• Title/Summary/Keyword: Methicillin 내성

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Tigecycline Treatment for Infections Caused by Multidrug-Resistant Pathogens (다약제내성 균주 감염에 대한 Tigecycline의 치료)

  • Lee, Mi-Jung;Seo, A-Young;Bae, Sang-Soo;Jeong, Dong-Hyong;Yoon, Kyung-Hwa;Hwang, Byung-Sik;Kang, Sung-Hoon;Oh, Dae-Myung;Kwon, Ki-Tae;Lee, Shin-Won;Song, Do-Young
    • Journal of Yeungnam Medical Science
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    • v.28 no.2
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    • pp.133-144
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    • 2011
  • Background: Tigecycline (TIG), a new broad-spectrum glycylcycline with anti-multidrug-resistant-(MDR)-pathogen activity, was launched in March 2009 in South Korea, but there are insufficient clinical studies on its use in the country. As such, this study was performed to analyze cases of severe MDR-pathogen-caused infections treated with TIG. Methods: Patients treated with TIG within the period from May 2009 to June 2010 were enrolled in this study. Their clinical and microbiologic data were reviewed retrospectively. Results: Twenty-one patients were treated with TIG for complicated skin and soft-tissue infections (cSSTIs) (42.9%), complicated intra-abdominal infections (cIAIs) (38.1%), or pneumonia (19.1%) caused by MDR pathogens like carbapenem-resistant $Acinetobacter$ $baumannii$ (76.2%), methicillin-resistant $Staphylococcus$ $aureus$ (61.9%), extended-spectrum beta-lactamase-producing $Escherichia$ $coli$ and $Klebsiella$ $pneumoniae$ (38.1%), and penicillin-resistant $Enterococcus$ species (33.3%). Thirteen patients (61.9%) had successful clinical outcomes while five (23.8%) died within 30 days. The rate of clinical success was highest in cSSTI (77.8%), followed by cIAI (50%) and pneumonia (50%), and the mortality rate was highest in pneumonia (50%), followed by cIAI (25%) and cSSTI (11.1%), Conclusion: Tigecycline therapy can be an option for the treatment of severe MDR-pathogen-caused infections in South Korea, Due to its high risk of failure and mortality, however, prudence is required in its clinical use for the treatment of severe infections like nosocomial pneumonia.

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Antioxidant and Skin Whitening Effect of Graviola (Annona muricata) Leaf Extracts (Graviola (Annona muricata) 잎 추출물의 항산화 및 미백 효과)

  • Jo, Eun Hee;Kim, In Hae;Lee, Jae Hwa
    • Applied Chemistry for Engineering
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    • v.28 no.2
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    • pp.198-205
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    • 2017
  • In this study, graviola leaf extracts (GLE) was investigated for the effect of antioxidant, antibacterial, whitening, anti-wrinkle. The antioxidant effect of GLE was measured by an electron donating ability assay. As a result, GLE increased the electron donating ability in a concentration-dependent manner. The antibacterial effect of GLE was found to show the higher antibacterial effect in Methicillin-resistant Staphylococcus aureus CCARM3115 compared with that of ampicillin by a paper disc method. The whitening effect of GLE was also measured by tyrosinase inhibition assay, and it was found that the tyrosinase activity of GLE decreased as the concentration increased. The inhibition activity of tyrosinase involved in hydroxylation reaction which is related to converting L-tyrosine to (DOPA) was higher than that of arbutin's at the concentration ranging from 125 to $250{\mu}g/mL$. In addition, GLE reduced melanin contents of B16-F10 melanoma cells in a dose-dependant manner and decreased to about 76.7% at a concentration of $100{\mu}g/mL$ Regarding wrinkling formation of GLE, an elastase inhibition assay was performed. As a result, GLE and ursolic acid were 10.5% and 56.5%, respectively under the identical concentration. These results suggest that GLE has significant antioxidant and whitening activities, and also may be potentially used as a therapeutic agent for hyperpigmentation treatment as an ingredient of whitening cosmetics.

Interaction with Polyphenols and Antibiotics (폴리페놀 화합물과 항생제의 상호작용)

  • Cho, Ji Jong;Kim, Hye Soo;Kim, Chul Hwan;Cho, Soo Jeong
    • Journal of Life Science
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    • v.27 no.4
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    • pp.476-481
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    • 2017
  • Polyphenols are secondary metabolites produced by higher plants and have been used as antiallergic, anticancer, antihypertensive, antiinflammatory, antimicrobial and antioxidant agents. They are generally divided into flavonoids and non-flavonoids. The antimicrobial activity of flavonoids are stronger than that of non-flavonoids. The skeleton structures of flavonoids possessing antimicrobial activity are chalcone, flavan-3-ol (catechin), flavanone, flavone, flavonol and proanthocyanidin. The flavonols are shown antibacterial activity against several gram-positive bacteria (Actinomyces naeslundii, Lactobacillus acidophilus and Staphylococcus aureus) and gram-negative bacteria (Fusobacterium nucleatum, Porphyromonas gingivalis, Prevotella melaninogenica and Prevotella oralis). Among of non-flavonoids, caffeic acids, ferulic acids and gallic acids showed antimicrobial activity against gram-positive (Listeria monocytogenes and S. aureus) and gram-negative bacteria (Escherichia coli and Pseudomonas aeruginosa). These are found to be more efficient against the E. coli, L. monocytogenes, P. aeruginosa and S. aureus than antibiotics such as gentamicin and streptomycin. The kaempferol and quercetin showed synergistic effect with ciprofloxacin and rifampicin against S. aureus and methicillin resistant S. aureus (MRSA). Epigallocatechin gallate (EGCG) acts synergistically with various ${\beta}-lactam$ antibiotics against MRSA. In particular, the epicatechin, epigallocatechin (EGC), EGCG and gallocatechin gallate from Korean green tea has antibacterial activity against MRSA clinical isolates and the combination of tea polyphenols and oxacillin was synergistic for all the clinical MRSA isolates.

Antimicrobial Resistance of Organisms Isolated from Clinical Specimens (임상재료에서 분리한 각종세균의 항균제내성)

  • Suh, Seong-Il;Park, Jong-Wook;Chun, Do-Ki
    • The Journal of the Korean Society for Microbiology
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    • v.22 no.3
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    • pp.283-294
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    • 1987
  • One hundred and fifty-seven strains of staphylococci isolated from various clinical specimens and 80 of Gram-negative bacilli from urine of patients with urological diseases were tested for resistance to antimicrobial drugs by microdilution broth method. Among staphylococci, 50 to 89% of the strains were resistant to gentamicin(Gm), kanamycin(Km), erythromycin(Em), nalidixic acid(Na), and tetracycline. Ninety per cent MIC was lowest in ciprofloxacin(Cp), followed by vancomycin(Vc), trimethoprim(Tp), enoxacin(Ex), and norfloxacin(Nf) with the values of two ${\mu}g/ml$ or lower. Twenty-seven strains were resistant to methicillin(MR), with 24 strains of Staphylococcus aureus and 3 of S. epidermidis. All strains of MR S. aureus were resistant to oxacillin, rifampin(Rf), Gm, Km, Em, Na, and Tc, and no strain was resistant to Vc and Tp. Almost all staphylococci isolated from urine were S. epidermidis and sensitive to most drugs tested without MR strain. Among Gram-negative bacilli from urine, Escherichia coli(43 strains) was most frequently isolated, and followed by Klebsiella spp.(11), Proteus spp.(10), Serratia spp.(10), and Pseudomonas aeruginosa(6) in the decreasing order. The majority of E. coli and Serratia spp. were resistant to chloramphenicol(Cm), Tc, streptomycin, sulfisomidine(Su), ampicillin(Ap), Km, and carbenicillin(Cb), and 50 and 90% MICs of these drugs were also high. In Klebsiella spp., 54% or more were resistant to Cm, Su, Ap, cephalothin, and Cb. Proteus spp. were susceptible to most drugs tested, but Pseudomonas were resistant to nearly all drugs tested except Rf, amikacin, and moxalactam(Mx). All Gram-negative bacilli tested were found to be susceptible to Mx. New quinolone carboxylic acid compounds, such as Nf, Ex, and Cp showed very high antimicrobial activities against the majority of organisms tested except Pseudomonas, and 50 and 90% MICs of Nf and Ex were always equal or 2 to 4 times higher than Cp. Organisms multiply resistant to drugs were noted in almost all isolates tested. Twenty-seven strains of staphylococci were multiply resistant to 11 or more drugs, and 6 of Klebsiella spp. to 8 to 11 drugs. The most frequent multiplicity of durg resistance were 7 and 8, 12, and 13 in E. coli, Serratia spp., and Pseudomonas, respectively. No strain was resistant to more than 5 drugs in Proteus spp..

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Clinical Features of Staphylococcal Scalded Skin Syndrome Caused by Community-Associated Methicillin-Resistant Staphylococcus aureus in Changwon City, Korea, during 2006 and 2015 (2006년부터 2015년까지 창원 지역에서 발생한 지역사회관련 메티실린내성 황색포도알균에 의한 포도알균 열상 피부증후군의 임상양상)

  • Park, Jun Hyeong;Kim, Min Chae;Kang, Jin Han;Choi, Jae Won;Lee, Hak Sung;Shin, Ju Hwa;Lee, Je Chul;Ma, Sang Hyuk
    • Pediatric Infection and Vaccine
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    • v.26 no.1
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    • pp.42-50
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    • 2019
  • Purpose: We investigated the clinical features and epidemiology of staphylococcal scalded skin syndrome (SSSS) from year 2006 to 2015 in Changwon city, Korea. Methods: We reviewed medical records of 69 patients diagnosed with SSSS from year 2006 to 2015. Antibiotic susceptibility testing was performed by agar dilution method. Methicillinresistant Staphylococcus aureus (MRSA) was phenotypically identified by oxacillin susceptibility testing and genotypically confirmed by the existence of the mecA gene. Results: The median age of patients was 2.0 years (range 0.2-6 years). Three (4.3%), 53 (76.8%), and 13 (18.9%) patients showed the generalized type, the intermediate type, and the abortive type, respectively. Patients occurred throughout the year, but most patients occurred between July and October. MRSA was isolated from 54 of the 60 patients regardless of the clinical types. All patients recovered without any complications. Conclusions: There was a constant occurrence of SSSS patients caused by MRSA in Changwon area during 2006 and 2015. It is needed to constantly monitor the occurrence of patients with SSSS.

Bacteremia in pediatric cancer patients : A single center study (소아 암 환아에서 발생한 균혈증의 분석 : 단일기관 연구)

  • Park, Sun Mi;Choe, Byung Kyu;Kim, Chun Soo;Kim, Joon Sik;Kim, Heung Sik;Ryoo, Nam-Hee
    • Clinical and Experimental Pediatrics
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    • v.49 no.8
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    • pp.882-888
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    • 2006
  • Purpose : Bacteremia is one of the major concerns in the treatment of pediatric cancer patients. This study was to determine the etiologic agents and the pattern of antibiotic susceptibilities in a single tertiary medical center. Methods : We retrospectively reviewed the medical records of the cases of bacteremia in pediatric cancer patients from 1998 to 2005 in Keimyung University Dongsan Medical Center. Results : There were 62 cases of bacteremia from 44 patients. Gram-positive organisms(48.3%) were more common than gram-negative organisms(38.7%) or fungi(13%). Among gram-positive organisms, Staphylococcus epidermidis was the most common etiologic agent(63.3%), followed by Staphylococcus aureus(16.7%), ${\alpha}$-hemolytic Streptococcus(16.7%), and Streptococcus mitis(3.3%). Among gram-negative organisms, Alcaligenes xylosoxidans was the most common agent(41.7%) and the other organisms were Klebsiella pneumoniae(20.8%), Stenotrophomonas maltophilia(12.5%), Acinetobacter baumanii(8.2%), etc. In febrile neutropenic patients, however, K. pneumoniae was the most common cause of gram-negative bacteremia. All of the isolated K. pneumoniae in our center produced extended-spectrum beta-lactamase and were related with high mortality. S. aureus, S. epidermidis, and Streptococcus species were all susceptible to vancomycin and teicoplanin. Most staphylococci were resistant to penicillin and oxacillin. Most of the gram-negative organisms were susceptible to imipenem. Conclusion : Gram-positive organisms were more commonly isolated than gram-negative organisms in pediatric cancer patients like other studies. We could obtained valuable information on the choice of proper antibiotics in our institution. Further studies will be needed to explain the prevalence of A. xylosoxidans in our center.

Forest Structure in Relation to Slope Aspect and Altitude in valley Forests at Hambaeksan Area (함백산지역 계곡부의 사면방향과 해발고에 따른 산림구조)

  • 박인협;최윤호;이석면;최영철;유석봉
    • Korean Journal of Environment and Ecology
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    • v.15 no.4
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    • pp.361-368
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    • 2002
  • The valley forests located at the east-facing slope and the west facing slope in Hambaeksan area were studied to investigate forest structure in relation to aspect and altitude of the slope. There was little difference in density. mean DBH and basal area of the tree layer between east-facing slope and west-facing slope. The importance percentages of Tilia amurensis and Betula costata in west-facing slope were higher than those in east-facing slope. However, the importance percentages of Quercus mongilica and Fraxinus rhynchophylla in the west facing slope were lower than those in east-facing slope. Species diversity of the west-facing slope was 1.415 and that of the east-facing slope was 1.328. Elevation trends were also found for forest structure. As elevation Increased basal area and mean height of the tree layer decreased in both of east-facing slope and west-facing slope. There was a tendency that number of species, species diversity and evenness decreased with increasing elevation. The importance percentage of Quercus mongolica increased with increasing elevation while those of Betula costata and Maackia amurensis decreased. The result of cluster analysis for the tree and subtree layer indicated that the studied forests were classified into the mixed forest community of broad-leaved tree species at west-facing slope and the low and middle elevation belts of east-facing slope and Quercus mongolica community at the high elevation belt of east-facing slope. Quercus mongolica was significantly and positively correlated with Symplocos chinensis for. pilosa, Acer tschonoskii var. rubripes and deutzia glabrata. Betula costata was significantly and negatively correlated with Quercus mongolica and Acer pseudo-sieboldianum.

Clinical Presentations and Causative Organisms in Children and Adolescents with Osteoarticular Infections: A Retrospective Study (소아청소년기에 발생한 골관절염의 임상 양상 및 원인균에 대한 고찰)

  • Lee, Soyoung;Kim, Han Wool;Cho, Hye-Kyung;Yun, Yoe Hon;Ryu, Kyung Ha;Kim, Kyung-Hyo
    • Pediatric Infection and Vaccine
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    • v.22 no.3
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    • pp.154-163
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    • 2015
  • Purpose: Osteoarticular infections in children and adolescents are important because it can cause functional compromise if appropriate treatment is delayed. Therefore, this study was designed to describe the clinical presentations and causative organisms of osteoarticular infections in children and adolescents in order to propose early diagnosis method and an appropriate empiric antimicrobial therapy. Methods: Forty-two medical records were reviewed retrospectively, which were confirmed as osteomyelitis (OM) or septic arthritis (SA) at Department of Pediatrics or Orthopedic Surgery in patients under 18 years old of Ewha Womans University Mokdong Hospital from March 2008 to March 2015. Results: We identified 21 cases of OM, 13 cases of SA and 8 cases of OM with SA. There were 31 males and 11 females and mean age was 7.1 years old. The most common symptoms were pain and tenderness of involved site. Major involved bones were femur (10 cases, 34.5%), tibia (7 cases, 24.1%) and major involved joints were hip (9 cases, 42.9%), and knee (5 cases, 23.8%). Increased serum C-reactive protein and erythrocyte sedimentation rate were observed in 37 cases (88.1%) respectively. Magnetic resonance imaging was performed in 40 cases among 42 cases and was used to demonstrate osteoarticular infections and other adjacent infections. Nine cases (23.7%) among 38 cases and 20 cases (50.0%) among 40 cases were positive in blood culture and infected site culture respectively. The most common causative organism was Staphylococcus aureus, which was represented in 22 cases (75.9%), of which nine cases (40.9%) were resistant to methicillin. Conclusions: S. aureus was the most common causative organism of osteoarticular infections in children and adolescents and the proportion of MRSA was high in this study. Therefore, we recommend vancomycin as the first empiric antimicrobial therapy and suggest that further study is necessary to elucidate an appropriate guideline for treatment which takes into account MRSA proportion.