• Title/Summary/Keyword: MDR analysis

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Detection of Rifampicin- and Isoniazid-Resistant Mycobacterium tuberculosis Using the Quantamatrix Multiplexed Assay Platform System

  • Wang, Hye-young;Uh, Young;Kim, Seoyong;Cho, Eunjin;Lee, Jong Seok;Lee, Hyeyoung
    • Annals of Laboratory Medicine
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    • v.38 no.6
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    • pp.569-577
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    • 2018
  • Background: The increasing prevalence of drug-resistant tuberculosis (TB) infection represents a global public health emergency. We evaluated the usefulness of a newly developed multiplexed, bead-based bioassay (Quantamatrix Multiplexed Assay Platform [QMAP], QuantaMatrix, Seoul, Korea) to rapidly identify the Mycobacterium tuberculosis complex (MTBC) and detect rifampicin (RIF) and isoniazid (INH) resistance-associated mutations. Methods: A total of 200 clinical isolates from respiratory samples were used. Phenotypic anti-TB drug susceptibility testing (DST) results were compared with those of the QMAP system, reverse blot hybridization (REBA) MTB-MDR assay, and gene sequencing analysis. Results: Compared with the phenotypic DST results, the sensitivity and specificity of the QMAP system were 96.4% (106/110; 95% confidence interval [CI] 0.9072-0.9888) and 80.0% (72/90; 95% CI 0.7052-0.8705), respectively, for RIF resistance and 75.0% (108/144; 95% CI 0.6731-0.8139) and 96.4% (54/56; 95% CI 0.8718-0.9972), respectively, for INH resistance. The agreement rates between the QMAP system and REBA MTB-MDR assay for RIF and INH resistance detection were 97.6% (121/124; 95% CI 0.9282-0.9949) and 99.1% (109/110; 95% CI 0.9453-1.0000), respectively. Comparison between the QMAP system and gene sequencing analysis showed an overall agreement of 100% for RIF resistance (110/110; 95% CI 0.9711-1.0000) and INH resistance (124/124; 95% CI 0.9743-1.0000). Conclusions: The QMAP system may serve as a useful screening method for identifying and accurately discriminating MTBC from non-tuberculous mycobacteria, as well as determining RIF- and INH-resistant MTB strains.

Antibacterial Activity of Selected Fruit Juices against Multidrug-Resistant Bacterial Pathogens Involved in Urinary Tract and Sexually Transmitted Infections among Tribal Women in Madhya Pradesh, India

  • Poonam Sharma;Juhi;Vaishali Halwai;Sainivedita Rout;Rambir Singh
    • Journal of Pharmacopuncture
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    • v.26 no.3
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    • pp.265-275
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    • 2023
  • Objectives: The aim of this study was to evaluate the effect of fruit juices on Multi-Drug Resistant (MDR) bacterial pathogens involved in Urinary Tract Infections (UTIs) and Sexually Transmitted Infections (STIs) among tribal women in the district Anuppur, Madhya Pradesh, India. Methods: Fresh juices of lemon (Citrus limon), amla/Indian gooseberry (Phyllanthus emblica), pineapple (Ananas comosus), mosambi/sweet lime (Citrus limetta), orange (Citrus sinensis), kiwi (Actinidia deliciosa), and pomegranate (Punica granatum) fruits were evaluated for in vitro antibacterial activity against bacterial pathogens involved in UITs and STIs among tribal women. Physico-chemical analysis of fresh fruits was also carried out by measuring the pH, moisture, protein, fat, crude fibre, carbohydrate, and ascorbic acid content. Results: Lemon and amla juice showed better antibacterial activity against the pathogens as compared to other juices. MIC results fruit juices against UTIs and STIs pathogens vary depending on the specific pathogen and juice chemical constituents. The physico-chemical analysis showed that the moisture content was highest in mosambi (90%), followed by orange (87%). Ascorbic acid content was found highest in amla (540 mg/100 g), followed by kiwi (90.3 mg/100 g). Pomegranate showed highest concentration of carbohydrate (15.28 g/100 g), fat (1.28 g/100 g), and protein (1.65 g/100 g). Lemon juice had lowest pH of 2.20, followed by amla 2.67. Conclusion: The lemon juice showed highest antibacterial activity against MDR bacterial pathogens involved in UTIs and STIs among tribal women in district Anuppur, Madhya Pradesh, India. The low pH of lemon may be responsible for its high antibacterial activity as compared to other juices.

Clinical Features and Management of Multidrug-Resistant Tuberculosis (다제 내성 폐결핵 환자의 임상상 및 치료에 대한 고찰)

  • Lee, Jae-Cheol;Lee, Seung-Jun;Kim, Gye-Soo;Yoo, Chul-Gyu;Cheong, Hee-Soon;Kim, Young-Whan;Han, Sung-Koo;Shim, Young-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.1
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    • pp.14-21
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    • 1996
  • Objectives: Although outbreak of MDR Tb has been a recent problem in western countries, it has been a longstanding problem in Korea. The poor outcome of MDR Tb is mainly due to poor compliance, high rate of side reaction of secondary drugs, and limitation in number of available drugs. Thus, to improve the outcome of MDR Tb, it is crucial to make individualized adequate prescription based on the knowledge of the patterns of resistance to each drugs in the community as well as the natural history. The purpose of present study is to evaluate the clinical features of Korean MDR Tb patients including patterns of drug resistance and success rate of treatment which was prescribed according to the sensitivity tests. Methods: Retroscpective analysis of 71 Korean patients with MDR Tb was made. All strains isolated from patients showed resistence to at least two first line drugs. Patients profile, previous treatment history, patterns of drug resistance, outcome of treatment was analysed. Initial treatment regimen was selected according to the previous treatment history and was modified according to the sensitivity reports. The regimen was composed to include at least 4 sensitive drugs when possible. Results: The patients showed resistance to 4.1 drugs on average. 90% of them were resistant to INH and RFP. Among 71 patients, 35 patients(49%) had cavitary lesions in CXR. Treatment outcome was analysed in 55 patients. 35 patients(67%) were improved after treatment and 18 patients(33%) showed treatment failure. 5 patients showed primary resistance. Treatment outcome could be evaluated in 4 of them and all showed improvement after treatment. 14 patients(20%) had to change their regimens due to drug side effects. The most frequent side effect was elevation of liver enzymes(6 patients). Others included dizziness, hyperuricemia, tinnitus, skin rash, GI troubles. More than 50% of side effects developed within 3 months. In repeated drug sensitivity test, the concordance rate of resistance to INH was 100% and RFP 98%. EMB, PZA showed 80% concordance rate. But in the other drugs, the concordances were less than 50%. Operation was done in 5 patient - 1 patients as a adjunctive means of chemotherapy -. In that case, negative conversion of sputum AFB was done. Conclusion: 2/3 patients of multidrug-resistant tuberculosis were improved by appropriate prescription and regular medication suggesting that more aggressive management and monitoring is indicated in multidrug-resistant tuberculosis.

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Analysis of Water Purification Capability of the Spent Fuel Storage Pool Using Consolidated Fuel Storage in Uljin 1&2 (조밀화 핵연료 집합체 저장에 의한 울진 1&2호기의 사용후 핵연료 저장조 정화능력 해석)

  • Lim, Chae-Joon;Park, Goon-Cherl;Chung, Chang-Hyun
    • Nuclear Engineering and Technology
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    • v.22 no.2
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    • pp.83-94
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    • 1990
  • The radioactivity in the spent fuel storage pool is calculated to ensure to maintain its concentration below the permissible limit, when the storage capacity of Uljin nuclear power plant unit 1&2 is extended from 9/3 to 32/3 core using consolidated fuels in maximum density rack (MDR). For this evalulation, two models to calculate the spent fuel pool activities on the continuous and intermittent operating its purification system are developed and these results compared, The results of above two cases show that the current water purification system can not guarantee the radioactivity concentration below the design limit, 5$\times$10$^{-4}$ $\mu$Ci/ml, for the extention to 32/3 core. Therefore, it has been concluded that a modification of the current purification system is necessary to extend the spent fuel storage capacity with the above method. The alternative way suggested in this study is to increase the number of cation bed demineralizers.

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The Criticality Analysis of Spent Fuel Pool with Consolidated Fuel in KNU 9 & 10 (조밀화 집합체로 중간저장하는 경우 원자력 발전소 9, 10호기의 사용 후 핵연료 저장조의 임계분석)

  • Jae, Moo-Sung;Park, Goon-Cherl;Chung, Chang-Hyun;Jang, Jong-Hwa
    • Nuclear Engineering and Technology
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    • v.20 no.1
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    • pp.27-34
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    • 1988
  • Since the lack of the spent fuel storage capcity has been expected for all Korean nuclear power plants in the mid-1990s, the maximum density rack (MDR) with consolidated fuels can be proposed to overcome the shortage of the storage capacity in KNU 9 & 10 which have most limited capacities. To ensure the safety when the alternatives are applied in the KNU 9 & 10, the multiplication factor are calculated with varying the rack pitch and the thickness of consolidated storage box by the AMPX-KENO IV codes. The computing system is verified by the benchmark calculation with criticality experiments for arrays of consolidated fuel modules, which was reported by B & W in 1981. Also an abnormal condition, i.e. malposition accident, is simulated. The results indicate that the KNU 9 & 10 storage pools with consolidated fuel are safe in the view of the criticality. Thus the storage capacity can be expanded from 9/3 cores into 27/3 cores even with considering equipments and cooling spaces.

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1:5000 Scale DSM Extraction for Non-approach Area from Stereo Strip Satellite Imagery (스테레오 스트립 위성영상을 이용한 비 접근지역의 1:5000 도엽별 DSM 추출 가능성 연구)

  • Rhee, Sooahm;Jung, Sungwoo;Park, Jimin
    • Korean Journal of Remote Sensing
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    • v.36 no.5_2
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    • pp.949-959
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    • 2020
  • In this paper, as a prior study related to the generation of topographic information using the CAS500-1/2 satellite, we propose a method of extraction DSM for each 1:5000 scaled map in North Korea using KOMPSAT-3A strip images. This technique is designed to set the processing area by receiving shape file, only to generate output for every 1:5000 scaled map. In addition, dense point clouds and the DSM were extracted by applying MDR, a robust stereo image matching technique. Considering that the strip images are input in the units of scenes, we attempted to extract a DSM by processing and merging multiple image pairs in one 1:5000 map area. As a result, it was possible to confirm the generation of an integrated DSM with minimal separation at the junction, and as a result of the accuracy analysis, it was confirmed that the accuracy was within 5m compared to GCP.

Hypoxia Induced Multidrug Resistance of Laryngeal Cancer Cells via Hypoxia-inducible Factor-1α

  • Li, Da-Wei;Dong, Pin;Wang, Fei;Chen, Xin-Wei;Xu, Cheng-Zhi;Zhou, Liang
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.8
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    • pp.4853-4858
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    • 2013
  • Objectives: To investigate whether hypoxia has an effect on regulation of multidrug resistance (MDR) to chemotherapeutic drugs in laryngeal carcinoma cells and explore the role of hypoxia-inducible factor-$1{\alpha}$ (HIF-$1{\alpha}$). Methods: Laryngeal cancer cells were cultured under normoxic and hypoxic conditions. The sensitivity of the cells to multiple drugs and levels of apoptosis induced by paclitaxel were determined by MTT assay and annexin-V/propidium iodide staining analysis, respectively. HIF-$1{\alpha}$ expression was blocked by RNA interference. The expression of HIF-$1{\alpha}$ gene was detected by real-time quantitative RT-PCR and Western blotting. The value of fluorescence intensity of intracellular adriamycin accumulation and retention in cells was evaluated by flow cytometry. Results: The sensitivity to multiple chemotherapy agents and induction of apoptosis by paclitaxel could be reduced by hypoxia (P<0.05). A the same time, the adriamycin releasing index of cells was increased (P<0.05). However, resistance acquisition subject to hypoxia in vitro was suppressed by down-regulating HIF-$1{\alpha}$ expression. Conclusion: HIF-$1{\alpha}$ could be considered as a key regulator for mediating hypoxia-induced MDR in laryngeal cancer cells via inhibition of drug-induced apoptosis and decrease in intracellular drug accumulation.

Healthcare-Associated Pneumonia among Hospitalized Patients: Is It Different from Community Acquired Pneumonia?

  • Seong, Gil Myung;Kim, Miok;Lee, Jaechun;Lee, Jong Hoo;Jeong, Sun Young;Choi, Yunsuk;Kim, Woo Jeong
    • Tuberculosis and Respiratory Diseases
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    • v.76 no.2
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    • pp.66-74
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    • 2014
  • Background: The increasing number of outpatients with multidrug-resistant (MDR) pathogens has led to a new category of pneumonia, termed healthcare-associated pneumonia (HCAP). We determined the differences in etiology and outcomes between patients with HCAP and those with community-acquired pneumonia (CAP) to clarify the risk factors for HCAP mortality. Methods: A retrospective study comparing patients with HCAP and CAP at Jeju National University Hospital. The primary outcome was 30-day mortality. Results: A total of 483 patients (208 patients HCAP, 275 patients with CAP) were evaluated. Patients with HCAP were older than those with CAP (median, 74 years; interquartile range [IQR], 65-81 vs. median, 69 years; IQR, 52-78; p<0.0001). Streptococcus pneumoniae was the major pathogen in both groups, and MDR pathogens were isolated more frequently from patients with HCAP than with CAP (18.8% vs. 4.9%, p<0.0001). Initial pneumonia severity was greater in patients with HCAP than with CAP. The total 30-day mortality rate was 9.9% and was higher in patients with HCAP based on univariate analysis (16.3% vs. 5.1%; odds ratio (OR), 3.64; 95% confidence interval (CI), 1.90-6.99; p<0.0001). After adjusting for age, sex, comorbidities, and initial severity, the association between HCAP and 30-day mortality became non-significant (OR, 1.98; 95% CI, 0.94-4.18; p=0.167). Conclusion: HCAP was a common cause of hospital admissions and was associated with a high mortality rate. This increased mortality was related primarily to age and initial clinical vital signs, rather than combination antibiotic therapy or type of pneumonia.

Characterization of Veterinary Hospital-Associated Isolates of Enterococcus Species in Korea

  • Chung, Yeon Soo;Kwon, Ka Hee;Shin, Sook;Kim, Jae Hong;Park, Yong Ho;Yoon, Jang Won
    • Journal of Microbiology and Biotechnology
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    • v.24 no.3
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    • pp.386-393
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    • 2014
  • Possible cross-transmission of hospital-associated enterococci between human patients, medical staff, and hospital environments has been extensively studied. However, limited information is available for veterinary hospital-associated Enterococcus isolates. This study investigated the possibility of cross-transmission of antibiotic-resistant enterococci between dog patients, their owners, veterinary staff, and hospital environments. Swab samples (n=465) were obtained from five veterinary hospitals in Seoul, Korea, during 2011. Forty-three Enterococcus strains were isolated, representing seven enterococcal species. E. faecalis and E. faecium were the most dominant species (16 isolates each, 37.2%). Although slight differences in the antibiotic resistance profiles were observed between the phenotypic and the genotypic data, our antibiogram analysis demonstrated high prevalence of the multiple drug-resistant (MDR) isolates of E. faecalis (10/16 isolates, 62.5%) and E. faecium (12/16 isolates, 75.0%). Pulsed-field gel electrophoretic comparison of the MDR isolates revealed three different clonal sets of E. faecalis and a single set of E. faecium, which were isolated from different sample groups or dog patients at the same or two separate veterinary hospitals. These results imply a strong possibility of cross-transmission of the antibiotic-resistant enterococcal species between animal patients, owners, veterinary staff, and hospital environments.

Induction of Resistance to BRAF Inhibitor Is Associated with the Inability of Spry2 to Inhibit BRAF-V600E Activity in BRAF Mutant Cells

  • Ahn, Jun-Ho;Han, Byeal-I;Lee, Michael
    • Biomolecules & Therapeutics
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    • v.23 no.4
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    • pp.320-326
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    • 2015
  • The clinical benefits of oncogenic BRAF inhibitor therapies are limited by the emergence of drug resistance. In this study, we investigated the role of a negative regulator of the MAPK pathway, Spry2, in acquired resistance using BRAF inhibitor-resistant derivatives of the BRAF-V600E melanoma (A375P/Mdr). Real-time RT-PCR analysis indicated that the expression of Spry2 was higher in A375P cells harboring the BRAF V600E mutation compared with wild-type BRAF-bearing cells (SK-MEL-2) that are resistant to BRAF inhibitors. This result suggests the ability of BRAF V600E to evade feedback suppression in cell lines with BRAF V600E mutations despite high Spry2 expression. Most interestingly, Spry2 exhibited strongly reduced expression in A375P/Mdr cells with acquired resistance to BRAF inhibitors. Furthermore, the overexpression of Spry2 partially restored sensitivity to the BRAF inhibitor PLX4720 in two BRAF inhibitor-resistant cells, indicating a positive role for Spry2 in the growth inhibition induced by BRAF inhibitors. On the other hand, long-term treatment with PLX4720 induced pERK reactivation following BRAF inhibition in A375P cells, indicating that negative feedback including Spry2 may be bypassed in BRAF mutant melanoma cells. In addition, the siRNA-mediated knockdown of Raf-1 attenuated the rebound activation of ERK stimulated by PLX4720 in A375P cells, strongly suggesting the positive role of Raf-1 kinase in ERK activation in response to BRAF inhibition. Taken together, these data suggest that RAF signaling may be released from negative feedback inhibition through interacting with Spry2, leading to ERK rebound and, consequently, the induction of acquired resistance to BRAF inhibitors.