• Journal of Yeungnam Medical Science
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• 제37권4호
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• pp.277-285
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• 2020

Tuberculosis (TB) is still a major health problem worldwide. Especially, multidrug-resistant TB (MDR-TB), which is defined as TB that shows resistance to both isoniazid and rifampicin, is a barrier in the treatment of TB. Globally, approximately 3.4% of new TB patients and 20% of the patients with a history of previous treatment for TB were diagnosed with MDR-TB. The treatment of MDR-TB requires medications for a long duration (up to 20-24 months) with less effective and toxic second-line drugs and has unfavorable outcomes. However, treatment outcomes are expected to improve due to the introduction of a new agent (bedaquiline), repurposed drugs (linezolid, clofazimine, and cycloserine), and technological advancement in rapid drug sensitivity testing. The World Health Organization (WHO) released a rapid communication in 2018, followed by consolidated guidelines for the treatment of MDR-TB in 2019 based on clinical trials and an individual patient data meta-analysis. In these guidelines, the WHO suggested reclassification of second-line anti-TB drugs and recommended oral treatment regimens that included the new and repurposed agents. The aims of this article are to review the treatment strategies of MDR-TB based on the 2019 WHO guidelines regarding the management of MDR-TB and the diagnostic techniques for detecting resistance, including phenotypic and molecular drug sensitivity tests.

• 한국미생물·생명공학회지
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• 제31권3호
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• pp.230-234
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• 2003

Small multidrug resistance(SMR) family(TC #2.A.7.1)에 속하는 막단백질 중 하나를 coding하는 Bacillus subtilis의 yvaE유전자의 발현을 유도한 결과, 발현된 YvaE단백질에 의해 대장균세포내에서 살균제를 포함한 다양한 양이온 약제에 대한 efflux활성을 촉매하는 것으로 확인되었다. 같은 operon내에 인접한 yaD유전자의 동시발현을 유도한 결과, 이러한 efflux활성은 억제가 되는 것으로 나타났다. Ethidium bromide를 기질로 하여 fluorimeter를 이용한 efflux transport실험결과, YvaE 단백질이 발현된 대장균세포의 경우 vector만을 함유한 대조세포에 비해 현저히 빠른 efflux활성을 보여주었다 따라서 YvaE 막단백질은 multidrug export를 촉매하는 SMR-type efflux pump임을 확인하였다.

• 약학회지
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• 제49권1호
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• pp.38-43
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• 2005

The occurrence of resistance to chemotherapeutic drugs is a major problem for successful cancer treatment. This resistant phenotype of cancer cell frequently reveals a broad spectrum to structurally and/or functionally unrelated anticancer drugs, termed multidrug resistance (MDR). Overexpression of P-glycoprotein (P-gp), a transmembrane drug efflux pump, is a major mechanism of MDR. Accordingly, considerable effort has been directed towards to development of compounds that inhibit P-gp, reverse the MDR phenotype and sensitize cancer cells to conventional chemotherapy without undesired toxicological effects. In an effort to search for novel MDR reversal agent, we tested the cytotoxicity of paclitaxel, a well-known substrate of P-gp, against P-gp-expressing HCT15 and HCT15/CL02 human colorectal cancer cells in the presence or absence of benzotriazepin analogues, as well as against P-gp-negative A549 human non-small cell lung and SK-OV-3 human ovarian cancer cells in vitro. Among the compounds tested, the agents that have phenyl amide moiety at 3 position remarkably increased the cytotoxicity of paclitaxel against P-gp-expressing cancer cells, but not against P-gp-negative cancer cells. BTZ-15 and BTZ-16 at $4\;{\mu}M$ revealed similar MDR reversal activity to $10\;{\mu}M$ verapamil, a well-known MDR reversal agent.

• Journal of Veterinary Science
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• 제24권6호
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• pp.82.1-82.12
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• 2023

Background: The current conventional serotyping based on antigen-antisera agglutination could not provide a better understanding of the potential pathogenicity of Salmonella enterica subsp. enterica serovar Brancaster. Surveillance data from Malaysian poultry farms indicated an increase in its presence over the years. Objective: This study aims to investigate the virulence determinants and antimicrobial resistance in S. Brancaster isolated from chickens in Malaysia. Methods: One hundred strains of archived S. Brancaster isolated from chicken cloacal swabs and raw chicken meat from 2017 to 2022 were studied. Two sets of multiplex polymerase chain reaction (PCR) were conducted to identify eight virulence genes associated with pathogenicity in Salmonella (invasion protein gene [invA], Salmonella invasion protein gene [sipB], Salmonella-induced filament gene [sifA], cytolethal-distending toxin B gene [cdtB], Salmonella iron transporter gene [sitC], Salmonella pathogenicity islands gene [spiA], Salmonella plasmid virulence gene [spvB], and inositol phosphate phosphatase gene [sopB]). Antimicrobial susceptibility assessment was conducted by disc diffusion method on nine selected antibiotics for the S. Brancaster isolates. S. Brancaster, with the phenotypic ACSSuT-resistance pattern (ampicillin, chloramphenicol, streptomycin, sulphonamides, and tetracycline), was subjected to PCR to detect the corresponding resistance gene(s). Results: Virulence genes detected in S. Brancaster in this study were invA, sitC, spiA, sipB, sopB, sifA, cdtB, and spvB. A total of 36 antibiogram patterns of S. Brancaster with a high level of multidrug resistance were observed, with ampicillin exhibiting the highest resistance. Over a third of the isolates displayed ACSSuT-resistance, and seven resistance genes (β-lactamase temoneira [bla_TEM], florfenicol/chloramphenicol resistance gene [floR], streptomycin resistance gene [strA], aminoglycoside nucleotidyltransferase gene [ant(3")-Ia], sulfonamides resistance gene [sul-1, sul-2], and tetracycline resistance gene [tetA]) were detected. Conclusion: Multidrug-resistant S. Brancaster from chickens harbored an array of virulence-associated genes similar to other clinically significant and invasive non-typhoidal Salmonella serovars, placing it as another significant foodborne zoonosis.

• 한국환경보건학회지
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• 제39권3호
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• pp.239-246
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• 2013

Objectives: Antimicrobial resistance and multidrug resistance patterns have been studied with a total of 189 samples of Salmonella Enteritidis and Salmonella Typhimurium isolated from diarrhea patients in Incheon from 2008 to 2012. Methods: Antimicrobial resistance tests were determined by Disc Diffusion method. Results: The serological distribution of Salmonella spp. showed 108 strains (30.1%) of S. Enteritidis, 81 strains (22.6%) of S. Typhimirium, eight strains (8.0%) of S. Typhi, 11 strains ( 3.1% ) of S. Paratyphi, and the 151 other strains (42.1%). The separation rate of Salmonella spp. by year showed 14.5% (52 strains) in 2008, 13.6% (49 strains) in 2009, 22.8% (82 strains) in 2010, 25.3% (91 strains) in 2011, and 23.7% (85 strains) in 2012. Additionally, the separation rate of S. Enteritidis and S. Typhimirium in 2010 was the highest. The Salmonella spp. isolated from diarrhea patients showed significant differences according to age (p<0.05), gender (p<0.01) and medical institution (p<0.05). The highest resistance was found to the following antimicrobial agents: imipenem 77 strains, ampicillin 47 strains, ciprofloxacin 34 strains, nalidixic acid 29 strains for S. Enteritidis, and ampicillin 45 strains, nalidixic acid 45 strains for S. Typhimurium. Separated S. Enteritidis and S. Typhimurium resistance to the antibiotics by the year showed significant differences (p<0.05). The patterns of multidrug resistance rates were 43.1% (47 strains) for one drug, 8.3% (9 strains) for two drugs, 11.0% (12 strains) for three drugs, 15.62% (17 strains) for four drugs, and 13.7% (15 strains) for five or more drugs for S. Enteritidis. For S. Tyhpimurium, the rates were 15.0% (12 strains) for one drug, 10.0% (8 strains) for two drugs, 6.3% (five strains) for three drugs, 18.7% (15 strains) for four drugs, and 23.8% (19 strains) for five or more drugs. Conclusion: The antibiotic resistance issue is directly related to people's lives. Thus, the usage of antibiotics should be reduced in order to manage antibiotic resistance.

• 대한골관절종양학회지
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• 제3권1호
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• pp.9-17
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• 1997

Resistance to combination chemotherapy remains challenge in the treatment of osteosarcoma. One of the mechanisms of multiple drug resistance is an increased expression of the multidrug resistance gene(mdr1). Expression of the P-glycoprotein(mdr-1 gene product) was studied immunohistochemically and the mdr-1 gene by in situ hybridization in 33 osteosarcomas relating to various prognostic factors. Thirty cases out of 33 osteosarcomas(90.9%) showed positive cytoplasmic reactions with P-glycoprotein and nineteen instances(57.6%) were strong positive(2+). The older(>20 years) and female patients revealed more intense immunohistochemical reactions rather than those of the younger and male patients. Osteoblastic and chondroblastic osteosarcomas revealed more strong immunohistochemical reactions compared to fibroblastic types. There were no significant staining differences between the type of bony involvement, Broder's grade and the presence of necrosis. On follow-up, the mean survival rate was decreased in the strong positive group, however, this was not statistically significant. In situ hybridization for mdr-1 gene revealed positive signals in 22 cases out of 29 osteosarcomas(75.9%). Chemotherapy was done in 15 cases out of 28 patients(53.6%). The results of immunohistochemistry and in situ hybridization were not correlated with the protocols for chemotherapy. However, this result should be confirmed by a larger scale study about mdr1 mRNA expression.

• Clinical and Experimental Pediatrics
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• 제52권5호
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• pp.529-537
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• 2009

Drug-resistant tuberculosis in children has important implications for both the patients and tuberculosis control programs. In Korea, among all new patients, the isoniazid resistance rate was 9.9% and multidrug-resistant tuberculosis rate was 2.7% in 2004 (in patients aged 10-19 yr, the multidrug-resistant tuberculosis rate reached 2.1%). Tuberculosis in pediatric patients is difficult to diagnose because many children have nonspecific clinical signs and the detection rates of acid-fast bacilli smears and cultures are low. Therefore, every effort should be made to identify adult sources and obtain information on drug susceptibility because symptomatic adult patients have a higher chance of culture positivity and drug-susceptibility patterns are the same in most adult-child pair patients. Korean children are at significant risk of drug-resistant tuberculosis. As the isoniazid resistance rate is greater than 4% among the new cases in Korea, a four-drug regimen should be considered for initial treatment of children with active tuberculosis, unless drug-susceptibility test results are available. Treatment of drug-resistant tuberculosis in children is challenging and there are only few available data. Tuberculosis control programs should be continuous with specific focus on pediatric populations because they can serve as reservoirs for future active cases. Further studies are needed regarding treatment of drug-resistant tuberculosis in children.

• 대한수의학회지
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• 제51권2호
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• pp.123-128
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• 2011

Salmonella spp. is an important pathogen to both public and swine industry. The aim of this study was to investigate the distribution of Salmonella serovar and antibiotics susceptibility of the isolates from Korean swine producing systems. A total of 63 (5.28%) Salmonella spp. was isolated from 1,194 samples (977 fecal materials and 67 organ samples). The predominant Salmonella (S.) enterica serotype and serovar was group B (69.8%) and S. Typhimurium (47.6%), S. Derby (20.6%) and S. Heidelberg (1.6%). But S. Cholerasuis which is characterized host specific by septicemia and enteritis to pigs was not isolated. Antimicrobial susceptibility of the isolates varies as follows: Norfloxacine (75%), Ciprofloxacin (67.5%), Amikacin (60%), Colistin (60%), Enrofloxacin (55%). All of isolates were resistant to Erythromycin, Penicillin, Tetracycline and Lincomycin. The results of this study provided useful information regarding antimicrobial susceptibility and resistance patterns to treat salmonellosis and to prevent emergence of multidrug resistance Salmonella.

• 한국축산식품학회지
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• 제42권2호
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• pp.252-265
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• 2022

Kocuria salsicia can survive in extreme environments and cause infections, including catheter-related bacteremia, in humans. Here, we investigated and evaluated the characteristics of nine K. salsicia strains (KS1-KS9) isolated from cheese brine from a farmstead cheese-manufacturing plant in Korea from June to December, 2020. Staphylococcus aureus American Type Culture Collection (ATCC) 29213 was used as a positive control in the growth curve analysis and biofilm-formation assays. All K. salsicia isolates showed growth at 15% salt concentration and temperatures of 15℃, 25℃, 30℃, 37℃, and 42℃. KS6 and KS8 showed growth at 5℃, suggesting that they are potential psychrotrophs. In the biofilm-formation analysis via crystal violet staining, KS6 exhibited the highest biofilm-forming ability at various temperatures and media [phosphate buffered saline, nutrient broth (NB), and NB containing 15% sodium chloride]. At 25℃ and 30℃, KS3, KS6, and KS8 showed higher biofilm-forming ability than S. aureus ATCC 29213. The antimicrobial resistance of the isolates was evaluated using the VITEK^® 2 system; most isolates were resistant to marbofloxacin and nitrofurantoin (both 9/9, 100%), followed by enrofloxacin (7/9, 77.8%). Five of the nine isolates (5/9, 55.6%) showed multidrug resistance. Our study reports the abilities of K. salsicia to grow in the presence of high salt concentrations and at relatively low temperatures, along with its multidrug resistance and tendency to form biofilms.

• 대한수의학회지
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• 제52권2호
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• pp.133-139
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• 2012

Antimicrobial resistance is one of the most concerns in pig industry. Escherichia (E.) coli have been used for the indicator to monitor the antimicrobial resistance. In this study, 321 E. coli from diarrheic and non-diarrheic piglets were tested for antimicrobial resistance and frequency of $Bla_{TEM}$. In non-diarrheic piglets, they were resistant to oxytetracycline (93%), streptomycin (92%) and sulfadiazine (90%) but susceptible to ceftiofur (99%), colistin (97%), and enrofloxacin (82%). The isolates from diarrheic piglets were resistant to enrofloxacin (72.9%), ceftiofur (17.6%), and colistin (11.3%), whereas the resistance was 1%, 18% and 3% in case of non-diarrheic piglets, respectively. The resistance for amoxicillin/clavulanic acid (54.1%) and ceftiofur (22%) was high in isolates from post-weaning piglets. The resistance for colistin was 15.2% in nursery piglets. Seventy-three percent of isolates from diarrheic piglets showed high multidrug resistance profile (more than 13 antimicrobials) compared to those from non-diarrheic pigs in which 71% of isolates showed moderate multidrug resistance profile (7 to 12 antimicrobials). The frequency of $Bla_{TEM}$ in E. coli from non-diarrheic and diarrheic piglets was 57% and 69%, respectively. The results might provide the basic knowledge to establish the strategies for treatment and reduce antibiotic resistance of E. coli in piglets.