• Journal of Microbiology and Biotechnology
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• v.16 no.6
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• pp.889-895
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• 2006

To investigate the antibiotic-resistant patterns and the gene types of extended-spectrum $\beta$-lactamase (ESBL)-producing Klebsiella pneumoniae, we collected 226 Klebsiella pneumoniae strains from three general hospitals with more than 500 beds in Busan, Korea from September 2004 to October 2005, The minimum inhibitory concentration (MIC) of antibiotics was measured using the Gram-negative susceptibility (GNS) cards of Vitek (Vitek system, Hazelwood Inc., MO, U.S.A.). Of the 226 K, pneumoniae isolates, 65 ESBL-producing K. pneumoniae strains were detected by the Vitek system and confirmed by the double-disk synergy test. TEM (Temoniera) type, SHV (sulfhydryl variable) type, and CTX-M (cefotaxime) type genes were detected by polymerase chain reaction. All 65 K. pneumoniae strains were resistant to ampicillin, cefazolin, cefepime, ceftriaxone, and aztreonam, and 83.0% of the organisms were resistant to ampicillin/sulbactam, 66.1% to tobramycin, 67.6% to piperacillin/tazobactam, 61.5% to ciprofloxacin, and 47.6% to trimethoprim/sulfamethoxazole, and 43.0% to gentamicin. TEM-type ESBLs (TEM-1 type, -52 type) were found in 64.6% (42 of 65) of the isolates, SHV-type ESBLs (SHV-2a type, -12 type, -28 type) in 70.7% (46 of 65) of isolates, and CTX-M-type ESBLS (CTX-M-15 type) in 45% (29 of 65) of isolates. Of the 65 ESBL-producing K. pneumoniae strains, two strains were found to harbor blaSHV-28, which were detected in Korea for the first time. Therefore, more investigation and research on SHV-28 are needed in order to prevent the ESBL type-producing K. pneumoniae from spreading resistance to oxyimino cephalosporin antibiotics.

• Korean Journal of Veterinary Service
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• v.31 no.3
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• pp.305-313
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• 2008

The present study was conducted to investigate the epidemiological characteristics such as isolation rate and antimicrobial drug susceptibility of etiological agents. The specimens (stool or intestine) were collected from 319 calves with clinical diarrhea from 195 farms in Gyeongnam south area (Gosung, Tongyung, Hadong) from June 2005 to August 2006. The isolation rate of Salmonella spp was higher in summer (8.4%) than in winter (4.8%) and the average was 7.2% (23/319 head). Some of Salmonella spp isolated were resistant to penicillin, oxytetracycline, tetracycline, and cephalexin (>90%), but some of them were susceptible to norfloxacin, ciprofloxacin, sulfamethoxazole/trimethoprim and amikacin(>30%). There was no statistical difference in the isolation rate of Eimeria spp between summer(48.9%) and winter(42.3%). For the evaluation of infection level of Eimeria spp oocyst per gram of feces (OPG) was examined, and severe, moderate and light infection level were 11.9%, 12.5% and 22.3%, respectively. In the isolation rates of Eimeria spp the calves under 19 days was lowerthan those over 60 days, but there was not different among herd size.

• Clinical and Experimental Pediatrics
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• v.59 no.6
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• pp.252-255
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• 2016

Purpose: Pneumocystis jirovecii pneumonia occurs in various immunocompromised patients. Despite the prophylaxis strategies in clinical practice, certain patients develop P. jirovecii pneumonia. This study was performed to investigate pediatric cases with P. jirovecii pneumonia in a single center. Methods: We identified pediatric patients younger than 19 years with microbiologically confirmed P. jirovecii pneumonia from January 2000 to February 2014. A retrospective chart review was performed. Results: Fifteen episodes of P. jirovecii pneumonia in 14 patients were identified with median age of 8.3 years (range, 0.4-18.6 years). Among these patients, 11 patients had hematology-oncology diseases, 2 had primary immunodeficiency disorders (one with severe combined immunodeficiency and the other with Wiskott Aldrich syndrome), 1 had systemic lupus erythematosus and 1 received kidney transplant. Four patients were transplant recipients; 1 allogeneic and 2 autologous hematopoietic cell transplant and 1 with kidney transplant. The median absolute lymphocyte count at the diagnosis of P. jirovecii pneumonia was $5,156cells/mm^3$ (range, $20-5,111cells/mm^3$). In 13 episodes (13 of 15, 86.7%), patients were not receiving prophylaxis at the onset of P. jirovecii pneumonia. For treatment, trimethoprim/sulfamethoxazole was given as a main therapeutic agent in all 15 episodes. Steroid was given in 9 episodes (60%). Median treatment duration was 15 days (range, 4-33 days). Overall mortality at 60 days was 35.7% (5 of 14). Conclusion: Majority of our patients developed P. jirovecii pneumonia while not on prophylaxis. Continuous efforts and more data are needed to identify high risk patients who may get benefit from P. jirovecii pneumonia prophylaxis.

• Biomedical Science Letters
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• v.12 no.3
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• pp.267-274
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• 2006

Klebsiella pneumoniae is the leading cause of nasocomial infection and the most commonly isolated from clinical specimens. $Extended-spectrum-{\beta}-lactamase$ (ESBL) producing K. pneumoniae infection was associated with a significantly longer duration of hospital stay and greater hospital charges. The purpose of this study is to investigate the antibiotic resistant patterns and the DNA fingerprint types of extended-spectrum ${\beta}-lactamase$ (ESBL) producing K. pneumoniae. 223K. pneumoniae strains were collected from three general hospitals with more than 500 beds in Busan, Korea from September 2004 to October 2005. The minimum inhibitory concentration (MIC) of antibiotics was measured using the Gram negative susceptibility (GNS) cards of VITEK (Vitek system, Hazelwood Inc., MO). Random amplified polymorphic DNA method was used to detect DNA fingerprint of the organisms. Of the 226 K. pneumoniae isolates 65 ESBL-producing K. pneumoniae strains were detected by the Vitek system and confirmed by the double-disk synergy test. All the 65K. pneumoniae strains were resistant cefazolin, cefepime, ceftriaxone and aztreonam, and 83.0% of the organisms were resistant to ampicillin/sulbactam, 66.1% to tobramycin, 67.6% to piperacillin/tazobactam, 61.5% to ciprofloxacin, and 47.6% to trimethoprim/sulfamethoxazole and 43.0% to gentamicin. The RAPD patterns were distincted as 10 types by three random 10-mer primers (208, 272, 277). Among ten type patterns, three types (Ic, IIb, IIIe) were remarkably represented at patient of internal department, nerve surgery department, general surgery department, and neonatal room. These results indicate that RAPD can be useful for DNA of strains typing in the epidemiological investigations. Therefore more investigation are needed in order to prevent the ESBL type-producing K. pneumoniae from spreading resistance to oxyimino cephalosphorin antibiotics.

• Parasites, Hosts and Diseases
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• v.51 no.2
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• pp.207-212
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• 2013

Chronic diarrhea with a 35 kg weight loss (75 kg to 40 kg) occurred during 2 years in an alcoholic patient was diagnosed with Isospora belli infection in the Republic of Korea. The patient, a 70-year old Korean male, had been a heavy drinker for more than 30 years. He was admitted to the Seoul National University Hospital because of long-standing diarrhea and severe weight loss. He had an increased white blood cell (WBC) count with high peripheral blood eosinophilia (36.8-39.9%) and lowered protein and albumin levels but without any evidence of immunosuppression. A parasitic infection was suspected and fecal examination was repeated 3 times with negative results. Peroral endoscopy with mural biopsy was performed in the upper jejunum. The biopsy specimens revealed villous atrophy with loss of villi together with various life cycle stages of I. belli, including trophozoites, schizonts, merozoites, macrogamonts, and microgamonts. The patient was treated successfully with oral doses of trimethoprim 160-320 mg and sulfamethoxazole 800-1,600 mg daily for 4 weeks. A follow-up evaluation at 2.5 years later revealed marked improvement of body weight (68 kg), increased protein and albumin levels, and normal WBC count with low eosinophils (3.1%). This is the first clinical case of isoporiasis with demonstration of various parasitic stages in the Republic of Korea.

• Childhood Kidney Diseases
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• v.24 no.1
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• pp.47-52
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• 2020

Pneumocystis pneumonia (PCP) is a rare disease in healthy people but a potentially fatal opportunistic infection by Pneumocystis jirovecii in immunocompromised patients with organ transplantation. We present three cases of PCP after kidney transplantation in pediatric patients. First case was a 4-year-old boy diagnosed with Denys-Drash syndrome and received living-donor kidney transplantation from his mother at age of 1. Second case was a 19-year-old male, with polycystic kidney disease, who received kidney transplantation from his mother at the age of 18. Third case was a 19-year-old female with chronic kidney disease of unknown etiology, who received kidney transplantation from her father at age of 15. These three patients who were on immunosuppressive therapy and completed of routine PCP prophylaxis for 6 months had presented with cough and dyspnea more than 1 year after transplantation. Chest x-ray all showed diffuse haziness of both lung fields, and bronchoalveolar lavage from bronchoscopy revealed Pneumocystisjirovecii infection. All patients showed clinical resolution with intravenous trimethoprim-sulfamethoxazole (TMP-SMX) therapy for at least 3 weeks and had continued secondary prophylaxis for another 6-12 months. This report suggests that clinicians should have suspicion for the possibilities of opportunistic infection such as PCP after kidney transplantation in children.

• Pediatric Infection and Vaccine
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• v.12 no.1
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• pp.95-99
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• 2005

Pneumocystis carinii pneumonia is an infectious disease which is highly prevalent in the group of immunosuppressed patients, particularly with hematologic tumors as lymphomas and acquired immune deficiency syndrome(AIDS), severe malnutrition, organ transplantations, high dose corticosteroid therapy. Some cases of Pneumocystis carinii pneumonia in infants with primary immune deficiency were already reported. The authors present a case of Pneumocystis carinii pneumonia developed in an infant who suffered from 10 days of poor feeding and failure to thrive and not included in the risk groups listed above. He had bilateral interstitial infiltrations on the chest radiography, diagnosed as Pneumocystis carinii pneumonia after Gomori-methenamine silver staining of his sputum that was taken through tracheal intubation. He improved after administering Trimethoprim-sulfamethoxazole for 14 days.

• Korean Journal of Veterinary Service
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• v.36 no.3
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• pp.171-180
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• 2013

This study was carried out to investigate the antimicrobial resistance pattern and distribution of resistance gene in 44 Enterobacteriaceae and 21 Pseudomonas (P) aeruginosa isolated from hospitalized dogs and cats in animal hospital from 2010 to 2011 in Daegu. Among Enterobacteriaceae, Escherichia (E) coli was highly resistant to ampicillin (56.7%), followed by tetracycline (53.3%), cephalothin, streptomycine, sulfamethoxazole/trimethoprim, gentamicin and norfloxacin (40.0~43.3%). The remaining isolates of Enterobacteriaceae had high resistance to ampicillin (64.3%) and streptomycin (42.9%). Whereas, P. aeruginosa was low resistant to all antimicrobials tested (less than 15%). int I 1 gene was detected in 20 (57.1%) of 35 antimicrobial resistant Enterobacteriaceae and 2 (9.5%) of 21 P. aeruginosa., but int I 2 gene was not detected in all isolates. The eight resistance genes were found either alone or combination with other gene (s): $bla_{TEM}$, aadA, strA-strB, clmA, tetA, tetB, sul I and sul II. About 78% of integron-positive isolates were resistance to more than four antimicrobial agents. The findings suggest that class I integrons are widely distributed in E. coli among Enterobacteriaceae from dogs and cats and multi-drug resistance related to the presence of class I integrons. The prudent use of antimicrobials and continuous monitoring for companion animals are required.

• Korean Journal of Veterinary Research
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• v.47 no.4
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• pp.395-398
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• 2007

A total of 114 Salmonella spp. (17.90%) were isolated from 637 fecal swab samples collected in October 2005 and they were from 25 (78.13%) of 32 farms investigated nation-widely in Korea. Salmonella spp. from age group of 30-, 60-, 90-, 120-day olds were 17.61%, 16.98%, 15.72%, and 21.25%, respectively. Nine serovars of Salmonella spp. were identified. The predominant serovars of isolates were S. Typhimurium (including var Copenhagen), S. Agona, S. Derby, and S. Heidelberg by turns. Almost isolates belonged to serogroup B (69.30%). All isolates were resistant to penicillin G and oxytetracycline, and this was considered due to be used as feed additive through the most of pig farms for decades. And also, frequent resistance observed for ampicillin, sulfamethoxazole-trimethoprim, and lincomycin-spectinomycin, which are commonly used in veterinary medicine for decades, indicates an urgent need to utilize these antimicrobials more prudently if their benefits are to be preserved.

• The Journal of the Korean Society for Microbiology
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• v.13 no.1
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• pp.31-36
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• 1978

Twenty strains of Salmonella paratyphi A, 55 of S. typhi, 7 of Shigella flexneri, and 14 of Sh. sonnei which were isolated in Taegu area in 1977, were tested for the susceptibility to antimicrobial drugs. All strains of S. paratyphi A were resistant to sulfisomidine(Sa), but none was resistant to chloramphenical(Cm), tetracycline(Tc), streptomycin(Sm), ampicillin, nalidixic acid, kanamycin, gentamicin, amikacin, 1:20 mixture of trimethoprim and sulfamethoxazole, carbenicillin, cephaloridine, and rifampicin. Only one strain. of S. typhi was multiply resistant to Cm, Tc, Sm, and Sa, but all strains were susceptible to the other drugs tested. The resistant strain carried R plasmid; R(Cm Tc Sm Sa). All strains except one were highly resistant to Cm, Tc, Sm, and Sa, and all except one of multiply resistant strains carried R plasmid; R(Cm Tc Sm Sa).