• Title/Summary/Keyword: antibiotic use

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Clinical Characteristics of Pneumococcal Bacteremia in Adults : The Effect of Penicillin Resistance on the Mortality of Patients with Pneumococcal Bacteremia (폐렴구균 균혈증에서 폐렴구균의 페니실린 내성 여부가 사망률에 미치는 영향)

  • HwangBo, Bin;Yoon, Ho-Il;Lee, Sang-Min;Choi, Seung-Ho;Park, Gye-Young;Yoo, Chul-Gyu;Lee, Choon-Taek;Kim, Young-Whan;Han, Sung-Koo;Min, Kyung-Up;Kim, You-Young;Shim, Young-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.2
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    • pp.184-194
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    • 1999
  • Backgrounds : The advent of penicillin has led to the marked reduction in the mortality from pneumococcal bacteremia, however, the mortality is still relatively high in this post-antibiotic era. Actually the prevalence of infection due to penicillin-resistant penumococci is increasing worldwide, and it is especially high in Korea due to irrelevant use of antibiotics. So, the high mortality of pneumococcal sepsis might be related to the emergence of penicillin-resistant strains, however, many other antibiotics, which eradicate pneumococci effectively, are available in these days. This has led us to suspect the role of penicillin-resistance in the high mortality rate. In this study, we evaluated the effect of penicillin resistance on the mortality of patients with penumococcal bacte remia. Methods: The study population consisted of 50 adult patients with penumococcal bacteremia who were admitted between Jan, 1990 and July, 1997. Medical records were analyzed retrospectively. Results: Most of the patients (96%) had underlying diseases. The most common local disease associated with pneumococcal bacteremia was pneumonia (42%), which was followed by spontaneous bacterial peritonitis (14%), cholangitis (10%), meningitis (8%), liver abscess (4%), pharyngotonsillitis (4%), sinusitis (2%) and cellulitis (2%). While the overall case-fatality rate in this study was 24%, it was higher when peumococcal bacteremia was associated with pneumonia (42%) or meningitis (50%). The rate of penicillin resistance was 40%, which was increased rapidly from 1991. The rate of penicillin resistance was significantly higher in patients with the history of recent antibiotics use and hospitalization within 3 months respectively. The clinical manifestations, that is, age, severity of underlying diseases, nosocomial infection, associated local diseases, and the presence of shock or acute renal failure were not statistically different between the patients with penicillin-resistant and -sensitive pneumococcal bacteremia. The mortality of patients infected with penicillin-resistant pneumococci was not statistically different from those with penicillin-sensitive pneumococcal bacteremia. Conclusion: Penicillin resistance is not associated with high mortality in adult patients with pneumococcal bacteremia. As the overall mortality is high, active penumococcal vaccination is recommended in patients with high risk of infection.

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Clinical aspects of an outbreak of Serratia marcescens infections in neonates (신생아 중환자실에서 Serratia marcescens에 의한 집단 감염 발생에 대한 고찰)

  • Sung, Min-Jung;Chang, Chul-Hun;Yoon, Yeon-Kyong;Park, Su-Eun
    • Clinical and Experimental Pediatrics
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    • v.49 no.5
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    • pp.500-506
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    • 2006
  • Purpose : We evaluated an outbreak of Serratia marcescens infections in 24 neonates in a neonatal intensive care unit(NICU). Methods : From January to August, 2004 a nosocomial outbreak of S. marcescens occurred in our NICU. We describe the clinical characteristics of the outbreak and analyse the risk factors for infections with S. marcescens. After the outbreak stopped, 7 isolates from blood were typed using rapid amplified polymorphic DNA analysis(RAPD). Results : S. marcescens was isolated from 24 neonates, 19 infected and 5 colonized. Seven out of nineteen neonates had bacteremia, 4 had ventilator associated pneumonia, 4 had purulent conjunctivitis, 2 had UTI, 1 had meningitis and 1 had a wound infection. Three neonates died due to S. marcescens infection, 2 of 3 had ventilator associated pneumonia, 1 had meningitis complicated with abscess. The mortality rate of S. marcescens infection was 15.8%. Factors associated with S. marcescens infections were previous antibiotic therapy, indwelling catheter and use of ventilators. The isolated strains were resistant to most antibiotics, but frequently sensitive to imipenem, bactrim and amikacin. RAPD typing results show that at least 3 epidemic strains were related with this outbreak. But one genotype was predominant type in this outbreak. The control measures were instituted and the outbreak stopped within 2 months. Conclusion : S. marcescens can cause rapidly spreading outbreaks associated with fatal infections in neonates. If S. marcescens is isolated from clinical specimens, meticulous infection control measures and epidemiologic investigations should be done at an early stage of the outbreak.

Stenotrophomonas maltophilia and Ventilator-Associated Pneumonia in Critically Ill Pediatric Patients: a Retrospective Analysis at a Single Center (소아 환자에서 Stenotrophomonas maltophilia와 인공 환기요법 관련 폐렴에 관한 연구)

  • Lee, Byung-Kee;Choi, Soo-Han;Kim, Soo Jin;Cho, Joong Bum;Ae, Hong;Yoo, So-young;Kim, Ji Hye;Lee, Nam Young;Kim, Yae-Jean
    • Pediatric Infection and Vaccine
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    • v.22 no.2
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    • pp.75-80
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    • 2015
  • Purpose: Ventilator-associated pneumonia (VAP) is a serious threat in critically ill pediatric patients. Data regarding Stenotrophomonas maltophilia VAP in pediatric population is limited. We evaluated the clinical data of S. maltophilia associated VAP in critically ill pediatric patients. Methods: A retrospective chart review was performed in pediatric patients 18 years old or younger who developed S. maltophilia associated VAP at Samsung Medical Center, Seoul Korea from January 2008 to December 2012. Results: A total of 31 patients were identified S. maltophilia associated VAP. Median age was 8 months (range, 0.5 month to 16.6 years) and 13 patients were male (40.6%). Underlying illnesses were cardiologic diseases (n=11, 34.4%), hematologic oncologic malignancies (n=7, 25%), neurologic diseases (n=4, 12.5%), pulmonary diseases (n=3, 9.4%), and others (n=4, 12.5%). The median duration of ventilator use before S. maltophilia VAP diagnosis was 14 days (range, 4-256 days). Overall mortality at 30 days was 12.5% (4/32). Conclusions: S. maltophilia should be also considered as a possible pathogen for VAP in critically ill pediatric patients. Empiric antibiotic choice should include agents that are active against S. maltophilia in patients who are deteriorating on broad spectrum beta-lactam antimicrobial agents.

Pathogen, Insect and Weed Control Effects of Secondary Metabolites from Plants (식물유래 2차 대사물질의 병충해 및 잡초 방제효과)

  • Kim, Jong-Bum
    • Applied Biological Chemistry
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    • v.48 no.1
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    • pp.1-15
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    • 2005
  • Pathogens, insects and weeds have significantly reduced agricultural productivity. Thus, to increase the productivity, synthetic agricultural chemicals have been overused. However, these synthetic compounds that are different from natural products cannot be broken down easily in natural systems, causing the destruction of soil quality and agricultural environments and the gradually difficulty in continuous agriculture. Now agriculture is faced with the various problems of minimizing the damage in agricultural environments, securing the safety of human health, while simultaneously increasing agricultural productivity. Meanwhile, plants produce secondary metabolites to protect themselves from external invaders and to secure their region for survival. Plants infected with pathogens produce antibiotics phytoalexin; monocotyledonous plants produce flavonoids and diterpenoids phytoalexins, and dicotylodoneous plant, despite of infected pathogens, produce family-specific phytoalexin such as flavonoids in Leguminosae, indole derivatives in Cruciferae, sesquitepenoids in Solanaceae, coumarins in Umbelliferae, making the plant resistant to specific pathogen. Growth inhibitor or antifeedant substances to insects are terpenoids pyrethrin, azadirachtin, limonin, cedrelanoid, toosendanin and fraxinellone/dictamnine, and terpenoid-alkaloid mixed compounds sesquiterpene pyridine and norditerpenoids, and azepine-, amide-, loline-, stemofoline-, pyrrolizidine-alkaloids and so on. Also plants produces the substances to inhibit other plant growths to secure the regions for plant itself, which is including terpenoids essential oil and sesquiterpene lactone, and additionally, benzoxazinoids, glucosinolate, quassinoid, cyanogenic glycoside, saponin, sorgolennone, juglone and lots of other different of secondary metabolites. Hence, phytoalexin, an antibiotic compound produced by plants infected with pathogens, can be employed for pathogen control. Terpenoids and alkaloids inhibiting insect growth can be utilized for insect control. Allelochemicals, a compound released from a certain plant to hinder the growth of other plants for their survival, can be also used directly as a herbicides for weed control as well. Therefore, the use of the natural secondary metabolites for pest control might be one of the alternatives for environmentally friendly agriculture. However, the natural substances are destroyed easily causing low the pest-control efficacy, and also there is the limitation to producing the substances using plant cell. In the future, effects should be made to try to find the secondary metabolites with good pest-control effect and no harmful to human health. Also the biosynthetic pathways of secondary metabolites have to be elucidated continuously, and the metabolic engineering should be applied to improve transgenics having the resistance to specific pest.

Evaluation of Uricult Trio Test as a Rapid Screening of UTI in Children with Fever (소아 요로감염 진단에 있어 신속배양검사(Uricult Trio)의 유용성에 관한 연구)

  • Lee, Jin;Kim, Eun Jin;Lee, Taek Jin;Chang, Jin Keun;Cha, Sung-Ho
    • Pediatric Infection and Vaccine
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    • v.17 no.2
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    • pp.74-82
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    • 2010
  • Purpose : The Dipslide culture test is a rapid method for diagnosis of urinary tract infection (UTI). The aim of this study is to determine the diagnostic availability of a urine Dipslide test for evaluation of UTI in febrile children. Methods : Urine specimens from 151 febrile infants were inoculated by a routine blood agar urine culture method and the Dipslide test at the same time. Following incubation for 16-24 hours, the results of the Dipslide test were read at the next visit. Both results of Dipslide and those of routine culture were compared. Results : The mean age of subjects was 15${\pm}$10.6 months. There were 150 infants (99.3%) who had fever with a mean duration of 2.6${\pm}$2.6 days. Thirty two infants (21.2%) were diagnosed as having UTI. Sensitivity and specificity of Uricult Trio CLED medium were 59.4% and 84.8%, respectively. Sensitivity and specificity of Uricult Trio E. coli medium were 60.0% and 96.2%, respectively. The Pearson correlation coefficient between results of Uricult Trio CLED medium and urine culture was 0.438 (P=0.01). Correlation between results of Uricult Trio E. coli medium and urine culture was 0.617 (P=0.01). Conclusion : The Dipslide test requires only 16-24 hours with high specificity in terms of UTI caused by E. coli without the problems associated with specimen delay. This test seems to be helpful for exclusion of UTI in febrile infants and it may reduce unnecessary hospitalization and antibiotic use. However, further studies are required before the product can be recommended as a routine diagnostic tool.

Clinical Analysis of Video Assisted Thoracic Surgery for the Treatment of Thoracic Empyema (비디오 흉강경을 이용한 농흉수술의 임상분석)

  • Oh, Sang-Gi;Song, Sang-Yun;Yun, Chi-Hyeong;Na, Kook-Ju;Kong, Kang-Eun;Park, Song-Ran;Kim, Sang-Hyung
    • Journal of Chest Surgery
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    • v.43 no.2
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    • pp.139-143
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    • 2010
  • Background: Thoracic empyema remains a serious problem despite the availability of modern diagnostic methods and appropriate antibiotics. The condition presents in many different forms and stages that require different therapeutic options. Video-assisted thoracic surgery (VATS) has become increasingly popular for use in the treatment of empyema. Material and Method: From January 2005 to May 2009, VATS was performed in 36 patients with pleural empyema and for whom chest-tube drainage and antibiotic therapy had failed or the CT scan showed multiseptate disease. The perioperative clinical factors were analyzed for all the study patients. Result: All the patients underwent VATS, but it was necessary to convert to thoracotomy in one patient. The mean operation time was $90{\pm}38.5\;min$. For the operative evaluation, 11 patients were compatible with ATS stage III. The duration of chesttube insertion was $11.9{\pm}5.8$ (3~24) days. One patient did not improve and therefore this patient underwent additional open drainage. At discharge, costophrenic angle blunting was observed in 22 patients, pleural thickening was noted in 20 patients, both were noted in 17 patients and neither was noted in 11 patients. However, at follow-up, each of these changes was observed in 9, 7, 4 and 24 patients, respectively. All except one patient showed radiographic improvement. Conclusion: VATS is suitable for the treatment of early and fibrinopurulent thoracic empyema, and even in selected patients with stage III disease.

Effect of Pitamin as an Antibiotics Replacement for Organic livestock Feed Additives in Broiler Chickens (유기사료원료로서 소나무껍질 추출물 피타민의 브로일러에 대한 항생제 대체효과)

  • Kim, Byong-Wan;Oh, Jin-Seok;Han, Ohan-Taek;Park, Sang-Oh;Park, Byung-Sung
    • Korean Journal of Organic Agriculture
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    • v.17 no.1
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    • pp.111-125
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    • 2009
  • Pitamin is a component of pine bark extract that exhibits antimicrobial activity and a variety of physiological effects. This study was earned out to investigate the effects of dietary pitamin as an organic livestock feed additive in broiler chickens. A 35 day trial was conducted to determine the influence of dietary premix containing 5% pitamin; investigated parameters included blood lipids, growth performance, quality characteristics of carcasses, and changes of caecal microbials in broiler chickens. Chickens were randomly divided into groups that were untreated (control), treated conventionally with antibiotics in the absence of premix, received 0.1 % or 0.2% premix containing 5% pitamin. Plasma lipids were lower in groups fed diets with pitamin premix (p<0.05). The body weight gain from broiler chickens fed with the diet containing 0.1% pitamin premix and antibiotics was similar, and was significantly higher than that of the other groups (p<0.05). The weight of breast muscle and thigh meat of carcasses was similar, and was higher than that of the control group (p<0.05). Abdominal fat and thymus index from chickens receiving either pitamin-supplemented premix was significantly lower and increased, respectively, that of the antibiotic and control groups (both p<0.05). The chickens on the pitamin premix-supplemented diets evidenced significantly higher caecal levels of Bifidobacterium species as compared with the chickens on the control diet (p<0.05). These results suggest that feeding a diet supplemented with a 0.1% premix containing 5.0% pitamin for 35 days maintains the production of broiler chickens at a level comparable to that obtained from the use of antibiotics.

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Identification and Characterization of Lactobacillus salivarius subsp. salivarius from Korean Feces

  • Bae, Hyoung-Churl
    • Proceedings of the Korean Society for Food Science of Animal Resources Conference
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    • 2004.05a
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    • pp.89-119
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    • 2004
  • This study was conducted to isolate lactobacilli having probiotic characteristics to be used as health adjuncts with fermented milk products. Acid tolerant strains were selected in Lactobacilli MRS broth adjusted to pH 4.0 from 80 healthy persons (infants, children and adults). And bile tolerant strains were examined in Lactobacilli MRS broth in which 1.0% bile salt was added. By estimation above characteristics, the strains No. 27, which was isolated from adult feces, was selected and identified as Lactobacillus salivarius subsp. salivarius based on carbohydrate fermentation and 16S rDNA sequencing. It was used as a probiotic strain in fermented milk products. The pH of fermented milk decreased from pH 6.7 to 5.0 and titratable acidity increased from 0.3% to 1.0% by L. salivarius subsp. salivarius (isolation strain 20, 35, and 37), when incubated for 36 h at $37^{\circ}C$. The number of viable cell counts of fermented milk was maximized at this incubation condition. The SDS-PAGE evidenced no significant change of casein but distinct changes of whey protein were observed by isolated L. salivarius subsp. salivarius for titratable acidity being incubated by $0.9{\sim}1.0%$ at $37^{\circ}C$. All of the strains produced 83.43 to 131.96 mM of lactic acid and 5.39 to 26.85 mM of isobutyric acid in fermented products. The in vitro culture experiment was performed to evaluate ability to reduce cholesterol levels and antimicrobial activity in the growth medium. The selected L. salivarius subsp. salivarius reduced $23{\sim}38%$ of cholesterol content in lactobacilli MRS broth during bacterial growth for 24 hours at $37^{\circ}C$. All of the isolated L. salivarius subsp. salivarius had an excellent antibacterial activity with $15{\sim}25$ mm of inhibition zone to E. coli KCTC1039, S. enteritidis KCCM3313, S. typhimurium M-15, and S. typhimurium KCCM40253 when its pH had not been adjusted. Also, all of the isolated L. salivarius subsp. salivarius had partial inhibition zone to E. coli KCTC1039, E. coli KCTC0115 and S. enteritidis KCCM3313 when it had been adjusted to pH 5.7. The selected strains were determined to have resistances of twelve antibiotic. Strains 27 and 35 among the L. salivarius subsp. salivarius showed the highest resistance to the antibiotics. Purified ${\alpha}$-galactosidase was obtained by DEAE-Sephadex A-50 ion exchange chromatography, Mono-Q ion exchange chromatography and HPLC column chromatography from L. salivarius subsp. salivarius 27. The specific activity of the purified enzyme was 8,994 units/mg protein, representing an 17.09 folds purification of the original cell crude extract. The molecular weight of enzyme was identified about 53,000 dalton by 12% SDS-PAGE. Optimal temperature and pH for activity of this enzyme were $40^{\circ}C$ and 7.0 respectively. The enzyme was found to be stable between 25 and $50^{\circ}C$. ${\alpha}$-galactosidase activity was lost rapidly below pH 5.0 and above pH 9.0. This enzyme was liberated galactose from melibiose, raffinose, and stachyose, and also the hydrolysis rate of substrate was compound by HPLC. These results indicated that some of the L. salivarius subsp. salivarius (strain 27 and 35) are considered as effective probiotic strains with a potential for industrial applications, but the further study is needed to establish their use as probiotics in vivo.

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Effects of Antimicrobials on Methane Production in an Anaerobic Digestion Process (혐기소화공정에서 항생항균물질이 메탄생성에 미치는 영향)

  • Oh, Seung-Yong;Park, Noh-Back;Park, Woo-Kyun;Chun, Man-Young;Kwon, Soon-Ik
    • Korean Journal of Environmental Agriculture
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    • v.30 no.3
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    • pp.295-303
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    • 2011
  • BACKGROUND: Anaerobic digestion process is recently adapted technology for treatment of organic waste such as animal manure because the energy embedded in the waste can be recovered from the waste while the organic waste were digested. Ever increased demand for consumption of meat resulted in the excessive use of antimicrobials to the livestocks for more food production. Most antimicrobials administered to animals are excreted through urine and feces, which might highly affect the biological treatment processes of the animal manure. The aim of this study was to investigate the effects of antimicrobials on the efficiency of anaerobic digestion process and to clarify the interactions between antimicrobials and anaerobes. METHODS AND RESULTS: The experiment was consisted of two parts 1) batch test to investigate the effects of individual antibiotic compounds on production of methane and VFAs(volatile fatty acids), and removal efficiency of organic matter, and 2) the continuous reactor test to elucidate the effects of mixed antimicrobials on the whole anaerobic digestion process. The batch test showed no inhibitions in the rate of methane and VFAs production, and the rate of organic removal were observed with treatment at 1~10 mg/L of antimicrobials while temporary inhibition was observed at 50 mg/L treatment. In contrast, treatment of 100 mg/L antimicrobials resulted in continuous decreased in the rate of methane production and organic removal efficiency. The continuous reactor test conduced to see the influence of the mixed antimicrobials showed only small declines in the methane production and organic matter removal when 1~10 mg/L of combined antimicrobials were applied but this was not significant. In contrast, with the treatment of 50 mg/L of combined antimicrobials, the rate of organic removal efficiency in effluent decreased by 2~15% and the rate of biogas production decreased by 30%. CONCLUSION(s): The antimicrobials remained in the animal manure might not be removed during the anaerobic digestion process and hence, is likely to be released to the natural ecosystem. Therefore, the efforts to decline the usage of antimicrobials for animal farming would be highly recommended.

Studies on Chronic Mastitis of Dairy Cattle in Taegu-Kyungpook Provinces (대구(大邱).경북지방(慶北地方)에서 문제되는 젖소의 만성(慢性) 유방염(乳房炎)에 관한 연구(硏究))

  • Kim, Bong Hwan;Park, Hoo Yhul;Chang, In Ho
    • Current Research on Agriculture and Life Sciences
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    • v.2
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    • pp.115-121
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    • 1984
  • Some investigations on chronic mastitis in dairy cattle in Taegu-Kyungpook Provinces from the beginning of October, 1984 till the end of August, 1985 were conducted with the particular regard to the causative agents and their drug susceptibility. Milk samples from 83 isolated cases of chronic mastitis cattle were investigated bacteriologically and the causative organisms recovered were examined for their antibiotic susceptibility by using disc diffusion susceptibility technique against the major antibiotics of current veterinary use. Major causative agents involved in chronic mastitis in Taegu-Kyungpook Provinces were in order of prevalence Staphylococcus spp. (48.2 %), Escherichia coli (18.1 %), Candida spp. (10.8 %) and Corynebacterium spp. (8.4 %), Streptococcus agalactiae (3.6 %), Bacillus cereus (3.6 %) and Pseudomonas aeruginosa (2.4 %) were found to be one of the minor agents. The majority of staphylococcal isolates and E. coli were highly resistant to the most antibiotics tested. The percentages of staphylococcal cultures resistant to penicillin, methicillin, lincomycin, novobiocin, ampicillin and tetracycline were 87.2 %, 78.7 %, 68.1 %, 61.7% and 57.4 %, respectively, while the majority of them were susceptible to gentamicin(78.7 %), cephalothin(76.6 %) and chloramphenicol (74.5%). E. coli isolates were found to be highly resistant to streptomycin, cephalothin, tetracycline and ampicillin while the majority of them were susceptible to colistin (83.3 %), gentamicin (77.8 %) and chloramphenicol (66.7 %). Corynebacterium spp. were susceptible to ampicillin, chloramphenicol, erythromycin, gentamicin, oleandomycin and tetracycline although they showed resistance to novobiocin and penicillin. Two cultures of Pseudomonas aeruginosa recovered from mastitis milk were highly resistant to the antibiotics employed in the present study.

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