• The Korean Journal of Pain
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• 제36권1호
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• pp.11-50
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• 2023

As the field of interventional pain management (IPM) grows, the risk of surgical site infections (SSIs) is increasing. SSI is defined as an infection of the incision or organ/space that occurs within one month after operation or three months after implantation. It is also common to find patients with suspected infection in an outpatient clinic. The most frequent IPM procedures are performed in the spine. Even though primary pyogenic spondylodiscitis via hematogenous spread is the most common type among spinal infections, secondary spinal infections from direct inoculation should be monitored after IPM procedures. Various preventive guidelines for SSI have been published. Cefazolin, followed by vancomycin, is the most commonly used surgical antibiotic prophylaxis in IPM. Diagnosis of SSI is confirmed by purulent discharge, isolation of causative organisms, pain/tenderness, swelling, redness, or heat, or diagnosis by a surgeon or attending physician. Inflammatory markers include traditional (C-reactive protein, erythrocyte sedimentation rate, and white blood cell count) and novel (procalcitonin, serum amyloid A, and presepsin) markers. Empirical antibiotic therapy is defined as the initial administration of antibiotics within at least 24 hours prior to the results of blood culture and antibiotic susceptibility testing. Definitive antibiotic therapy is initiated based on the above culture and testing. Combination antibiotic therapy for multidrug-resistant Gram-negative bacteria infections appears to be superior to monotherapy in mortality with the risk of increasing antibiotic resistance rates. The never-ending war between bacterial resistance and new antibiotics is continuing. This article reviews prevention, diagnosis, and treatment of infection in pain medicine.

• Tuberculosis and Respiratory Diseases
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• 제79권4호
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• pp.282-288
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• 2016

Background: Tuberculosis (TB) is a major health problem, and accurate and rapid diagnosis of multidrug-resistant (MDR) and extended drug-resistant (XDR) TB is important for appropriate treatment. In this study, performances of solid and liquid culture methods were compared with respect to MDR- and XDR-TB isolate recovery and drug susceptibility testing. Methods: Sputum specimens from 304 patients were stained with Ziehl-Neelsen method. Mycobacterium tuberculosis (Mtb) isolates were tested for recovery on $L{\ddot{o}wenstein$-Jensen (LJ) medium and the BacT Alert 3D system. For drug susceptibility testing of Mtb, isolates were evaluated on M-KIT plates and the BacT Alert 3D system. Results: The recovery rates were 94.9% (206/217) and 98.2% (213/217) for LJ medium and the BacT Alert 3D system, respectively (kappa coefficient, 0.884). The rate of drug resistance was 13.4% for at least one or more drugs, 6.0% for MDR-TB and 2.3% for XDR-TB. M-KIT plate and BacT 3D Alert 3D system were comparable in drug susceptibility testing for isoniazid (97.7%; kappa coefficient, 0.905) and rifampin (98.6%; kappa coefficient, 0.907). Antibiotic resistance was observed using M-KIT plates for 24 of the total 29 Mtb isolates (82.8%). Conclusion: The liquid culture system showed greater reduction in the culture period, as compared with LJ medium; however, drug susceptibility testing using M-KIT plates was advantageous for simultaneous testing against multiple drug targets.

• Journal of Microbiology and Biotechnology
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• 제9권3호
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• pp.328-333
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• 1999

Susceptibility of 61 strains of Helicobacter pylori to metronidazole was examined by both the disk diffusion method using a cut-off of 15㎜ for resistance and the E test with a cut-off of 8㎎/l. The MIC/sub 50/ and MIC/sub 90/ by the E test were 2 ㎎/l and 256㎎/l, respectively. Metronidazole resistance was found in 22 (36％) out of the 61 H. pylori strains by the E test and in three additional strains by the disk diffusion method. Amongst the latter three isolates, the MICs by the E test were 4 ㎎/l, 6㎎/l, and 6㎎/l, respectively. These figures are one log₂ or half log₂ dilution lower than the cut-off of 8㎎/l recommended as resistance for the E test. All 22 metronidazole resistant H. pylori isolates by the E test that were subjected to random amplified polymorphic DNA (RAPD) fingerprinting showed different DNA fingerprints. Interestingly, >90％ of resistant isolates possess two common DNA bands of 0.4 and 0.9 kb. This study demonstrates that the results of the disk diffusion method for testing H. pylori susceptibility to metronidazole correlates well with that of the E test. The criteria for interpretation need to be internationally standardized so that the results from different centers can be compared.

• 대한수의학회지
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• 제23권2호
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• pp.173-178
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• 1983

This paper deals with the isolation of citrate-utilizing variants of Escherichia coli ($Cit^+$ E. coli) from the animals, their biochemical reactivity and antibiotic susceptibility, and whether the citrate utilizing ability is transmissible. One hundred arid twenty-three isolates of $Cit^+$ E. coli were obtained from cattle and pigs. but from other animals, no isolates were obtaied. Antibiotic susceptibility testing of $Cit^+$ E. coli was performed by the agar dilution method, using the following 9 antibiotics, chloramphenicol(CP), tetracycline(TC), streptomycine(SM), kanamycin(KM), colistin(CL), gentamicin(GM), cephaloridine(CR), aminobenzycillin and nalidixic acid(NA). All the variants tested were susceptible to KM, CL, GM, CR and NA. Of all the variants, 80(65%) were resistant to the drugs tested and resistance to TC and SM was most frequent. The transmission of the ability to utilize citrate on Simmons citrate agar at $37^{\circ}C$ was demonstrated in 78(67.8%) out of the 115 $Cit^+$ E. coli. There were no significant difference in the transfer rates of citrate utilizing ability between resistant and susceptible variants to above 9 drugs. Of 123 isolates, 8 were lost their citrate utilizing ability, spontaneously.

• Annals of Clinical Microbiology
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• 제21권4호
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• pp.69-74
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• 2018

진단검사의학은 신속하고 정확한 체외검사 결과를 제공함으로써 임상의사가 환자를 진료하는 데 도움을 주는 전문 분야이다. 정확한 검사 결과를 제공하기 위해서는 검사에 관련된 모든 요소의 표준화가 필요하다. Clinical and Laboratory Standards Institute (CLSI)는 1968년에 표준화를 하는 데에 모두가 동의할 수 있는 공식적인 절차를 마련하기 위해 만들어졌고, 현재까지 임상검사실, 연구용 검사실을 포함한 많은 종류의 검사실 전 분야에 대해서 표준과 지침을 출판하여, 전 세계의 많은 검사실들이 표준화를 위해 이를 이용하고 있다. CLSI의 항생제 감수성 검사 소위원회(AST SC)는 6개의 상설 부서와 필요에 따라 만들어지는 많은 특설 부서로 구성되어 있다. AST SC의 구성원들은 소위원회에 제안된 내용을 검토하여 연 2차례 열리는 회의에서 제안 내용을 반영할지 여부를 결정함으로써 문서의 개정이 이루어진다. 이 회의는 등록한 사람은 누구나 참여할 수 있으므로, 우리 학회원들도 회의에 참여하여 표준 혹은 지침 문서의 생산에 능동적인 역할을 하기를 기대한다.

• Asian Pacific Journal of Cancer Prevention
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• 제16권10호
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• pp.4353-4356
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• 2015

Background: Levofloxacin is an effective medication for second line Helicobacter pylori (H. pylori) eradication. However, limited studies have approved its use as an effective antibiotic in first line therapy. Dexlansoprazole is a new PPI and lacks of evidence in support of a role in H. pylori eradication. This study was designed to evaluate efficacy of levofloxacin-dexlansoprazole-based quadruple therapy for H. pylori eradication in Thailand. Materials and Methods: This prospective randomized control study was performed during June 2014 to December 2014. H. pylori infected gastritis patients were randomized to receive 7- or 14-day levofloxacin-dexlansoprazole based on quadruple therapy (levofloxacin 500 mg OD, dexlansoprazole 60 mg bid, clarithromycin MR 1000 mg OD, bismuth subsalicylate 1048 mg bid). CYP2C19 genotyping and antibiotic susceptibility tests were conducted for all patients. A 13C urea breath test was performed to confirm H. pylori eradication at least 4 weeks after treatment. Results: A total of 100 patients were enrolled, comprising 44 males and 56 females (mean age of 52.6 years). Eradication rate by PP analysis was 85.7% (42/49) with the 7-day regimen and 98% (48/49) with the 14-day regimen (85.7% vs 98%; p-value=0.059). ITT analysis was 84% and 96% with 7- and 14-day regimens, respectively (84% vs 96%; p-value=0.092). Antibiotic susceptibility testing demonstrated 35.1% resistance to metronidazole, 18.3% to clarithromycin, and 13.5% to levofloxacin. CYP2C19 genotyping revealed 54.1% RM, 34.7% IM and 11.2% PM. The 14-day regimen provided 100% eradication in patients with clarithromycin or dual clarithromycin and metronidazole H. pylori resistant strains. Moreover, the eradication rate was 96.6% in patients with CYP2C19 genotype RM. Conclusions: The 14-day levofloxacin-dexlansoprazole based quadruple therapy provides high H. pylori eradication regardless of CYP2C19 genotype, clarithromycin or dual clarithromycin and metronidazole resistant strains. This regimen could be use as an alternative first line therapy for H. pylori eradication in Thailand.

• 한국환경보건학회지
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• 제50권2호
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• pp.93-101
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• 2024

Background: As pollutants caused by non-point sources flow into rivers, river water quality monitoring for fecal pollution is becoming increasingly important. Objectives: This study was conducted to investigate the distribution of microbial communities in the Yeongsangang River water system and sewage treatment plants in Gwangju and to evaluate their antibiotic resistance. Methods: In the experiment, samples were distributed to five selective media at each point and then cultured for 18 to 24 hours. When bacteria were observed, they were sub-cultured by size and shape and identified using MALDI-TOF MS equipment. When identification was completed, 17 types of antibiotic susceptibility tests were performed using VITEK II equipment, focusing on gram-negative dominant species among the identified strains. Results: During the study period, a total of 266 strains were isolated from 39 samples. Gram-positive bacteria were 37 strains in four genera, or 13.9% of the total, and Gram-negative bacteria were 229 strains in 23 genera, or 86.1% of the total. Antibiotic susceptibility testing of 23 strains, the major dominant species, showed that one strain (4.3%) was resistant to only one antibiotic, and two strains (8.7%) were 100% susceptible to the 17 antibiotics tested. The other 20 strains (87.0%) were multidrug resistant bacteria resistant to two or more antibiotics. There were various types of multidrug resistance. Among them, penicillin and cephalosporin series showed the highest resistance. Conclusions: Based on the results of this study, it was found that the bacterial community structure changed according to regional and environmental factors, and it was judged that continuous research such as genetic analysis of antibiotic-resistant bacteria present in natural rivers is necessary.

• 한국환경보건학회지
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• 제35권4호
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• pp.278-286
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• 2009

The total of 181 students in Seoul were made up questions to analysis hand washing awareness from 2007 to 2008. And their hands were sampled to isolate Staphylococcus aureus for testing antibiotic resistance. The average of hand washing frequency was $2.8{\pm}2.6$ per day in their schools. The rates of the students washing hands before eating food, after outdoor activity and after using bathroom were 22.2%, 24.4% and 49.4%, respectively. The rate of students washing hand less than 20 seconds was 64.4%. The students of 43.3% answered that they thought they were washing hands well. The middle school students were worse than elementary and high school students were aware of the frequency, duration and activity of hand washing. The isolation rate of S. aureus on the hands was 29.4%. The isolates were resitant to ampicillin (28.6%), chloramphenicol (6.1%), erythromycin (31.0%), gentamycin (2.0%), penicillin (79.6%) and tetracycline (6.1%) of 17 antibiotics tested. They were all sensitive to oxacillin and vancomycin.

• 대한미생물학회지
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• 제18권1호
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• pp.39-46
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• 1983

We collected three hundred thirty-five strains of Salmonella typhi isolated from human sources during the period January to December 1982 Korea. Most of them were from general hospitals and city health center, the remaining one hundred sixtyone strains were obtained from other 12 provincial health centers among 335 testing strains. We used ninety-nine Vi-phages as distributed from International Center for Enteric phage Typing(ICEPT) in London. We found nine phage types among 335 strains of Salmonella typhi in this study. Additionally, I+IV, degraded Vi-positive and Vi negative strains were presented. This study documented the occurrence of the new $B_2$ type in Korea for the first time. The present basic phage type formula in Korea appeared to be A, $B_2,\;D_1,\;D_2,\;D_4,\;D_6,\;D_8,\;D_{12},\;E_1,\;E_9,\;D_1,\;M_1$, 40 and plus I+IV and degraded vi strains(Table 2). The current phage types of Salmonella typhi isolated in Korea 1982 were A, $B_2,\;D_1,\;D_2,\;D_6,\;D_8,\;E_1,\;M_1$ and 46 $M_1$ type was widely distributed all over the country, and E type was next predominant. Antibiotic susceptibility test were performed by means of Kirby-Bauer disc diffution method using 12 kind of antibiotics such as Ampicillin, Carbenicillin, Cephalosporin, Chloramphenicol, Colistin, Gentamicin, Kanamycin, Nalidix acid, Neomycin, Polymyxin-B, Streptomycin and Tetracycline. The sensitivity pattern to antibiotics of Salmonelia typhi cultures were summarized.

• Journal of Microbiology
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• 제43권2호
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• pp.172-178
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• 2005

To determine the prevalence and genotypes of $\beta$-lactamases among clones of a metagenomic library from the cold-seep sediments of Edison seamount (10,000 years old), we performed pulse-field gel electrophoresis, antibiotic susceptibility testing, pI determination, and DNA sequencing analysis. Among the 8,823 clones of the library, thirty clones produced $\beta$-lactamases and had high levels of genetic diversity. Consistent with minimum inhibitory concentration patterns, we found that five ($167\%$) of thirty clones produced an extended-spectrum $\beta$-lactamase. 837- and 259-bp fragments specific to bla$_{TEM}$ genes were amplified, as determined by banding patterns of PCR amplification with designed primers. TEM­1 was the most prevalent $\beta$-lactamase and conferred resistance to ampicillin, piperacillin, and cephalothin. TEM-116 had a spectrum that was extended to ceftazidime, cefotaxime, and aztreonam. The resistance levels conferred by the pre-antibiotic era alleles of TEM-type $\beta$-lactamases were essentially the same as the resistance levels conferred by the TEM-type alleles which had been isolated from clinically resistant strains of bacteria of the antibiotic era. Our first report on TEM-type $\beta$-lactamases of the pre-antibiotic era indicates that TEM-type $\beta$-lactamases paint a picture in which most of the diversity of the enzymes may not be the result of recent evolution, but that of ancient evolution.