• 생명과학회지
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• 제24권10호
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• pp.1118-1124
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• 2014

국내에서 발생하는 돼지호흡기복합증후군(Porcine respiratory disease complex, PRDC)의 발생 상황 및 원인체의 검출 방법의 비교와 PRDC에서 cytokine의 발현변화 여부를 확인하기 위해서 481건의 시료에 대해 PRDC 발생상황을 조사하였다. 총 481건 중 단독감염은 113건(23.5%), 2종 이상의 원인체에 의한 발병이 348(72.3%)건으로 나타났다. PRDC 발생상황을 주령별로 분석한 결과, 총 348건에서 3주령에서 10주령미만의 돼지에서 258건(74.1%)으로 가장 많이 나타났다. PRDC의 주 원인체로 알려진 PRRSV, PCV2, SIV에 대한 감별진단을 위해 면역조직화학염색법(IHC)과 PCR에 의한 검출을 원인체 검출을 비교한 결과, 결과 PCR 방법이 IHC보다 원인균인 PRRSV, PCV-2의 검출에 효과적인 것으로 나타났으며 이러한 결과를 근거로 PRDC를 유발하는 원인체에 대해서는 임상적으로는 PCV-2는 감염되더라도 병리소견을 발현하지 않는 예가 있어 임상증상을 나타내는 PRDC의 주요 원인체는 PRRSV로 확인되었다. PRDC로 진단된 시료 중 2종 및 3종의 혼합감염군을 대상으로 폐와 림프절에서 cytokine의 발현의 변화를 조사한 결과에서는, IL-6을 제외한 조사된 모든 cytokine들이 2종 및 3종 복합 감염군에서 대조군에 비해 감소되었다.

• Journal of Chest Surgery
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• 제47권2호
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• pp.155-159
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• 2014

Cardiac tamponade due to purulent pericarditis with a characteristic greenish fluid is rare in this antibiotic era. It is highly fatal despite early diagnosis and advanced treatment. Gram-positive cocci are the leading cause of purulent pericarditis, which usually results from a direct or hematogenous spread of organisms to the pericardium from the primary foci of infection. We describe an index case of rapidly developing pericardial tamponade caused by oropharyngeal polymicrobial infection in the absence of a primary source of infection in a 62-year-old man, who was successfully managed with emergency large-volume pericardiocentesis followed by pericardiectomy.

• Pediatric Infection and Vaccine
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• 제17권2호
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• pp.83-90
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• 2010

목적:다균혈증이란 동일한 환자의 혈액에서 24시간 이내에 2종 이상의 세균 또는 진균이 분리되는 질환으로 정의하며 이러한 다균혈증은 높은 사망률과 치료의 어려움으로 인해 많은 연구가 필요한 부분이다. 따라서 본 저자들은 국내 단일 기관에서 일정 기간동안 전체 소아환자를 대상으로 하여 발생한 다균혈증 환자에 대한 임상적 특징과 균종의 특성에 대한 조사를 시행하였다. 방법 : 동일한 환자에서 무균적으로 검출된 혈액 검체를 호기성 배지와 혐기성 배지에서 배양한 결과 2종 이상의 균종이 검출되는 경우에 해당하는 환자의 의무 기록을 후향적으로 조사하였으며 이들의 임상 양상과 혈액학적 검사결과를 T-검정과 카이제곱 검정을 통해 분석하였다. 결과: 2001년부터 2008년까지 소아 환자에서 총 97명, 113예의 다균혈증이 있었으며 이들은 남자 78명, 여자 19명으로 4.1:1의 성비를 보였다. 다균혈증이 전체 균혈증에서 나타난 빈도를 연도별로 조사한 결과 2001년에 4예(1.4%)에서 2008년에는 14예(10.9%)로 전체적으로 증가하는 양상을 보였다. 기저 질환별 다균혈증의 검출되는 빈도는 면역 저하를 보인 혈액 종양 환자 31.9%, 심혈관 질환 15.4%, 신경계 질환 10.3%, 호흡기 질환 8.2%의 빈도로 나타났으며 전체 균종별 빈도는 그람 양성이 60.5%, 그람 음성이 29.2%, 혐기성 균주이 2.5%, 진균이 7.6%으로 검출되었다. 다균혈증 환자들의 사망률과 연관된 위험 인자로 기저 질환이 있었던 경우와 중심 혈관 도관이 있었던 경우, 원내 감염이었던 경우, 중환자실에서 치료를 받은 경우, 2회 이상의 다균혈증이 나타난 경우, 진균 감염이 동반된 경우에서 사망률과 의미있는 연관성을 보였다(P<0.05). 결론 : 다균혈증은 세계적으로 증가하는 추세를 보이고 있는 질환으로 다균혈증이 있는 소아 환자에서의 사망률은 성인에 비해 높으며 복합적인 위험인자와 중증의 합병증의 발생으로 인해 치료가 어려우므로 더욱 적극적인 치료가 필요할 것으로 보인다. 본원의 결과는 이전의 연구 결과와 비교하여 다균혈증 환자들의 기저질환으로 만성적인 면역저하자에서 가장 많이 나타났고 진균이 동반된 감염과 그람 양성 균종에 의한 감염이 이전보다는 증가한 것으로 보이고 있으나 이러한 결과에 대해서는 단일 균종에 의한 감염까지 포함하는 좀 더 포괄적인 조사가 필요할 것으로 보인다.

• Archives of Plastic Surgery
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• 제33권3호
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• pp.330-334
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• 2006

Polymicrobial nature of diabetic foot infection has been well documented in the literature. Initial antibiotic therapy of diabetic foot infection is usually empiric until reliable culture data is shown. This study was carried out to determine the common bacteriological flora of diabetic foot infection and antimicrobial sensitivity pattern in order to enhance possible empiric treatment. The specimens were obtained from wounds of 207 cases of diabetic foot ulcer, and the bacteriological isolation, and antimicrobial susceptibility tests of the isolates were carried out by standard microbiological methods. Staphylococcus aureus was the most common isolate, with 46.2% of recover rate among total bacterial isolated cases. Among gram-negative organisms, Pseudomonas aeruginosa was most common. Gram-positive organisms showed significant susceptibility to clindamycin, trimethoprim/sulfamethoxazole, and levofloxacin, besides vancomycin. Cefoperazone, piperacillin/tazobactam, and amikacin in addition to imipenem were most effective agents compared to gram-negative organisms. Diabetic foot infection requires use of combined antimicrobial therapy for initial management. Our results indicate that the most effective antibiotic combination for diabetic foot infection of Korean patients is clindamycin plus cefoperazone.

• 대한미생물학회지
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• 제20권1호
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• pp.35-44
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• 1985

Isolation and identification of anaerobic bacteria from blood cultures are still technically demanding procedures. Recently, with the use of gas liquid chromatography, the accuracy of identification is much improved. However, there has never been a satisfactory data analysis on anaerobic bacteremia in Korea. The authors evaluated both the clinical and the bacteriological data of 129 anaerobic bacteremias found at the Yonsei Medical Center during the period of 1973 to 1984. The most frequently isolated anaerobic bacteria were Bacteroides (52.7%), among which the major species was B. fragilis (38.7%). Incidence of anaerobic bacteremia by sex was 57% in male and 43% in female. Mortality was higg in groups below 1-year old and above 50-year old. The cause of death seemed closely correlated with the patient's age, general condition and the severity of the underlying disease. Various neoplasms were the most common (20%) underlying diseases predisposing the anaerobic bacteremia. Biliary tract was considered the most frequent route of infection in anaerobic bacteremia. The frequent clinical signs in anaerobic bacteremia were fever (65%), followed by liver function abnormality (29%), jaundice (20%) and hypotention(18%). When analysis of positive rate of blood culture was made on the patients from whom 4 cultures were done within 24 hours, it was found that 33% of the samples were positive. Isolation rate of anaerobic bacteria in thioglycollate medium was 83.8%, while it was 44% in Tryptic soy broth. Among the anaerobic bacteremia, 25.4% were polymicrobial infections with aerobic bacteria (92.5%), such as E. coli(33.3%). From these studies, it is concluded that B. fragilis is the most important causative organism in anaerobic bacteremia, with high fatality, particularly in those who have underlying diseases. The ports of entry are mainly biliary, gastrointestinal and female genital tract. Fever is the most frequent clinical sign. Single blood culture is not sufficient to detect all anaerobic bacteremia, therefore more cultures with optimal time interval are needed. The incidence of polymicrobial infection in anaerobic bacteremia is higher than that in overall bacteremia.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제30권6호
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• pp.540-544
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• 2004

The oral lesion of acquired syphilis - primary, secondary, and tertiary - is comparatively rare. Most of the time secondary syphilis manifests itself as a systemic disease with maculopapular eruptions of the skin, generalized lymphadenopathy, fever, and occasional eruptions on the mucous membranes. The lesions of the tertiary stage may occur anywhere in the body, including the oral cavity. Necrotizing faciitis of the head and neck is an uncommon, rapidly spreading soft tissue infection of polymicrobial origin characterized by extensive necrosis and gas formation in the subcutaneous tissue and superficial fascia. This is characterized by its fulminating, devastating, and rapid-progressing course. The mortality rate is high if it is not treated promptly and vigorously. Patients with an impaired immune system and those with small-vessel disease such as diabetes mellitus are more prone to develop this infection.

• Pediatric Infection and Vaccine
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• 제5권2호
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• pp.296-301
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• 1998

Flavobacterium species are nonfastidious, oxidase-positive gram-negative rods that do not ferment glucose. These organism are widely distributed in nature and in hospital environments. In past, one of flavobacteria, Flavobacterium indologenes, was treated with non-pathogenic organism. Recently, several investigators have demonstrated the infection of this organism in human. Nowadays, the growth of F. indologenes in specimen should be considered a potential pathogen in infectious patients including neonate, especially in the setting of malignancy and with use of invasive procedures. The resistance of this organism to multiple antibiotics and the high incidence of polymicrobial bacteremia make it difficult to determine optimal therapeutic options. We experienced a case of neonatal bacterial meningitis causing by F. indologenes. So we report this case to evoke more concerns about the infections of this organism in human.

• Journal of Chest Surgery
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• 제25권3호
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• pp.271-275
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• 1992

One hundred forty patients with empyema thoracis were managed under the general anesthesia at the Seoul National University Hospital between 1980 and 1990. The patients, who were managed by thoracentesis or intercostal tube drainage alone, were excluded in this study. There were 92 males and 48 females, ranging from 8 to 80 years of age. Underlying pathologic lesions of empyema thoracis were primary bronchopulmonary infection [84%], postoperative empyema[11%], malignancy, paragonimiasis, spontaneous pneumothorax and so on. A single causal organism was isolated only in 17 patients[the most common being staphylococcus aureus, pseudomonas, & streptacoccus pneumoniae], multiple organism in 31, and no growth in 32. Surgical treatment modalities were decortication[75], pleuropneumonectomy[30], decortication with lobectomy[10], empyemectomy[9], open drainage[13], Clagett procedure [6], thoracoplasty with or without muscle transposition[9]. Hospital mortality were in 2 cases[1.4%], one empyema related and the other nonrelated. In this study, bacteriologic findings were nonspecific and often polymicrobial. We conclude that early thoracotomy can be lifesaving in the presence of a benign clinical course.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제41권2호
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• pp.90-96
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• 2015

Necrotizing fasciitis (NF) is an infection that spreads along the fascial planes, causing subcutaneous tissue death characterized by rapid progression, systemic toxicity, and even death. NF often appears as a red, hot, painful, and swollen wound with an ill-defined border. As the infective process continues, local pain is replaced by numbness or analgesia. As the disease process continues, the skin initially becomes pale, then mottled and purple, and finally, gangrenous. The ability of NF to move rapidly along fascial planes and cause tissue necrosis is secondary to its polymicrobial composition and the synergistic effect of the enzymes produced by the bacteria. Treatment involves securing the airway, broad-spectrum antimicrobial therapy, intensive care support, and prompt surgical debridement, repeated as needed. Reducing mortality rests on early diagnosis and prompt aggressive treatment.

• Journal of Microbiology and Biotechnology
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• 제14권2호
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• pp.401-410
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• 2004

Soil samples from five different areas in Korea were collected during 2001/02 and examined for presence of the genus Clostridium. Direct immuno-fluorescent assay (IFA) examination showed that Clostridium septicum, Cl. novyi and Cl. chauvoei were detected in the soil of specific areas in Korea. Sixteen species of Clostridium were isolated and cultivated from the soil samples. Cl. peifringens was detected in all sampling locations, while the other species were not. The in vitro activity of 14 antibiotic agents was determined against 421 clostridia isolated from the soil contaminated with animal feces in Korea. Trovafloxacin was effective against all isolates of the genus Clostridium except one isolate of Cl. subterminale, two of Cl. tetani, and three of Cl novyi with $MIC_{50}$ $8- 16\mu$g $ml^{-1}$. Thirteen species of Clostridium were resistant to vancomycin except for Cl. perfringens, Cl. sporogenes, and Cl. subterminale. Imipenem and trovafloxacin showed high antimicrobial activities (>95%) against all strains in the clostridia investigated. Therefore, antibiotic agents such as imipenem and trovafloxacin are the most suitable agents for polymicrobial infection as broad-spectrum monotherapy.