• Childhood Kidney Diseases
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• v.19 no.2
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• pp.148-153
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• 2015

Purpose: We investigated trends in antibiotic resistance for gram-negative bacteria in infants with a urinary tract infection (UTI) over 15 years at a single institution. Methods: A retrospective chart review was conducted for children younger than 24 months who visited the emergency room and were diagnosed with a UTI between January 2000 and December 2014. We selected urine culture data that grew Escherichia coli and Klebsiella pneumoniae. Baseline clinical information and results of antimicrobial susceptibility tests were analyzed by dividing the 15-year study time frame into three periods (A: 2000-2004, B: 2005-2009, and C: 2010-2014). Results: During the study period, 478 applicable children were identified (E. coli, 89.7% and K. pneumoniae, 10.3%). Antibiotic resistance to third-generation cephalosporins was increased from period A to period C (A, 2.1%; B, 8.3%; C, 8.8%; P=0.025). Resistance to quinolones also showed a steady pattern during periods A to C, although it was not statistically significant (A, 7.9%; B, 9.7%; C, 12.4%; P=0.221). The incidence of Extended-spectrum ${\beta}$-lactamase (ESBL)-producing gram-negative bacteria increased from period A to period C (A, 1.4%; B, 7.6%; C, 8.2%; P=0.012). Conclusion: This study revealed that the common uropathogens E. coli and K. pneumoniae experienced increasing resistance rates against third-generation cephalosporins and a constant antibiotic resistance to quinolones in children younger than 24 months. We also showed a recent increased incidence of ESBL-producing gram-negative bacteria in patients with community-acquired UTIs. Therefore, it is necessary to actively surveil resistance in order to properly select empirical antibiotics.

• Tuberculosis and Respiratory Diseases
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• v.52 no.3
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• pp.207-218
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• 2002

Background : Intensive care units (ICUs) are generally considered epicenters of antibiotic resistance and the principal sources of multi-resistant bacteria outbreaks. The antibiotic resistance in newly opened intensive care unit that has no microbial colonization on and around the devices was investigated. Materials and Methods : The authors analyzed the antibiotic resistance patterns for common hospital acquired-pneumonia pathogens in the ICUs(Staphylococcus aureus, Pseudomonas aeruginosa, Acinetobacter spp.) at the newly opened ICU of Hanyang University Medical Center, Kuri Hospital during 6 years(1995-2000). Results : 1) Regarding Staphylococcus aureus, the resistance rate to methicillin was 15% at 1995, 21% at 1996, 20% at 1997, 23% at 1998, 22% at 1999, 55% at 2000. 2) Regarding Pseudomonas aeruginosa, the resistance rate to $3^{rd}$ cephalosporin was 50% at 1995, 50% at 1996, 78% at 1997, 40% at 1998, 77% at 1999, 39% at 2000. Imipenam was 0% at 1995, 27% at 1996, 65% at 1997, 12% at 1998, 16% at 1999, 12% at 2000. Ciprofloxacin was 0% at 1996, 56% at 1997, 36% at 1998, 57% at 1999, 58% at 2000. Tobramycin was 7% at 1995, 10% at 1996, 67% at 1997, 36% at 1998, 65% at 1999, 12% at 2000. Gentamycin was 14% at 1995, 36% at 1996, 67% at 1997, 36% at 1998, 65% at 1999, 12% at 2000. Amikacin was 14% at 1995, 30% at 1996, 61% at 1997, 16% at 1998, 39% at 1999, 18% at 2000. 3) Regarding Acinetobacter spp., the resistance rate to $3^{rd}$ cephalosporin was 92% at 1996, 89% at 1997, 88% at 1998,84% at 1999, 77% at 2000. Imipenem was 50% at 1996, 48% at 1997, 45% at 1998, 49% at 1999, 50% at 2000. Ciprofloxacin was 0% at 1996, 48% at 1997, 33% at 1998, 27% at 1999, 71% at 2000. Tobramycin was 67% at 1995, 100% at 1996, 89% at 1997, 95% at 1998, 87% at 1999, 77% at 2000. Gentamycin was 67% at 1995, 100% at 1996, 89% at 1997, 95% at 1998, 87% at 1999, 83% at 2000. Amikacin was 33% at 1995, 83% at 1996, 82% at 1997, 88% at 1998, 75% at 1999, 69% at 2000. Conclusion : The S.aureus resistance to methicillin, the Pseudomonas aeruginosa resistance to ciprofloxacin, and the Acinetobacter spp. resistance to ciprofloxacin have rapidly increased during 6 years. There is a need to pay speicial attention when using the the antibiotics for the above pathogens. This data may be useful in antibiotic therapy in newly opened intensive care units.

• Clinical and Experimental Pediatrics
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• v.51 no.10
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• pp.1042-1046
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• 2008

The fluoroquinolones are an important group of antibiotics widely used in the treatment of various infectious diseases in adults, as a result of an excellent spectrum of activity, good tissue penetration and convenient ways of administration. In recent decades, there has been extensive development, clinical investigation, licensure and use of fluoroquinolone antibiotics. However, the use of fluoroquinolones in children has been limited because of their potential to induce arthropathy in juvenile animals. Despite class label warnings against use in children, prescriptions for quinolone antibiotics to treat infections in children have become increasingly prevalent. The main use of fluoroquinolones in pediatrics should be, understandably, in serious life-threatening infections for which other antibiotics therapies are not effective or available. While most of the published studies failed to detect an increased rate of articular adverse effects in children treated with fluoroquinolones, an increase in the use of these compounds, particularly in community-acquired lower respiratory infections, could accelerate the emergence of multidrug-resistant (including fluoroquinolone) pneumococcal strains. This review will discus the main issues related to the use of fluoroquinolones in children, the major problems of resistance developing among these compounds, with special emphasis on the potential side effects and skilled use of these alternative potent drugs in pediatric infection.

• Korean Journal of Veterinary Research
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• v.34 no.1
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• pp.153-163
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• 1994

A study on quinolone antibacterial (pefloxacin methanesulfonate) was performed to use for the drug of fisheries. Petloxacin was proved excellent in antibacterial activity and resistance against fish pathogens when compared with the existing antibacterials. And any side effect was not observed during the period of indicated use. An outline of MIC(Minimal Inhibitory Concentration) was $1.6{\sim}6.4{\mu}g/ml$, $TLm_{48h}$ value were 380~420 ppm in Israeli carp(Cyprinus caprio) and 2100~2300 ppm in flounder(Paralichthys olivaceus). The residual time of fish body was less than 15 days. So we can treat some bacterial disease of fish by the dosage of 100 g/day/ton of fish body weight for 3 days and pefloxacin is thought to be used effectively and widely against most bacterial fish pathogens.

• Archives of Pharmacal Research
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• v.19 no.2
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• pp.143-147
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• 1996

LB20304 is a novel fluoroquinolone that exhibits a potent broad spectrum antibacterial activity against both gram-positve and gram-negative bacteria. The MICs (Minimal Inhibitory Concentration) of LB20304 were determined against both gram-positve and gram-negative bacteria under various conditions including several media, pHs, and inoculum concentrations. The in vitro activity of LB20304 was not significantly affected by the changes in testing conditions such as components of media and inoculum concentrations, but it was slightly reduced by acid condition. The MICs and MBCs (Minimal Bactericidal Concentration) of LB20304 against Staphylococcus aureus, Escherichia coli and Pseudomonas aeruginosa were hardly affected by the presence of 50 % human serum, mouse serum, guinea pig serum or horse serum, and the MBCs were equal to or at most four-times higher than the MiCs. The activities of LB20304 were decreased by the presence of high concentraion of $Mg^{++}$ or human urine (pH, 5.5) in the test media. The frequencies of mutants resistant to LB20304 were similar to or lower than those found in ciprofloxacin and sparfloxacin.

• YAKHAK HOEJI
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• v.43 no.6
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• pp.716-728
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• 1999

Whole oil and ketonic fraction (KF) of Leptospermum scoparium have been tested for their antimicrobial activity and combination effect with several antibiotics against various bacterial strains and fungi by using microbiological assay methods. Antibacterial activities of KF against a number of test strains were 2-3 fold stronger than those of whole oil. MICs of the KF were $65~125{\;}{\mu\textrm{g}}/ml$ against seven gram positive bacterial strains, $65~250{\;}{\mu\textrm{g}}/ml$ against 19 methicillin resistance Staphylococcus aureus strains, and $65~50{\;}{\mu\textrm{g}}/ml$ against 14 quinolone resistance strains. However, KF showed little or no activity against gram negative bacteria. MICs of the KF were $16~250{\;}{\mu\textrm{g}}/ml$ against more than 50% of the anaerobic bacterial strains tested. KF showed the higher antibacterial activity than bacitracin against 10 strains of Bacteroids thetaiotaomicron, or three strains of Bacteroides ovatus, and the more active than ciprofloxacin against one strain of Bacteroides thetaiotaomicron and three strains of Bacteroids ovatus. The MICs of KF was 63 and $250{\;}{\mu\textrm{g}}/ml$ against Aspergillus niger and Candida albicans, respectively. Antibacterial activities of KF in combination with 19 antibiotics against 14 strains and with four antifungal agents against one fungal strain were determined by paper strip diffusion method. While most of combination showed additivity, KF showed synergism with bacitracin, exfadroxil, cephradin, and meropenem for 29~57% of the strains tested. However, ofloxacin, enoxacin, sparfloxacin showed antagonism with KF for 43~71% of the strains. KF alone and in combination with bacitracin, gentamycin, neomycin, itraconazole, fluconazole, terfinafine and ketoconazole against five bacterial strains or one fungus strain synergistic effect was demonstrated against 33% of strains examined with FIC index value below 0.5 by checkerboard study. Synergistic effect of KF with gentamicin against Staphylococcus epidermidis 329 (QRS) was found by time-kill study.

• Korean Journal of Clinical Pharmacy
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• v.22 no.1
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• pp.55-64
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• 2012

The quinolones are broad-spectrum antibiotics and enhanced antimicrobial activity has extended the use of the quinolones beyond the traditional indications for quinolone antibiotics in the treatment of urinary tract infections. The quinolones are effective in a wider variety of infectious diseases, including skin and respiratory infections. Because of their excellent safety and tolerability, they have become popular alternatives to penicillin and cephalosporin derivatives in the treatment of various infections. A retrospective study was performed to evaluate efficacy and safety of IV quinolones for inpatient use. Total 117 patients who administerd quinolones for longer than 3 continuous days at community hospital from October 1st, 2008 to December 31st, 2008 were reviewed. The criterias for drug evaluation were included the validation of indication, outcome, dosage and side effects. In the results, ciprofloxacin 13 (total 93), levofloxacin 3 (total 59) and moxifloxacin 2 (total 19) cases were not met the criterias based on the culture results. Major indications were pneumonia (ciprofloxacin 16.3%, levofloxacin 67.8%, moxifloxacin 84.2%), urinary tract infection (ciprofloxacin 44.1%), skin infection (ciprofloxacin 7.5%, levofloxacin 20.3%, moxifloxacin 10.5%), intra-abdominal infection (ciprofloxacin 10.8%, moxifloxacin 5.3%), etc.. In the results of quinolone monotherapy, the frequencies were each ciprofloxacin 74.2%, levofloxacin 50.8% and moxifloxacin 47.4%. In the results of dosage validation, the validities were each ciprofloxacin 54.8%, levofloxacin 94.9% and moxifloxacin 100.0%. In the results of duration validation, the validities were each ciprofloxacin 59.1%, levofloxacin 78.0% and moxifloxacin 89.5%. Adverse drug reactions were reported for total 49 cases and those were gastrointestinal tract effects including nausea, vomiting, diarrhea and central nervous system effects including headache, dizziness. In summary, the quinolones appropriately used for hospitalized patients based on this study. A focused approach emphasizing "correct use of quinolones" may reduce development of antimicrobial resistance and maximize class efficacy. Consequently, correct use of antibiotics will contribute to decrease medical expenses for person and community.

• 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..

• Korean Journal of Clinical Laboratory Science
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• v.53 no.2
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• pp.137-142
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• 2021

This study investigated the patterns of acquiring anti-mycobacterial resistance in individuals who were susceptible to all anti-mycobacterial drugs in their initial treatment. From 2010 to 2019, anti-mycobacterial drug susceptibility tests were conducted on patients who were referred to the Green Cross Laboratories. The test results of 594 anti-mycobacterial drug sensitivity tests were collected at 111 medical institutions. The first test results had 594 cases in which all anti-mycobacterial drugs were susceptible. Isoniazid (INH), rifampin (RIF), streptomycin (SM), and quinolone (QUI) showed the highest single-resistant conversion rates. Out of 56 patients, 17 patients (30.4%) showed a high conversion rate of resistance to both INH and RIF. The tracking period was analyzed from a minimum of 98 days to 1,862 days, and an average of 435.6 days for INH, and a minimum of 108 days to 1,673 days, with an average of 457.7 days for RIF. In the case of tuberculosis patients who are susceptible to all anti-mycobacterial drugs, it is considered that the conversion to resistant and multi-drug resistant tuberculosis (MDR-TB) must be confirmed through an anti-mycobacterial susceptibility test after 3 months. It is hoped that this study will help the national tuberculosis management project to improve public health.

• 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.