• Childhood Kidney Diseases
• /
• v.3 no.1
• /
• pp.104-108
• /
• 1999

Atypical hemolytic uremic syndrome associated with neuraminidase-producing Streptococcus pneumoniae usually associated with invasive infection such as fulminant pneumonia, sepsis, and meningitis and may occur earlier in lift and has a higher mortality rate than typical hemolytic uremic syndrome. We have experienced a 22-month-old female patient with hemolytic uremic syndrome associated with S. pneumoniae pneumonia and empyema. The patient was treated with ceftriaxone and washed red blood cell transfusion. As the disese course could be aggravated by the use of blood products containing anti-Tomsen-Friedenreich antigen, early recognition and sensible use of blood products such as washed RBC might lead to the improved outcome.

• BMB Reports
• /
• v.33 no.1
• /
• pp.75-81
• /
• 2000

DnaK is a major heat shock protein and known to be highly conserved in all species. Previously, the dnaK in Streptococcus pneumoniae was cloned and the immunogenic nature characterized. In this study, dnaK mutants were generated by insertion of duplication mutagenesis and their characteristics examined. They had defective growths at all temperatures ($20^{\circ}C-42^{\circ}C$)and cell divisions, and formed filaments after a temperature shift from 30 to 42. A unique feature of the dnaK mutants of S. pneumoniae, unlike those of E. coli and B. subtilis, was the growth capability at high temperature ($42^{\circ}C$) without producing the putative GroEL. Our results suggest that DnaK may serve as a regulator and/or modifier in GroEL gene expression.

• Journal of Environmental Health Sciences
• /
• v.30 no.1
• /
• pp.15-21
• /
• 2004

In an attempt to analyze the characteristics of domestic pathogenic strains of S. pneumoniae, the basic epidemiological charactristics of pathogenic strains such as their serotypes and frequency of penicillin resistance, and pattern of chromosomal DNA from PFGE(pulsed-field gel electrophoresis) were observed. For this study,56 strains of S. pneumoniae isolated from inpatients and outpatients in the four domestic university hospitals were collected from January to December in 1998. Among those strains, a total of 56 pathogenic strains from blood(39 isolates), cerebrospinal fluid(8 isolates) and other specimen(9 isolates) were selected and isolated. The penicillin resistance frequency of those 56 strains was identified with disk diffusion method with 66.1％. From the invasive strains, predominant serotypes were isolated in the order of 19F(12.5％), 23F(10.7%), 14(10.7%) and 9V(10.7％), totalling 45 percent. This experiment also used PFGE patterns to compare the correlations among genetic subtypes in several serotypes. The DNA fragments digested with Sma I and Apa I were resolved by PFGE. The PFGE patterns digested with Sma I were better than Apa I for analysis. In the DNA fragments digested with Sma 1, PFGE analysis of 56 S. pneumoniae isolates showed 25 different patterns. As a result, serotype was on the whole correlated to PFGE pattern on the ground that each different PFGE pattern by serotype was observed. This study can be utilized not only fur the study of incidence trend of domestic pneumococcal diseases but also as a useful basic data for the development of identification tool and treatment.

• Natural Product Sciences
• /
• v.13 no.4
• /
• pp.342-346
• /
• 2007

The antimicrobial activity of the essential oil from Pelargonium graveolens and its effects when it was combined with current antibiotics against antibiotic-resistant strains of Streptococcus pneumoniae were evaluated. The minimal inhibitory concentrations (MICs) of the essential oil fraction and the main components of this plant were determined for two antibiotic-susceptible and two antibiotic-resistant strains of S. pneumoniae using broth microdilution tests. The combined effects of the oil with erythromycin, norfloxacin, or oxacillin were evaluated using a checkerboard microtitre assay. The combination of the oil fraction of P. graveolens, or its main component, together with the antibiotics tested significantly lowered the MICs of the antibiotics against all of the tested strains with fraction inhibiting concentration indices (FICs) ranging from 0.16 to 1.50. In particular, the activity of norfloxacin against all of the tested strains of S. pneumoniae was enhanced significantly by combination with citronellol. In conclusion, the combination of P. graveolens oil with antibiotics could be used to reduce the effective dose of antibiotic and to modulate the resistance of S. pneumoniae strains.

• Korean Journal of Microbiology
• /
• v.38 no.1
• /
• pp.38-44
• /
• 2002

Pneumococcal surfacce protein A (PspA) is an important virulence factor and an antigenically variable surface protein of the pneumococci. To purify the PspA from S. pneumoniae KNIH1156 , a clinical isolate (type 19F), we have taken advantage of the fact that PspA is released from the surface of pneumococci into the medium by growing in a CDM-ET medium and PspA is capable of binding human lactoferrin, the iron carrier protein. PspA of S. pneumoniae KNIH1156 was purified from culture supernatant by human lactoferrin (hLf) affinity chromatography. The purified PspA was confirmed with anti-PspA antiserum and also had the binding capacity to hLf specifically. To determine whether the purified PspA could elicit protection in mice against pneumococcal inflection, we immunized the mice with purified PspA and subsequently challenged with S. pneumoniae KNIH1156. Immunization with purified PspA protected mice from 500 times the $LD^{50}$ of S. pneumoniae KNIH1156. Therefore, it has been shown that purified PspA fromS. pneumoniae KNIH1156 (type 19F) is a protective immunogen.

• Clinical and Experimental Pediatrics
• /
• v.51 no.10
• /
• pp.1031-1037
• /
• 2008

Macrolide antimicrobial agents including erythromycin, roxithromycin, clarithromycin, and azithromycin are commonly used in the treatment of respiratory tract infections in children. Newer macrolides that have structural modifications of older drug erythromycin show improved change in the spectrum of activity, dosing, and administration. However, recent studies reported that increasing use of macrolide antibiotics is the main force driving the development of macrolide resistance in streptococci. In particular, azithromycin use is more likely to select for macrolide resistance with Streptococcus pneumoniae than is clarithromycin use, a possible reflection of its much longer half life. Recently, erythromycin resistance rates of S. pneumoniae and Streptococcus pyogenes are rapidly increasing in Korea. Two main mechanisms of acquired macrolide resistance have been described, altered binding site on the bacterial ribosome encoded by the ermB gene and active macrolide efflux pump encoded by the mef gene. Relationship between the susceptibility of S. pneumoniae and the response to macrolides has been shown in studies of acute otitis media, but less clear in cases of pneumonia. This article reviews the spectrum of activity, pharmacokinetic properties, mechanisms of action and resistance, and clinical implication of resistance on the treatment of respiratory tract infections in children.

• The Journal of Korean Medicine
• /
• v.26 no.2 s.62
• /
• pp.13-24
• /
• 2005

Objectives & methods; In order to evaluate the in vivo synergic effect of Mawhangyounpye-tang, a traditional poly-herbal formula used in the treatment of respiratory diseases in Korea, with the quinolone antibiotic ciprofloxacin (CPFX), the viable bacterial number and histopathological changes were monitored after experimental respiratory infection with Streptococcus Pneumoniae ATCC 6303. Results: 1. In CPFX groups, the viable bacterial numbers were significantly decreased compared to that of the control group, and were even more dramatically decreased in concomitant group treated with Mawhangyounpye-tang. 2. In the control group, severe infiltration of inflammatory cells, hemorrhage and hypertrophy of alveolar linings were demonstrated at microscopic levels. However, these abnormal histopathological changes were significantly decreased compared. to that of the control group in CPFX groups, and were even more dramatically decreased in concomitant groups treated with Mawhangyounpye-tang. 3. In CPFX groups, the LSA (Iuminal surface of alveoli $\%$) were significantly increased compared to that of the control group, and more dramatically in concomitant groups treated with Mawhangyounpye-tang. Conclusions: According to these results, it is considered that the in vivo antibacterial activity of CPFX against Streptococcus Pneumoniae ATCC 6303 infection of respiratory tract was dramatically increased by concomitant use of Mawhangyounpye-tang.

• Archives of Plastic Surgery
• /
• v.38 no.4
• /
• pp.516-518
• /
• 2011

Purpose: The prevalence of antibiotic-resistant Streptococcus pneumoniae meningitis has increased worldwide. There are some reports about postoperative antibiotic-resistant Streptococcus pneumoniae infection after craniofacial surgery, but, there is no report in Korea. We present a report on the treatment of postoperative multidrug-resistant Streptococcus pneumoniae (MRSP) meningitis and sepsis after craniofacial surgery based on our experience. Methods: The patient was a 7-year-old boy with Crouzon's disease who was treated by fronto-orbital bar advancement. Intraoperatively, frontal sinus opening was seen during osteotomy which was covered with forehead galeopericranial flap. MRSP meningitis was diagnosed after the surgery, he was treated with intravenous vancomycin, meropenem, and levofloxacin. Results: The patient was treated successfully after 3 weeks of intravenous antibiotics treatment. During the 8 month follow-up period, there was no neurologic sequelae. Conclusion: Postoperative infection after craniofacial surgery is an important phenomenon that needs immediate recognition. Prevention, early diagnosis, and treatment immediate after onset are important as countermeasures against postoperative drug-resistant bacterial infection. To prevent adverse outcome and reoperation, proper antibiotics treatment should be performed.

• Clinical and Experimental Pediatrics
• /
• v.55 no.11
• /
• pp.424-429
• /
• 2012

Purpose: Methods for quick and reliable detection of Streptococcus pneumoniae are needed for the diagnosis of pneumococcal disease and vaccine studies. This study aimed to show that sequential multiplex polymerase chain reaction (PCR) is more efficient than conventional culture in achieving S. pneumoniae -positive results. Methods: Nasopharyngeal (NP) secretions were obtained from 842 pediatric patients admitted with lower respiratory infections at Severance Children's Hospital in Korea between March 2009 and June 2010. For identification and serotype determination of pneumococci from the NP secretions, the secretions were evaluated via multiplex PCR technique with 35 serotype-specific primers arranged in 8 multiplex PCR sets and conventional bacteriological culture technique. Results: Among the results for 793 samples that underwent both bacterial culture and PCR analysis for pneumococcal detection, 153 (19.3%) results obtained by PCR and 81 (10.2%) results obtained by conventional culture technique were positive for S. pneumoniae. The predominant serotypes observed, in order of decreasing frequency, were 19A (23%), 6A/B (16%), 19F (11%), 15B/C (5%), 15A (5%), and 11A (4%); further, 26% of the isolates were non-typeable. Conclusion: As opposed to conventional bacteriological tests, PCR analysis can accurately and rapidly identify pneumococcal serotypes.

• BMB Reports
• /
• v.39 no.6
• /
• pp.703-708
• /
• 2006

During infection, the common respiratory tract pathogen Streptococcus pneumoniae encounters several environmental conditions, such as upper respiratory tract, lung tissue, and blood stream, etc. In this study, we examined the effects of blood on S. pneumoniae protein expression using a combination of highly sensitive 2-dimensional electrophoresis (DE) and MALDI-TOF MS and/or LC/ESI-MS/MS. A comparison of expression profiles between the growth in THY medium and THY supplemented with blood allowed us to identify 7 spots, which increased or decreased two times or more compared with the control group: tyrosyl-tRNA synthetase, lactate oxidase, glutamyl-aminopeptidase, L-lactate dehydrogenase, cysteine synthase, ribose-phosphate pyrophosphokinase, and orotate phosphoribosyltransferase. This global approach can provide a better understanding of S. pneumoniae adaptation to its human host and a clue for its pathogenicity.