• Journal of Korean Neurosurgical Society
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• v.47 no.3
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• pp.235-238
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• 2010

We present a case of tuberculous spondylitis in which diagnosis was masked by a concomitant pyogenic infection. The patient had undergone percutaneous needle aspiration of an abscess in the cavity of the psoas muscle. Early results from the culture regimen showed isolation of methicillin-resistant Staphylococcus aureus. After eight weeks, mycobacterium tuberculosis was grown at regimen which was cultured at the same site. Initial isolation of pyogenic bacteria, considered to be highly virulent organisms, led to delayed diagnosis and treatment of the tuberculosis.

• Pediatric Infection and Vaccine
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• v.4 no.2
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• pp.201-209
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• 1997

• The Journal of Internal Korean Medicine
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• v.23 no.2
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• pp.298-305
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• 2002

These cases were performed on the bases of clinical consideration about patients who had Methicillin-Resistant Staphylococcus aureus(MRSA) infection. One patient was a 67-years-old women who had sequela of inter cranial hemorrhage & inter ventricular hemorrhage, hypertention, urinary tract infection and pneumonia. Clinical symptoms were intermittent fever, sputum, Lt. side hemiparesis and dysphagia. She was chronic, repeated infection state. It could be regarded as "unpreparedness of the spirit which animates and controls the universe; 正氣虛", the oriental term which indicates a condition of chronic disease or general weakness. According to the oriental medicine principle, oriental medicine was taken such as Wunggunza-tang(六君子湯) and the patient had taken a turn for the better. After 3 months, MRSA infection diappeared. The other patient was a 43-years-old women who had Both brain stem infarction, Lt. cerebellar infarction, hypercholesterolemia, urinary tract infection and pneumonia, Clinical symptoms were quadriplegia, dysphagia(levin tube insert state), aphasia, respiration disorder(tracheostomy cannular keep state) and sputum. She was chronic, repeated infection state. It could be regarded as "unpreparedness of spleen energy, unpreparedness of both energy and blood; 脾氣虛, 氣血兩虛", the oriental term which indicates a condition of chronic disease or immunodeficiency. According to the oriental medicine principle, oriental medicine was taken such as Bojungyggi-tang(補中益氣湯), Palmul-tang(八物湯) and the patient had taken a turn for the better. After I month, MRSA was turned into Escherichia coli.

• Clinical and Experimental Pediatrics
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• v.48 no.1
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• pp.88-92
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• 2005

Pyomysitis is a primary acute bacterial infection of large skeletal muscule, usually occuring in the absence of specific cause of infection. Pyomyositis has been reported mainly in tropical countries and was rare in temperate climates. but it has been recognized with increasing frequency. Toxic shock syndrome(TSS) is an acute mutisystemic disease characterized by high fever, hypotension, multisystem dysfunction and erythematous rash followed by skin desquamation 8-12 days after onset. Especially, TSS and pyomyositis are rare conditions in the pediatric population. We experienced one case in a healthy 13-year-girl who developed pyomyositis of the right ileac and gluteal muscles associated with TSS caused by methicillin resistant Staphylococcus aureus. We reports a case of acute pyomyositis with TSS, in which the diagnosis was difficult because of the relative rare incidence in temperate climates and its vague symptoms. To our knowledge, this is the first reported case of pyomyositis with TSS in Korean pediatric population.

• Korean Journal of Clinical Laboratory Science
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• v.42 no.2
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• pp.86-91
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• 2010

We evaluated the performance of a novel screening test, PBP2a MRSA rapid kit (Dinona Inc., Iksan, Korea), for methicillin-resistant Staphylococcus aureus (MRSA) based on a immunochromatographic assay. The test is able to detect penicillin-binding protein 2a (PBP2a) using the nasal specimens from health care workers. The nasal specimens were obtained from 69 healthcare workers and were incubated in enrichment broth followed eight hours incubatin in BHI with cefoxitin $4{\mu}g/mL$. These broth were tested by PBP2a Rapid Kit. The enrichment broths were also directly tested for tube coagulase using the conventional identification method. 19 of 22 MRSA showed positive results by PBP2a rapid test and direct coagulase test (the sensitivity for detection of MRSA, 86.36%). While, 8 of 47 non-MRSA showed false positive results for the two tests. All of the 8 non-MRSA which showed false positive were co-colonizing isolates with MRCNS and MSSA. In addition, 46 of 49 methicillin-resistant staphylococci (MRS) showed positive results for PBP2a MRSA rapid kit (the sensitivity for detection of MRS, 93.8%), and all of 20 non-MRS showed negative results (specificity, 100%). The combination of PBP2a MRSA rapid kit and direct coagulase test showed the good sensitivity for detection of MRSA from anterior nares but frequently showed false positive results from the co-colonizing carrier with MRCNS and MSSA.

• Korean Journal of Microbiology
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• v.43 no.4
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• pp.346-350
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• 2007

We analyzed the phenotypic changes in coagulase serotype of S. aureus isolated from clinical sources and nasal cavities of healthy persons, $1994{\sim}2005$. A total of 715 isolates, 408 methicillin resistant S. aureus (MRSA) from clinical sources and 307 methicillin-susceptible S. aureus (MSSA), were classified into eight coagulase sero-types, I to VIII. The most prevalent serotype in MRSA was type II (54.3%, 222/408) and followed IV (24.7%), III (10.9%), and V (5.2%), whereas the majorities in MSSA were type VII (30.9%, 95/307), IV (22.2%), V (22.2%) and II (7.1%). Among the isolates collected periods, significant changes of coagulase serotypes in both strains were observed. In MRSA strains, the serotype V was not detected until 1997, but rapidly increased to 18.5% (20/108) in 2005, and the serotypes III decreased from 27% (31/115) in 1994 to 0.9% (1/108) in 2005. A similar trend in MSSA strains was observed but serotype II strain was not detected in 2005. The antigenic shift and changes in the coagulase of S. aureus were confirmed.

• Tuberculosis and Respiratory Diseases
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• v.78 no.3
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• pp.289-292
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• 2015

Lemierre syndrome (LS) is a septic thrombophlebitis of the internal jugular vein (IJV) following an oropharyngeal infection. LS is commonly caused by normal anaerobic flora and treated with appropriate antibiotics and anticoagulation therapy. Although the incidence of disease is very rare, 15% cases of LS are fatal even in the antibiotic era because of disseminated septic thromboemboli. We reported a case of extensive bilateral LS due to methicillin-resistant Staphylococcus epidermidis in a 63-year-old female with lung adenocarcinoma. Initial examination revealed a retropharyngeal abscess; hence, intravenous ceftriaxone and steroid were initiated empirically. However, pulmonary thromboembolism developed and methicillin-resistant S. epidermidis was identified in the bacterial culture. Despite intensive antibiotic and anticoagulation therapies, extensive septic thrombophlebitis involving the bilateral IJV and superior vena cava developed. Adjunctive catheter-directed thrombolysis and superior vena cava stenting were performed and the patient received antibiotic therapy for an additional 4 weeks, resulting in complete recovery.

• Pediatric Infection and Vaccine
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• v.23 no.3
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• pp.229-235
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• 2016

Infective endocarditis (IE) caused by methicillin-resistant Staphylococcus aureus (MRSA) has become a worldwide concern. We present a case of a 12-year-old child with IE of the native mitral valve due to MRSA infection after an invasive dental procedure. Based on the clinical symptoms and the presence of cerebrospinal fluid pleocytosis, the patient was initially diagnosed with presumed bacterial meningitis and treated with empiric antibiotics. On the third day of hospitalization, MRSA was cultured from the initial blood samples and vegetation was observed on the mitral valve during an echocardiogram, findings which are compatible with a diagnosis of IE. The revised guidelines for antibiotic prophylaxis for the prevention of IE advise that IE prophylaxis for dental procedures is reasonable only for patients with underlying cardiac conditions, who are at the highest risk of adverse outcomes from IE. However, in this case, the patient had no high risk factors indicative of IE prophylaxis, except for mitral valve prolapse. She had no recurrence of IE over a follow-up period of 12 months.

• Korean Journal of Veterinary Service
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• v.33 no.3
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• pp.233-240
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• 2010

Methicillin-resistant coagulase-negative staphylococci (MRCNS) were isolated from the respiratory sites of chickens in 4 farms and slaughter house located in Chungnam provinces. Isolation of coagulase-negative staphylococci (CNS) was positive for 61 (26.6%) of the 229 chickens tested, and isolation of MRCNS was positive for 17 (27.9%) of the isolated CNS. A total of 17 MRCNS isolates were selected and subjected to identification. Of the 17 MRCNS isolates selected, 6 were identified as Staphylococcus cohnii, 2 as S. saprophyticus, 3 as S. simulans, 3 as S. lentus, 2 as S. carnosus, and 1 as S. xylosus. The MRCNS isolates were resistant to many beta-lactam antibiotics, and some isolates were also resistant to macrolide and aminoglycoside antibiotics. The mecA gene was detected in some isolates of each MRCNS strains. The mecA-positive isolates were classified into five staphylococcal cassette chromosome mec (SCCmec). SCCmec types I to IV were detected in isolates from chickens.

• Archives of Pharmacal Research
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• v.19 no.1
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• pp.52-59
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• 1996

The in vitro activity of LB20304 was evaluated against clinical isolates and compared with those of Q-35, ciprofloxacin, sparfloxacin, lomefloxacin and ofloxacin. LB20304 demonstrated 16-to 64-fold more potent activity than ciprofloxacin against gram-positive bacteria. LB20304 inhibited 90% of the isolates of methicillin-susceptible Staphylococcus aureus(MSSA) at a concentration of $0.016\mug/ml\; (MIC_{90}). MIC_{90}$ values of LB20304 against methicillin-resistant Staphylococcus aureus (MRSA), methicillin-susceptible Staphylococcus epidermidis (MSSE), methicillin-resistant S. epidermidis (MRSE) and Streptococcus pneumoniae were $2\mug/ml,\; 0.016\mug/ml,\; 0.5\mug/ml \;and\; 0.031\mug/ml,$ respectively. LB20304 was also very active against gram-negative bacteria. Against Escherichia coli, Klebsiella pneumoniae, Serratia marcescens, Pseudomonas aeruginosa and Acinetobacter calcoaceticus, $MIC_{90}s of\; LB20304 were\; 0.031\mug/ml,\; 0.25\mug/ml,\; 2\mug/ml,\; 8\mug/ml\; and\; 0.5\mug/ml$, respectively. Its activity was comparable to that of ciprofloxacin but much better than those of Q-35, sparfloxacin, ofloxacin and lomefloxacin. LB20304 also exhibited the most potent acitvity among quinolones tested against laboratory standard strains, ofloxacin-resistant strains, .betha.-lactamase-producing strains and anaerobic strains. The inhibitory effect$ (IC_{50)$ of LB20304 on DNA gyrase from Micrococcus luteus, determined by the supercoiling assay, was 8-fold more potent than that of ciprofloxacin. LB20304 did not induce topoisomerase-associated DNA cleavage even at a concentration of 10 mg/ml, although ciprofloxacin induced DNA cleavage at a concentration of 1 mg/ml.