GAPDH, a well-known bacterial moonlighting protein, mediated this protective effect. Intranasal delivery of the purified GAPDH conferred significant resistance against other Gram-negative pathogens (Klebsiella pneumoniae and Acinetobacter baumannii) and influenza A virus. Our findings demonstrate the potential of a native nasal microbe and its secretory protein to enhance innate immune defense against airway infections. These results offer a promising preventive measure, particularly relevant in the context of global pandemics.
Eurycoma longifolia (pasak bumi) is a popular medicinal plant in Indonesia and is widely used in various products. Its high economic value has caused illegal harvesting and product falsification. Using molecular techniques, the authentication and traceability of E. longifolia derivatives can be controlled to ensure consumer safety. Therefore, this study aimed to authenticate the products and derivatives of E. longifolia (pasak bumi) produced, marketed, and consumed in Indonesia using molecular identification techniques. Genomic DNA from 37 leaf samples collected from the Sumatran mainland and the Riau Islands and six E. longifolia products were amplified and sequenced using trnL-trnF and internal transcribed spacer (ITS) regions. The results revealed that all leaf samples were indeed E. longifolia based on the markers used, with the six products, only the herbal tea product (sample code TCPB) was most likely derived from E. longifolia based on the two regions, suggesting that not all products labelled as E. longifolia in the market are authentic. The results also indicated that several other plants species are used as substitutes or adulterants, including Simaba spp., Simarouba spp., Homalolepis spp., Vernonia gigantea, Elephantopus scaber, Gymnanthemum amygdalinum, Cyanthillium spp., Potentilla lineata, Ailanthus altissima, Geijera paniculata, Hannoa chlorantha, and Dalbergia spp. Klebsiella pneumoniae bacteria were also identified in this study on the outer wooden cup of E. longifolia products. Therefore, this molecular approach is effective in identifying the authenticity of E. longifolia products, with trnL-trnF and ITS as the recommended DNA markers.
Park, Ji Young;Yun, Ki Wook;Kang, Hyoung Jin;Park, Kyung Duk;Shin, Hee Young;Lee, Hoan Jong;Choi, Eun Hwa
Pediatric Infection and Vaccine
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v.24
no.2
/
pp.71-78
/
2017
Purpose: The aim of this study was to identify the pathogens of blood stream infection (BSI) in children with hemato-oncologic disorders, to analyze susceptibility patterns of microorganisms to guide empirical antimicrobial therapy, and to compare temporal trends of the pathogen and antimicrobial susceptibility with those of previous studies. Methods: We retrospectively analyzed the medical records of children with hemato-oncologic disorders whose blood culture grew pathogens at the Seoul National University Children's Hospital between 2011 and 2015. Results: A total of 167 patients developed 221 episodes of bacteremia. Among 229 pathogens, gram-negative bacteria (GNB) accounted for 69.0% (64.0% in 2002 to 2005, 63.4% in 2006 to 2010); gram-positive bacteria (GPB) accounted for 28.8% (31.3% in 2002 to 2005, 34.6% in 2006 to 2010); and fungus accounted for 2.2%. Among GNB, Klebsiella species (53.2%, 84/158) and Escherichia coli (19.6%, 31/158) were common. Staphylococcus aureus (48.5%, 32/66) and viridans streptococci (21.2%, 14/66) were frequently isolated among GPB. The susceptibilities of oxacillin and vancomycin in GPB were 54.8% and 96.9% (51.5% and 95.5% in 2002 to 2005; 34.1% and 90.5% in 2006 to 2010), respectively, whereas in GNB, the susceptibilities of cefotaxime, piperacillin/tazobactam, and imipenem were 73.2%, 77.2%, and 92.6% (75.9%, 82.8%, and 93.4% in 2002 to 2005; 62.8%, 82.9%, 93.8% and in 2006 to 2010), respectively. There were no significant differences in the proportion of etiologic agents or the antimicrobial susceptibilities between the current study and that of the previous two studies from 2002 to 2010. Overall fatality rate was 13.1%. Conclusions: GNB predominated in BSI among children with hemato-oncologic disorders. The etiology of bacteremia and antimicrobial susceptibility were comparable to those of the previous studies. Thus, piperacillin/tazobactam can be used as the initial empirical antimicrobial agent in febrile neutropenia.
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