• Journal of Preventive Medicine and Public Health
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• v.52 no.1
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• pp.66-70
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• 2019

Objectives: In the Republic of Korea (ROK), the notified incidence of tuberculosis in foreign-born individuals (NITFBI) has increased recently, as has the rate of multidrug-resistant (MDR) and rifampicin-resistant (RR) tuberculosis in foreigners staying in the ROK. As Jeju Province in ROK has a no-visa entry policy, control programs for NITFBI should be consolidated. The aim was to evaluate the status of NITFBI, with a focus on the distribution of MDR/RR tuberculosis by nationality. Methods: Data on tuberculosis incidence in individuals born in Jeju Province and in foreign-born individuals were extracted from the Korean Statistical Information Service of Statistics Korea, and the Infectious Disease Surveillance Web Statistics of the Korea Centers for Disease Control and Prevention, respectively. Results: Among all notified incident cases of tuberculosis, the proportion of NITFBI increased from 1.46% in 2011 to 6.84% in 2017. China- and Vietnam-born individuals accounted for the greatest proportion of the 95 cases of NITFBI. Seven cases of MDR/RR tuberculosis were found, all involving patients born in China. Conclusions: In Jeju Province, ROK, NITFBI might become more common in the near future. Countermeasures for controlling active tuberculosis in immigrants born in high-risk nations for tuberculosis should be prepared in Jeju Province, since it is a popular tourist destination.

• Tuberculosis and Respiratory Diseases
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• v.82 no.2
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• pp.151-157
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• 2019

Background: Tuberculosis (TB) is the most important disease screened for upon patient history review during preimmigration medical examinations as performed in South Korea in prospective immigrants to certain Western countries. In 2007, the U.S. Centers for Disease Control and Prevention (CDC) changed the TB screening protocol from a smear-based test to the complete Culture and Directly Observed Therapy Tuberculosis Technical Instructions (CDOT TB TI) for reducing the incidence of TB in foreign-born immigrants. Methods: This study evaluated the effect of the revised (as compared with the old) protocol in South Korea. Results: Of the 40,558 visa applicants, 365 exhibited chest radiographic results suggestive of active or inactive TB, and 351 underwent sputum tests (acid-fast bacilli smear and Mycobacterium tuberculosis culture). To this end, using the CDOT TB TI, 36 subjects (88.8 per $10^5$ of the population) were found to have TB, compared with only seven using the older U.S. CDC technical instruction (TI) (p<0.001). In addition, there were six drug-resistant cases which were identified (16.7 per $10^5$ of the population), two of whom had multidrug-resistance (5.6 per $10^5$ of the population). Conclusion: The culture-based 2007 TI identified a great deal of TB cases current to the individuals tested, as compared to older U.S. CDC TI.

• Journal of Microbiology and Biotechnology
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• v.31 no.9
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• pp.1288-1294
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• 2021

There are a growing number of reports of hospital-acquired infections caused by pathogenic bacteria, especially methicillin-resistant Staphylococcus aureus (MRSA). Many plant products are now being used as a natural means of exploring antimicrobial agents against different types of human pathogenic bacteria. In this research, we sought to isolate and identify an active molecule from Sedum takesimense that has possible antibacterial activity against various clinical isolates of MRSA. NMR analysis revealed that the structure of the HPLC-purified compound was 1,2,4,6-tetra-O-galloyl-glucose. The minimum inhibitory concentration (MIC) of different extract fractions against numerous pathogenic bacteria was determined, and the actively purified compound has potent antibacterial activity against multidrug-resistant pathogenic bacteria, i.e., MRSA and its clinical isolates. In addition, the combination of the active compound and β-lactam antibiotics (e.g., oxacillin) demonstrated synergistic action against MRSA, with a fractional inhibitory concentration (FIC) index of 0.281. The current research revealed an alternative approach to combating pathogenesis caused by multi-drug resistant bacteria using plant materials. Furthermore, using a combination approach in which the active plant-derived compound is combined with antibiotics has proved to be a successful way of destroying pathogens synergistically.

• Journal of Korean Public Health Nursing
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• v.34 no.3
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• pp.490-502
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• 2020

Purpose: This study aimed to identify the factors influencing competency for Multi-Drug Resistant Organisms (MDRO) infection control in nursing students with clinical practice experience. Methods: This cross-sectional descriptive study was conducted from May 2020 to August 2020 by including 175 nursing students in two nursing schools located in Daegu. The data were collected using self-report questionnaires. The data were analyzed using the SPSS/WIN 25.0 program with descriptive statistics, independent t-test, ANOVA, correlation, and multiple regression. Results: The competency of MDRO infection control was 3.41.±0.38. The attitude to patient safety management and - knowledge of MDRO infection control were 3.81±0.47 and 16.98±3.02, respectively. Factors influencing the competency of MDRO infection control were perceived benefit(β=.38, p<.001), knowledge toward MDRO infection control(β=.21, p=.001), attitude in patient safety management(β=.17, p=.028), and perceived barrier(β=-.15, p=.029) with an explanatory power of 34.2%. Conclusion: A systemic education program regarding MDRO infection control is needed for nursing students to provide knowledge related to MDRO infection control and help establish positive beliefs toward MDRO infection control and attitudes in patient safety management.

• Journal of Veterinary Science
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• v.23 no.3
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• pp.37.1-37.8
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• 2022

Background: Avian pathogenic Escherichia coli (APEC) causes colibacillosis, resulting in significant economic losses in the poultry industry. Objectives: In this study, the molecular characteristics of two extended-spectrum beta-lactamase (ESBL)-producing APEC isolates were compared with previously reported ESBL-producing E. coli isolates. Methods: The molecular characteristics of E. coli isolates and the genetic environments of the ESBL genes were investigated using whole genome sequencing. Results: The two ESBL-producing APEC were classified into the phylogenetic groups C and B1 and ST410 and ST162, respectively. Moreover, the ESBL genes of the two isolates were harbored in different Inc plasmids. The EC1809182 strain, harboring the bla_CTX-M-55 gene on the plasmid, exhibited extensive homology to IncFIB (98.4%) and IncFIC(FII) (95.8%). The EC1809191 strain, harboring the bla_CTX-M-1 gene, was homologous to IncI1-I (Gamma) (99.3%). All chromosomes carried the multidrug transporter, mdf(A) gene. Mobile genetic elements, adjacent to CTX-M genes, facilitated the dissemination of genes in the two isolates, analogous to other ESBL-producing E. coli isolates. Conclusions: This study clarifies the transmission dynamics of CTX-M genes and supports strengthened surveillance to prevent the transmission of the antimicrobial-resistant genes to humans via the food chain.

• Journal of Food Hygiene and Safety
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• v.32 no.2
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• pp.135-140
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• 2017

The aim of this study was to investigate the distribution of genes that encode multi-drug efflux pumps and virulence factors in Enterococcus faecalis isolated from retail meat and antibiotic resistance patterns of these strains. Of the 277 retail meat samples, 93 Enterococcus faecalis were isolated. The strains exhibited resistance to ampicillin (35.5%), chloramphenicol (6.4%), ciprofloxacin (4.3%), erythromycin (18.3%), levofloxacin (0%), quinupristin-dalfopristin (76.3%), tetracycline (45.2%), teicoplanin (0%) and vancomycin (0%). The strains were positive for MFS type eme(A) (100%), ABC type efr(A) (100%), ABC type efr(B) (98.9%) and ABC type lsa (91.4%) efflux pump gene. The strains were positive for gelE (68.8%), ace (90.3%), asa1 (47.3%), efaA (91.4%) and esp (12.9%) virulence gene. This research will help to assess the hazards associated with the occurrence of drug resistance among enterococci from retail meat. Therefore, it is necessary to monitor enterococcus spp. isolated from retail meat continuously.

• Journal of Food Hygiene and Safety
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• v.39 no.2
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• pp.134-151
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• 2024

Salmonella spp. is among the most important water-borne and food-borne pathogens and is one of the most common causes of human gastroenteritis and diarrheal diseases globally. In this study, Salmonella spp. isolated from food, environmental samples, and patients with food poisoning or diarrhea were investigated Salmonella serovars, antibiotic resistance using Vitek2, and genetic characteristics through pulsed-field gel electrophoresis (PFGE). Salmonella spp. of 339 strains, including 26 strains from food or environmental samples and 313 strains from patients, were isolated from Jeju Island of South Korea between 2020 and 2023. The monthly number of isolated Salmonella spp. gradually increased from March, with the highest number being in August. No significant differences in Salmonella spp. isolated from patients according to gender was observed. However, Salmonella spp. was most frequently isolated from people aged 70 years or older and least frequently isolated from those between ages 10 and 19 years. Salmonella spp. isolated from food or environmental samples were distributed among eight different serovars and the main serovars were identified in the order of S. Bareilly (26.9%), S. Rissen (23.1%), and S. Thompson (19.3%). Salmonella spp. isolated from patients were distributed among 27 different serovars and the main serovars were identified in the order of S. Bareilly (31.0%), S. Typhimurium (24.6%), and S. Enteritidis (11.5%). The main cause serovars of Salmonella spp. outbreaks are S. Bareilly, S. Enteritidis, S. Thompson. Antibiotic resistance tests indicated resistance to various antibiotics and some Salmonella spp. exhibited multidrug resistance. Salmonella spp. showed various genetic correlations among the 17 serovars. These results indicate that they can be used as basic data for epidemiological investigations by predicting the appearance of Salmonella spp. and providing a scientific basis.

• Tuberculosis and Respiratory Diseases
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• v.80 no.2
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• pp.143-152
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• 2017

Background: Fluoroquinolones are considered important substitutes for the treatment of tuberculosis. This study investigates the current status of fluoroquinolone for the treatment of tuberculosis. Methods: In 2009, a retrospective analysis was performed at one tertiary referral center for 953 patients diagnosed with tuberculosis. Results: A total of 226 patients (23.6%), who received fluoroquinolone at any time during treatment for tuberculosis, were enrolled in this study. The most common reasons for fluoroquinolone use were adverse events due to other anti-tuberculosis drugs (52.7%), drug resistance (23.5%), and underlying diseases (16.8%). Moxifloxacin (54.0%, 122/226) was the most commonly administered fluoroquinolone, followed by levofloxacin (36.3%, 82/226) and ofloxacin (9.7%, 22/226). The frequency of total adverse events from fluoroquinolone-containing anti-tuberculosis medication was 22.6%, whereas fluoroquinolone-related adverse events were estimated to be 2.2% (5/226). The most common fluoroquinolone-related adverse events were gastrointestinal problems (3.5%, 8/226). There were no significant differences in the treatment success rate between the fluoroquinolone and fluoroquinolone-$na{\ddot{i}}ve$ groups (78.3% vs. 78.4%, respectively). Conclusion: At our institution, fluoroquinolones are commonly used for the treatment of both multidrug-resistant tuberculosis and susceptible tuberculosis, especially as a substitute for adverse event-related drugs. Considering the low adverse event rates and the comparable treatment success rates, fluoroquinolones seem to be an invaluable drug for the treatment of tuberculosis.

• Journal of Microbiology and Biotechnology
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• v.19 no.10
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• pp.1265-1270
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• 2009

The objectives of this study were to determine the antibiotypes, SCCmec subtypes, PVL carriage, and genetic diversity of MRSA strains from a tertiary hospital. Sixty-six MRSA strains were selected randomly (2003, 2004, and 2007) and tested for the Panton-Valentine leukocidin gene, mecA gene, and SCCmec type via a PCR. The antibiograms were determined using a standard disc diffusion method, and the genetic diversity of the isolates was determined by PFGE. Thirty-four antibiograms were obtained, with 55% of the 66 strains exhibiting resistance to more than 4 antimicrobials. All the isolates remained susceptible to vancomycin, and low resistance rates were noted for fusidic acid (11%), rifampicin (11%), and clindamycin acid (19%). The MRSA isolates that were multisensitive (n=12) were SCCmec type IV, whereas the rest (multiresistant) were SCCmec type III. Only two isolates (SCCmec type IV) tested positive for PVL, whereas all the isolates were mecA-positive. The PFGE was very discriminative and subtyped the 66 isolates into 55 pulsotypes (F=0.31-1.0). The multisensitive isolates were distinctly different from the multidrug-resistant MRSA. In conclusion, no vancomycin-resistant isolate was observed. The Malaysian MDR MRSA isolates were mostly SCCmec type III and negative for PVL. These strains were genetically distinct from the SCCmec type IV strains, which were sensitive to SXT, tetracycline, and erythromycin. Only two strains were SCCmec IV and PVL-positive. The infections in the hospital concerned were probably caused by multiple subtypes of MRSA.

• Journal of Microbiology and Biotechnology
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• v.13 no.3
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• pp.354-359
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• 2003

Multiplex-PCR protocols were designed in order to make a rapid identification of MRSA. MecA, femB, and 165 rRNA genes were amplified for making a detection of MRSA. The incidence of MRSA in the clinical isolates of Staphylococcus aureus was examined by using a multiplex-PCR assay. The mecA gene was detected in 266 strains out of 336 clinical isolates of S. aureus, thus the incidence of MRSA was approximately 76.5%. The MRSAs of 247 strains (96.1%) showed resistance to more than eight species of the antimicrobial agents tested. The isolates of MRSA showed 27 different antimicrobial-resistant patterns. The results indicate that many different MRSA strains having high multidrug resistance are actually prevalent in Korea. Also, VISA was screened from the MRSA. Two strains were grown on the BHI agar plate supplemented with $8\;\mu\textrm{g}/ml$ of vancomycin at a frequency of $1/10^8$ colony forming units or higher.