• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.22 no.5
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• pp.417-430
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• 2019

The policies developed for the treatment of Helicobacter pylori infection in adults may not be the most suitable ones to treat children and adolescents. Methods used to treat children and adolescents in Europe and North America may not be appropriate for treating children and adolescents in Korea due to differences in epidemiological characteristics of H. pylori between regions. Moreover, the agreed standard guidelines for the treatment of H. pylori infection in children and adolescents in Korea have not been established yet. In this study, the optimal treatment strategy for H. pylori infection control in children and adolescents in Korea is discussed based on these guidelines, and recent progress on the use and misuse of antimicrobial agents is elaborated. Non-invasive as well as invasive diagnostic test and treatment strategy for H. pylori infection are not recommendable in children aged less than ten years or children with body weight under 35 kg, except in cases of clinically suspected or endoscopically identified peptic ulcers. The uncertainty, whether enough antimicrobial concentrations to eradicate H. pylori can be maintained when administered according to body weight-based dosing, and the costs and adverse effects outweighing the anticipated benefits of treatment make it difficult to decide to eradicate H. pylori in a positive noninvasive diagnostic test in this age group. However, adolescents over ten years of age or with a bodyweight of more than 35 kg can be managed aggressively as adults, because they can tolerate the adult doses of anti-H. pylori therapy. In adolescents, the prevention of future peptic ulcers and gastric cancers is expected after the eradication of H. pylori. Bismuth-based quadruple therapy (bismuth-proton pump inhibitor-amoxicillin/tetracycline-metronidazole) with maximal tolerable doses and optimal dose intervals of 14 days is recommended, because in Korea, the antibiotic susceptibility test for H. pylori is not performed at the initial diagnostic evaluation. If the first-line treatment fails, concomitant therapy plus bismuth can be attempted for 14 days as an empirical rescue therapy. Finally, the salvage therapy, if needed, must be administered after the H. pylori antibiotic susceptibility test.

• Korean Journal of Clinical Laboratory Science
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• v.56 no.1
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• pp.52-58
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• 2024

Photodynamic therapy (PDT) activates intracellular oxygen using a photosensitizer activated by light of a specific wavelength and is a potential means of treating wound infections caused by antibiotic-resistant bacteria. Pseudomonas aeruginosa (P. aeruginosa) is typically non-pathogenic in healthy individuals but can induce severe illnesses like sepsis in the immunocompromised. Antibiotics have been conventionally used to treat P. aeruginosa infections, but increasing antibiotic resistance caused by drug misuse poses a growing challenge to the management of these infections. This study aimed to investigate the ability of PDT using photosensitizers (PhotoMed, Methyl pheophorbide A, or Radachlorin^®) and a diode laser to inhibit P. aeruginosa. Suspensions of P. aeruginosa and a photosensitizer were inoculated into Petri dishes and incubated for 30 minutes. Samples were then irradiated with the laser at 3 J/cm², and after incubation, colony areas were measured. P. aeruginosa killing rates were 79.65% for PhotoMed, 47.36% for Methyl pheophorbide A, and 40.91% for Radachlorin^®. This study shows that PDT using a diode laser and a photosensitizer constitutes an effective practical therapeutic approach for inhibiting P. aeruginosa.

• Tuberculosis and Respiratory Diseases
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• v.47 no.4
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• pp.460-470
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• 1999

Background : In 1993, American Thoracic Society (ATS) recommended a guideline for the initial management of adults with community-acquired pneumonia(CAP). However, etiologic organisms and medical system in Korea seem to be different from those in Western countries. Retrospective analysis was done to evaluate the efficacy of antibiotics chosen by ATS guideline in the treatment of Korean patients with CAP admitted to a tertiary university medical center. Methods : Hospitalized patients with CAP at Samsung Medical Center from April 1997 through March 1998 were retrospectively reviewed. Patients who fulfilled all of the following criteria were included in this study : (1) fever ${\geq}38^{\circ}C$ (2) purulent sputum (3) pulmonary infiltrates on chest X-ray. Patients were classified as : 1) ATS group ; patients whose initial antibiotics were chosen by ATS guideline 2) Non-ATS overuse group ; additional antibiotics administered more than those of ATS guideline, and 3) Non-ATS underuse group ; initial antibiotics were insufficient to ATS guideline. Response of empirical antibiotics and etiologic organisms of 3 groups were identified. Results : Sixty-four patients were enrolled. Thirty-six patients were classified into ATS group, 10 patients Non-ATS overuse group, and 18 patients Non-ATS underuse group. Thirty-three patients of 36 ATS group, 9 patients of 10 Non-ATS overuse group, and 14 patients of 18 Non-ATS underuse group showed improvement by initial empirical antibiotics. There was no statistical difference in antibiotic response between 3 groups (p>0.05). S. pneumoniae (12.5%), K. pneumoniae (9.4%), and P. aeruginosa (4.7%), Mycoplasma (3.1%) were the most commonly isolated organisms. In 18 patients with severe CAP, P. aeruginosa was isolated only in 1 patient and Legionella organism not isolated. Conclusion : Initial empirical antibiotics chosen by ATS guideline were effective in the management of Korean patients with CAP admitted to a tertiary hospital. However, well-designed large-scale prospective study is needed to identify etiologic organisms and choose an adequate initial empirical antibiotics in Korean adults patient with severe CAP.

• Pediatric Infection and Vaccine
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• v.16 no.2
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• pp.162-166
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• 2009

Purpose : Urinary tract infection (UTI) is one of the most common bacterial infectious disease in childhood. Renal scarring is an important complication of UTIs. Known risk factors for renal scarring are younger age, anatomic defects, delayed treatment, and causative pathogens other than Escherichia coli. The aim of this study was to compare the characteristics of clinical and laboratory features of UTI with E. coli to those with non-E. coli in infants. Methods : We reviewed the medical records of 1,120 infants under 12 months of age who had been admitted for UTIs between January 1998 and December 2007. All patients who were diagnosed with UTIs were divided into two groups (E. coli and non-E. coli UTIs). Results : Three hundred twenty-four of 1,120 cases met the inclusion criteria. The number of E. coli and non-E. coli UTIs was 273 (84.3%) and 51 (15.7%), respectively. As compared to the non-E. coli UTI group, the E. coli UTI group was younger (3.59 vs. 4.47 months, P =0.008), a longer duration of pyuria (3.96 vs. 3.06 days, P =0.01), higher peripheral white blood cell counts (13.89 vs. $12.13{\times}10^3/mm^3$, P =0.043), and lower rates of high degree (III-V) vesico-ureteral reflux (P =0.005). Conclusion : UTIs with E. coli might have more severe clinical features and a lower prevalence of high grade vesicoureteral reflux than UTIs with non-E. coli. However, no difference was noted in the clinical response to antibiotic therapy between the two groups.

• Proceedings of the Korean Society of Plant Pathology Conference
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• 1994.06a
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• pp.11-26
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• 1994

Crown gall of stonefruit and nut trees is one of the very few plant diseases subject to efficient biological control. The disease is caused by the soil-inhabiting bacteria Agrobacterium tumefaciens and Agrobacterium rhizogenes and the original control organism was a non-pathogenic isolate of A. rhizogenes strain K84. Control is achieved by dipping planting material in a cell suspension of strain K84 which specifically inhibits pathogenic strains containing a nopaline Ti plasmid. Because the agrocin 84-encoding plasmid (pAgK84) is conjugative, it can be transmitted from the control strain to pathogenic strains which, as a result, become immune to agrocin 84 and cannot be controlled. To prevent this happening, the transfer genes on pAgK84 were located and then largely eliminated by recombinant DNA technology. The resulting construct, strain K1026, is transfer deficient but controls crown gall just as effectively as does strain K84. Field data from Spain confirm that pAgK84 can transfer to pathogenic recipients from strain K84 but not from strain K1026. The latter has been registered in Australia as a pesticide and is the first genetically engineered organism in the world to be released fro commercial use. It is recommended as a replacement for strain K84 to prevent a breakdown in the effectiveness of biological control of crown gall. Several reports indicate that both strains K84 and K1026 sometimes control crown gall pathogens that are resistant to agrocin 84. A possible reason for this is that both strains produce a second antibiotic called 434 which inhibits growth of nearly all isolates of A. rhizogenes, both pathogens and non-pathogens. Crown gall of grapevine is caused by another species, Agrobacterium vitis. It is resistant to agrocin 84 and cannot be controlled by strains K84 or K1026. It is different from other crown gall pathogens in several characteristics, including the fact that, although a rhizosphere coloniser, its also lives systemically in the vascular tissue of grapevine. Pathogen free propagating material can be obtained from tissue culture or, less surely, by heat therapy of dormant cuttings. A number of laboratories are searching for a biocontrol strain that will prevent, or at least delay, reinfection. A non-pathogenic A. vitis strain F/25 from South Africa looks very promising in this regard.

• Korean Journal of Veterinary Research
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• v.50 no.3
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• pp.213-220
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• 2010

Salmonella (S.) Enterica infection ranks among the most common food borne bacterial infections worldwide. Although there are six subspecies of S. Enterica, the vast majority of human and animal infections are caused by strains belonging to subspecies 1 serovar Typhimurium and Enteritidis. Recent reports on antibiotic resistance of Salmonella spp. are rising steadily. The increasing problem of antibiotic resistance has rekindled interest in bacteriophage to therapy. Therefore, we investigated the efficacy of bacteriophage in S. enterica serovar Enteritidis infected mice and pigs by measuring of body condition, body weight, bacterial colonization and weight of organs based on the in vitro analysis. In vitro experiment, phage cultured with S. Enteritidis showed clear lysis pattern, the plaque forming unit (PFU) of our phage culture was $1.5{\times}10^{11}PFU/mL$, and phage showed its maximum activity at 4 h post inoculation. In mouse experiment, there was no significant difference among experimental groups in the general body conditions and body weight of mice. However, there was difference in weight of liver and spleen depending on the experimental group (p < 0.05). The weight of liver and spleen were reduced by the phage treatment. Also bacterial colonization in spleen and liver were significantly reduced by the phage treatment. In pig experiment, the general body conditions and body temperature exhibited not much difference among the pigs except few pigs in group 3 which showed poor body conditions. From the feces in each group, we could isolate the S. Enteritidis only from group 3. Bacterial enrichment culture was necessary for isolating the bacteria from 5 dpi and 10 dpi, however direct isolation was possible from 15 dpi feces. In phage treated group, postmortem lesion was better than non-phage treated group. Recently, antibiotic resistance concerns on the food-borne bacterial pathogens have been increasing because of the wide spread of the antibiotics resistance genes. This concern is widely transmitted to the human related public health. As one of the alternative treatments on the bacterial pathogens, attempt using phages have been made to control the bacterial diseases. The positive possibility of the trail using phage was observed to control the S. enterica serovar Enteritidis in this study even though the further analysis has been remained.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.5 no.2
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• pp.150-157
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• 2002

Purpose: As the incidence of non-typhoidal salmonella strains resistant to antibiotics has been increased, we attempted to investigate clinical aspects of non-typhoidal salmonella gastroenteritis and antibiotics resistance. Methods: From January 2000 to June 2002, 99 children with positive stool culture of non-typhoidal salmonella were studied about clinical features, the incidence of antibiotics and multi-drug resistance and the difference of incidence of antibiotics resistance according to immune status. Results: There were 66 males and 33 females. The majority of them were under 5 years of age (71%). 25 children were immunocompromised due to chemotherapy, steroid or immunosuppressive treatment. Serogroup D was the most common isolates (65%) followed by B (16%), C (8%) and E (8%). Resistance rate of 30% to ampicillin, 12% to chloramphenicol, 20% to trimethoprim-sulfamethoxazole (TMP-SMX), 11% to cefotaxime and 8% to cefixime were obtained. All isolates were susceptible to ciprofloxacine. Resistance rate to cefotaxime and cefixime in immunocompromised patients was 24% and 14.3% respectively, which were significantly higher compared to that in immunocompetent patients (6.8%, 5.6%, p<0.05). 11 isolates were resistant to three or more antibiotics. The incidence of multi-drug resistant isolates was significantly higher in immunocompromised patients (24%) than that of immunocompetent patients (6.8%). Conclusion: Because of the high prevalence of non-typhoidal salmonella strains resistant to ampicillin, chloramphenicol and TMP-SMX, third-generation cephalosporin might be the treatment of choice in non-typhoidal salmonella gastroenteritis. In particular, antibiotics should be carefully selected in immunocompromised patients because non-typhoidal salmonellas from them showed the higher incidence of antibiotic resistance and multi-drug resistance.

• The Journal of the Korean Society for Microbiology
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• v.20 no.1
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• pp.13-23
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• 1985

This investigation was performed to isolate and identify Staphylococcus sp. from air at the 25 sites in one hospital in Daegu. Drug sensitivity tests bacteriologically were also studied. The results are summarized as follows: 1. In gram staining of isolated colonies, the number of staphylococci strains was 959(70.2%) among 1367 collected in the morning, and 653(66.2%) among 987 collected in the afternoon. 2. The number of isolates was slightly higher in samples collected from the outpatient treatment rooms and wards in the main building than in samples from the other sites. 3. In biochemical tests of 1612 strains of isolates gram positive cocci, the number of coagulase positive strains was 584(36.2%) and coagulase negative 1028(63.8%). In experiments on growth on mannitol agar containing 7.5% NaCl and mannitol fermentation tests, the number of mannitol fermentation strains was 423(30.8%) and nonfermenter was 951(59.2%). 4. In antibiotic sensitivity tests of 746 identified strains of staphylococci, coagulase positive strains showed resistance in. higher portions to penicillin(89.7%), chloramphenicol(64.6%), gentamycin (52.1%) and tetracycline(45.2%), whereas in lower portions to kanamycin(39.2%) and apmicillin(33.1%). 5. Among coagulase negative and mannitol fermenting strains, higher portions showed resistance to chloramphenicol(76.5%), penicillin(69.8%) and ampicillin(63.6%), whereas lower portions showed resistance to kanamycin(48.8%), tetracycline(39.5%) and gentamycin(34.0%). 6. The number of strains showing multiple resistance to above 6 antibiotics were 15(52(19.8%) among coagulase positive and mannitol non-fermenter and 36(22.2%) among coagulase negative and mannitol fermenter.

• Proceedings of the Korean Society of Plant Pathology Conference
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• 2003.10a
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• pp.69.1-69
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• 2003

RSH (relA/spoT homolog) has been known to determine the level of guanosine tetraphosphate (ppGpp) and guanosine pentaphosphate (pppGpp), which are the effector nucleotide of the prokaryotic stringent response and also play a role in antibiotic production and differentiation in Streptomyces species but not a little in eukaryotic organism, especially in plant. Salicylic acid (SA), a critical signal molecule of establishing systemic acquired resistance (SAR), could induce SAR in Pepper (Capcicum annuum) against Phytophthora capsici. And the extent of SAR induction was in proportion to the dosage of SA (or BTH). Suppression subtractive hybridization (SSH), a PCR-based method for cDNA subtraction, was carried out between SA-treated and non-SA-treated pepper leaves to isolate genes which may be responsible for defense signaling against pathogens. Early upregulated gene was selected from reverse northern and kinetics of SSH-genes transcripts in SA-treated pepper leaves upon SA treatment. Full-length cDNA of the gene (PepRSH； Pepper RelA / SpoT homolog) had an open reading frame (ORF) of 2166 bp encoding a protein of 722 amino acids and a significant homology with (p)ppGpp phosphohydrolase or synthetase. Genomic DNA gel blot analysis showed that pepper genome has at least single copy of PepRSH. PepRSH transcripts was very low in untreated pepper leaves but strongly induced by SA and methyljasmonic acid (MeJA), indicating that PepRSH may share common SA and MeJA-mediated signal transduction pathway Functional analysis in E. coli showed PepRSH confers phenotypes associated with (p)ppGpp synthesis through a complementation using active site mutagenesis.

• Journal of Periodontal and Implant Science
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• v.24 no.2
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• pp.421-432
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• 1994

The local route of antibiotic administration can accomplish higher therapeutic doses in subgingival sites than those possible by systemic therapy. This investigation assessed on the clinical and microbiological effect of 30% Minocycline loaded polycaprolactone film (Mino-strip) on rapidly progressive periodontitis. Mino-strip was applied in the periodontal pockets of 15 patients with clinically diagnosed as a rapidly progressive periodontitis. 8sites for each patient with a 5mm probing pocket depth were selected in split mouth design and were assigned into group. i.e., placebo(group 1), supragingival scaling and R/P(group 2), Mino-strip applied only(group 3), R/P and Mino-strip applied(group 4). Supragingival scaling and oral hygiene instruction were performed 1 wk before experiment. Mino-strip was applied weekly on day 0 and 7. Clinical and microbiological test were performed on day 0, 7, 14, 28, 56. In R/P and Mino-strip applied group, Gingival index, GCF volume, probing depth and loss of attachment level were significantly reduced after the first weeks following treatment. In R/P and Mino-strip applied group, the relative proportions of spirochetes and motile rods were significantly reduced and the proportions of cocci and non motile rod were correspondingly increased for eight weeks following treatment. In R/P and Mino-strip treated group, total anaerobic and aerobic bacterial count were significantly decreased for the first two weeks following treatment and streptococcus count was decreased for eight weeks following treatment. In R/P and Mino-strip applied group, P. gingivalis, P. intermedius, B. forsythus, A. actinomycetemcomitans, F. nucleatum, E. corrodens, C. rectus counts were significantly reduced after the first week following treatment. According to this study, it is appeared that 30% Minocycline-loaded polycaprolacton film was effective in the treatment on rapidly progressive periodontitis.