• Title/Summary/Keyword: antibiotic use

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The Evaluation of Teicoplanin Usage in a University Hospital (대학병원에서의 Teicoplanin의 사용 현황 조사 및 실태 평가)

  • Kim, Eun A;Oh, Jung Mi
    • Korean Journal of Clinical Pharmacy
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    • v.11 no.1
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    • pp.19-29
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    • 2001
  • Teicoplanin, a glycopeptide antibiotic, has potential for use as an alternative to vancomycin in the treatment of gram-positive bacterial infections. However, unlike vancomycin, there is a lack of study on teicoplanin's efficacy and safety and the guideline for its use is not available, yet. The objective of this study was to investigate and evaluate the pattern of teicoplanin usage in a university hospital. A retrospective study was performed on 72 adult patients, who took teicoplanin for 3 continuous days at D. University hospital from 1 January 1999 to 30 June 2000. The microorganisms treated with teicoplanin were methicillin-resistant Staphylocorcus aureus $(69\%)$, coagulase-negative Staphylococci $(12\%)$, Enterococcus $(4\%)$, vancomycin-resistant Enterococci $(2\%)$, Streptococci $(2\%)$, and Bacillus $(1\%)$. The types of infection treated with teicoplanin were surgical wound infection $(58\%)$, lower respiratory infection $(11\%)$, bactremia $(7\%)$, urinary tract infection $(5\%)$, pleural fluid infection $(4\%)$, and peritoneal fluid infection $(2\%)$. The mean duration of teicoplanin usage was 16.5 days and teicoplanin was used with 1.4 other antibiotics, which were aminoglycosides (isepamicin, amikacin, netilmicin, astromicin) or quinolones (ciprofloxacin, tosufloxacin) or the third generation cephalosporin (ceftazidime). Only 24 cases $(28.6\%)$ met with the criteria for the justification of use, and the rest of 60 cases $(71.4\%)$ did not meet the criteria. In 84 cases $(100\%)$, blood culture tests were performed prior to the initial dose of teicoplanin. In 83 cases $(99\%)$, serum creatinine were conducted before the initial doses. In 45 cases $(53.6\%)$, serum creatinine was monitored at least twice weekly. In 55 cases $(65.5\%)$, WBC was tested at least twice weekly. In 84 cases $(100\%)$, body temperature was monitored at least once per nursing shift. In 15 cases out of 56 cases, maximum temperature decreased at least 1 degree within 3 days of teicoplanin use. In 15 case out of 35 cases, WBC values were within the normal range after treatment. In 23 cases $(27.4\%)$, dosage regimen was appropriate. Drug-related adverse effects were reported in 13 cases. Nephrotoxicity (progressively increasing SCr. or sustained SCr increase of $\geq$0.5 mg/dl from baseline) was noted in five cases. Neutropenia (absolute neutrophil count <1,500 $cells/mm^3$) was noted in one case and eosinophilia (total eosinophil count >350 $cells/mm^3$) was noted in seven cases. A more strict control on use of teicoplanin is required, considering that teicoplanin is categorized as one of restricted antibiotics.

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Immune Modulation of Recombinant OmpA against Brucella abortus 544 Infection in Mice

  • Simborio, Hannah Leah Tadeja;Reyes, Alisha Wehdnesday Bernardo;Hop, Huynh Tan;Arayan, Lauren Togonon;Min, Wongi;Lee, Hu Jang;Lee, Jin Ju;Chang, Hong Hee;Kim, Suk
    • Journal of Microbiology and Biotechnology
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    • v.26 no.3
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    • pp.603-609
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    • 2016
  • Brucellosis affects a wide range of host species, including humans and many livestock animals. Chronic infections of the disease make antibiotic treatment costly, and the current vaccine used in livestock has not been approved for human use. This study investigated the possible use of the Brucella abortus outer membrane protein A (OmpA) as a candidate subunit vaccine in an infected mouse model. The ompA gene was cloned and overexpressed, and the recombinant OmpA (rOmpA) protein fused to maltose binding protein (MBP) was purified in Escherichia coli. Immunogenicity was verified through western blotting, and mice were immunized and challenged to evaluate its protective effect. Mice treated with rOmpA exhibited induced humoral and host cell-mediated responses, with a significant increase in immunoglobulin G (IgG1 and IgG2a) and cytokine levels, especially TNF-α and IL-12, compared with the control groups treated with either MBP or PBS. In conclusion, rOmpA should be highly considered as a future subunit vaccine for brucellosis, and further studies regarding rOmpA and its protective ability are suggested.

Isolation and Characterization of Bacteriophages Against Pseudomonas syringae pv. actinidiae Causing Bacterial Canker Disease in Kiwifruit

  • Yu, Ji-Gang;Lim, Jeong-A;Song, Yu-Rim;Heu, Sunggi;Kim, Gyoung Hee;Koh, Young Jin;Oh, Chang-Sik
    • Journal of Microbiology and Biotechnology
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    • v.26 no.2
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    • pp.385-393
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    • 2016
  • Pseudomonas syringae pv. actinidiae causes bacterial canker disease in kiwifruit. Owing to the prohibition of agricultural antibiotic use in major kiwifruit-cultivating countries, alternative methods need to be developed to manage this disease. Bacteriophages are viruses that specifically infect target bacteria and have recently been reconsidered as potential biological control agents for bacterial pathogens owing to their specificity in terms of host range. In this study, we isolated bacteriophages against P. syringae pv. actinidiae from soils collected from kiwifruit orchards in Korea and selected seven bacteriophages for further characterization based on restriction enzyme digestion patterns of genomic DNA. Among the studied bacteriophages, two belong to the Myoviridae family and three belong to the Podoviridae family, based on morphology observed by transmission electron microscopy. The host range of the selected bacteriophages was confirmed using 18 strains of P. syringae pv. actinidiae, including the Psa2 and Psa3 groups, and some were also effective against other P. syringae pathovars. Lytic activity of the selected bacteriophages was sustained in vitro until 80 h, and their activity remained stable up to 50℃, at pH 11, and under UV-B light. These results indicate that the isolated bacteriophages are specific to P. syringae species and are resistant to various environmental factors, implying their potential use in control of bacterial canker disease in kiwifruits.

Management of complex surgical wounds of the back: identifying an evidence-based approach

  • Zolper, Elizabeth G.;Saleem, Meher A.;Kim, Kevin G.;Mishu, Mark D.;Sher, Sarah R.;Attinger, Christopher E.;Fan, Kenneth L.;Evans, Karen K.
    • Archives of Plastic Surgery
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    • v.48 no.6
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    • pp.599-606
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    • 2021
  • Background Postoperative dehiscence and surgical site infection after spinal surgery can carry serious morbidity. Multidisciplinary involvement of plastic surgery is essential to minimizing morbidity and achieving definitive closure. However, a standardized approach is lacking. The aim of this study was to identify effective reconstructive interventions for the basis of an evidence-based management protocol. Methods A retrospective review was performed at a single tertiary institution for 45 patients who required 53 reconstruction procedures with plastic surgery for wounds secondary to spinal surgery from 2010 to 2019. Statistical analysis was performed for demographics, comorbidities, and treatment methods. Primary outcomes were postoperative complications, including dehiscence, seroma, and infection. The secondary outcome was time to healing. Results The overall complication rate was 32%, with dehiscence occurring in 17%, seroma in 15% and infection in 11% of cases. Median follow-up was 10 months (interquartile range, 4-23). Use of antibiotic beads did not affect rate of infection occurrence after wound closure (P=0.146). Use of incisional negative pressure wound therapy (iNPWT) was significant for reduced time to healing (P=0.001). Patients treated without iNPWT healed at median of 67.5 days while the patients who received iNPWT healed in 33 days. Demographics and comorbidities between these two groups were similar. Conclusions This data provides groundwork for an evidence-based approach to soft tissue reconstruction and management of dehiscence after spinal surgery. Timely involvement of plastic surgery in high-risk patients and utilization of evidence-based interventions such as iNPWT are essential for improving outcomes in this population.

Lactobacillus casei Zhang Prevents Jejunal Epithelial Damage to Early-Weaned Piglets Induced by Escherichia coli K88 via Regulation of Intestinal Mucosal Integrity, Tight Junction Proteins and Immune Factor Expression

  • Wang, Yuying;Yan, Xue;Zhang, Weiwei;Liu, Yuanyuan;Han, Deping;Teng, Kedao;Ma, Yunfei
    • Journal of Microbiology and Biotechnology
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    • v.29 no.6
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    • pp.863-876
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    • 2019
  • Farm animals such as piglets are often affected by environmental stress, which can disturb the gut ecosystem. Antibiotics were commonly used to prevent diarrhea in weaned piglets, but this was banned by the European Union due to the development of antibiotic resistance. However, the use of probiotics instead of antibiotics may reduce the risk posed by pathogenic microorganisms and reduce the incidence of gastrointestinal diseases. Therefore, this study was conducted to investigate the effects of Lactobacillus casei Zhang on the mechanical barrier and immune function of early-weaned piglets infected using Escherichia coli K88 based on histomorphology and immunology. Fourteen-day-old weaned piglets were divided into a control group and experimental groups that were fed L. casei Zhang and infected with E. coli K88 with or without prefeeding and/or postfeeding of L. casei Zhang. The L. casei Zhang dose used was $10^7CFU/g$ diet. Jejunum segments were obtained before histological, immunohistochemical, and western blot analyses were performed. In addition, the relative mRNA expression of toll receptors and cytokines was measured. Piglets fed L. casei Zhang showed significantly increased jejunum villus height, villus height-crypt depth ratio, muscle thickness, and expression of proliferating cell nuclear antigen and tight junction proteins ZO-1 and occludin. The use of L. casei Zhang effectively reduced intestinal inflammation after infection. We found that L. casei Zhang feeding prevented the jejunum damage induced by E. coli K88, suggesting that it may be a potential alternative to antibiotics for preventing diarrhea in early-weaned piglets.

Variation of Practice in Prophylactic Protocol to Reduce Prosthetic Joint Infection in Primary Hip and Knee Arthroplasty: A National Survey in the United Kingdom

  • James Morris;Lee Hoggett;Sophie Rogers;John Ranson;Andrew Sloan
    • Hip & pelvis
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    • v.35 no.4
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    • pp.228-232
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    • 2023
  • Purpose: Prosthetic joint infection (PJI) has an enormous physiological and psychological burden on patients. Surgeons rightly wish to minimise this risk. It has been shown that a standardised, evidence-based approach to perioperative care leads to better patient outcomes. A review of current practice was conducted using a cross-sectional survey among surgeons at multiple centers nationwide. Materials and Methods: An 11-question electronic survey was circulated to hip and knee arthroplasty consultants nationally via the BOA (British Orthopaedic Association) e-newsletter. Results: The respondents included 56 consultants working across 19 different trusts. Thirty-four (60.7%) screen patients for asymptomatic bacteriuria (ASB) preoperatively, with 19 (55.9%) would treating with antibiotics. Fifty-six (100%) screen for methicillin-resistant Staphylococcus aureus and treat if positive. Only 15 (26.8%) screen for methicillin-sensitive S. aureus (MSSA) or empirically eradicate. Zero (0%) routinely catheterize patients perioperatively. Forty-one (73.2%) would give intramuscular or intravenous gentamicin for a perioperative catheterisation. All surgeons use laminar flow theatres. Twenty-six (46.4%) use only an impervious gown, 6 (10.7%) exhaust pipes, and 24 (42.3%) surgical helmet system. Five different antimicrobial prophylaxis regimens are used 9 (16.1%) cefuroxime, 2 (3.6%) flucloxacillin, 19 (33.9%) flucloxacillin and gentamicin, 10 (17.9%) teicoplanin, 16 (28.6%) teicoplanin and gentamicin. Twenty-two (39.3%) routinely give further doses. Conclusion: ASB screening, treatment and intramuscular gentamicin for perioperative catheterisation is routinely practiced despite no supporting evidence base. MSSA screening and treatment is underutilised. Multiple antibiotic regimens exist despite little variation in organisms in PJI. Practice varies between surgeons and centers, we should all be practicing evidence-based medicine.

Effect of Bacillus amyloliquefaciens-based Direct-fed Microbial on Performance, Nutrient Utilization, Intestinal Morphology and Cecal Microflora in Broiler Chickens

  • Lei, Xinjian;Piao, Xiangshu;Ru, Yingjun;Zhang, Hongyu;Peron, Alexandre;Zhang, Huifang
    • Asian-Australasian Journal of Animal Sciences
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    • v.28 no.2
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    • pp.239-246
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    • 2015
  • The present study was conducted to evaluate the effect of the dietary supplementation of Bacillus amyloliquefaciens-based direct-fed microbial (DFM) on growth performance, nutrient utilization, intestinal morphology and cecal microflora in broiler chickens. A total of two hundred and eighty eight 1-d-old Arbor Acres male broilers were randomly allocated to one of four experimental treatments in a completely randomized design. Each treatment was fed to eight replicate cages, with nine birds per cage. Dietary treatments were composed of an antibiotic-free basal diet (control), and the basal diet supplemented with either 15 mg/kg of virginiamycin as antibiotic growth promoter (AGP), 30 mg/kg of Bacillus amyloliquefaciens-based DFM (DFM 30) or 60 mg/kg of Bacillus amyloliquefaciens-based DFM (DFM 60). Experimental diets were fed in two phases: starter (d 1 to 21) and finisher (d 22 to 42). Growth performance, nutrient utilization, morphological parameters of the small intestine and cecal microbial populations were measured at the end of the starter (d 21) and finisher (d 42) phases. During the starter phase, DFM and virginiamycin supplementation improved the feed conversion ratio (FCR; p<0.01) compared with the control group. For the finisher phase and the overall experiment (d 1 to 42) broilers fed diets with the DFM had better body weight gain (BWG) and FCR than that of control (p<0.05). Supplementation of virginiamycin and DFM significantly increased the total tract apparent digestibility of crude protein (CP), dry matter (DM) and gross energy during both starter and finisher phases (p<0.05) compared with the control group. On d 21, villus height, crypt depth and villus height to crypt depth ratio of duodenum, jejunum, and ileum were significantly increased for the birds fed with the DFM diets as compared with the control group (p<0.05). The DFM 30, DFM 60, and AGP groups decreased the Escherichia coli population in cecum at d 21 and d 42 compared with control group (p<0.01). In addition, the population of Lactobacillus was increased in DFM 30 and DFM 60 groups as compared with control and AGP groups (p<0.01). It can be concluded that Bacillus amyloliquefaciens-based DFM could be an alternative to the use of AGPs in broilers diets based on plant protein.

An Investigation on the Anitibiotic Resistant Condition and Label-Stated of Domestically Distributed Livestock-Environment Improving Agents (국내에서 유통 중인 축산환경개선제의 표기사항 및 항생제 내성 현황조사)

  • Choi, Jung-Eun;Lee, Eun-Young
    • Microbiology and Biotechnology Letters
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    • v.37 no.3
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    • pp.258-265
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    • 2009
  • A study on livestock environment improving agents was conducted; top two brands (A and B) in the market, bottom two brands (E and F) based on market shares and two newly developed agents (C and D) were measured for viable count and tested for resistance towards antibiotics prohibited against livestock feeds. Test results revealed that the measured viable count of agents A and B matched those on the labels were identical; however agent E lacked information on viable counts nor the intended usage, while the measured viable count of agent F was less than the label-stated count. No correlation was found between the antibiotic-resistance test and market share, and most of the agents excluding B were found to display resistance case of Lincosimides such as Lincomycine and Clindmycin, resistant bacteria were found, with the except of agent B. Amoxicillin, Ampicillin and Penillin (type-Penecillins) and Erythromycin (type-Macrolide) were shown to contain resistant bacteria, with the except of agents Band E; the same for Norploxacin (type-Quinoline) and Neomycin antibiotics. Aminoglycosides such as Gentamycin and Streptomycin contained resistant bacteria, excluding agent B. Oxytetracyclin (type-Tetracycline), which is banned for use as resistant bacteria showed the highest sensitivity among the 12 antibiotics, revealed positive results in the test for resistant bacteria; again excluding of agents Band E. These results reveal that many agents contained resistant bacteria despite the fact that they were prohibited; this calls for a more accurate display of the facts and specifications, systematic distributions and strict verification processes of environment improving agents.

Effect of Methionine on Cephalosporin C Production in a Fluidized- bed Bioreactor (유동층 생물반응기에서 세파로스포린 C 생산에 대한 메치오닌의 영향)

  • Kim, Eui-Yong;Yoo, Young-Je;Park, Young-Hoon
    • Microbiology and Biotechnology Letters
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    • v.17 no.6
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    • pp.611-618
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    • 1989
  • Effects of methionine on cephalosporin C(CPC) production in a fluidized-bed bioreactor were investigated using bioparticles of Cephalosporium acremonium. Since methionine was found to be an important metabolic regulator on the synthesis of cephalosporin C, the effects of its concentration in the cuture broth and feeding mode to the bioreactor were studied. It was observed that the presence of initial methionine was essential for higher cephalosporin C production and there existed an optimal content of methionine. Carbon consumption rate also increased significantly under the presence of methionine. Production of cephalosporin C was most active when methionine was exhausted in the broth; however its additional feeding did not enhance the antibiotic production in the fluidized-bed bioreactor as much as expected. It was therfore considered important to feed an optimal content of methionine at the early operating stage for a higher cephalosporin C production in a fluidized-bed bioreactor. An interesting thing to note was that titre of the antibiotic with reused bioparticles was about 2 times higher in the methionine containing medium than that without methionine. Therefore repeated use of bioparticles, with an optimal content of methionine, was believed to be very useful to enhance to process productivity.

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EFFECT OF THIRD MOLAR ON POSTOPERATIVE INFECTION AFTER REDUCTION OF THE MANDIBULAR ANGLE FRACTURE (하악 제3대구치가 하악 우각부골절 정복술후 감염에 미치는 영향에 관한 연구)

  • Choi, Moon-Gi;Min, Seung-Ki;Lee, Dong-Keun;Oh, Seung-Hwan
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.23 no.3
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    • pp.217-225
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    • 2001
  • Any fracture passing through the socket of a teeth is compounded intraorally, even if the fracture is not displaced and the tooth is firm in its socket. Before the advent of antibiotic therapy the danger of infection in a compounded fracture posed severe problems in treatment. Infection is reduced by antibiotic therapy but prolonged use of antibiotics is not justified in an attempt to save a tooth which might eventually be sacrificed. There is still controversy in the management of third molar in mandibualr angle fracture, particulary in regard to their retention or removal at the time of fracture treatment. So we surveyed the 159 patients who were treated with open reduction of mandibular angle fracture containing third molar in fracture line, and compared with the postoperative infection rate depending on time intervals between injury and operation, eruption state of third molar, non-extraction or extraction of third molar related to eruption state, non-extraction or extraction of third molar related to condiition of third molar and its surrounding periodontium and were to propose treatment guidline of third molar in mandibular angle fracture The results obtained were as follows : 1. There were no statistical significance between the time from injury to operation and postoperative infection. 2. There were no statistical significance between eruption state of third molar and postoperative infection. 3. In case of retention of the third molar, there were no statistical significance between eruption state of third molar and postoperative infection, but in case of extraction, postoperative infection was high rate in complete impacted cases. 4. There were no statistical significance between non-extraction or extraction of third molar and postoperative infection depending on condition of third molar. There are no difference in infection rate statistically according to the time from injury to operation, eruption state and condition of third molar, but retention of third molar revealed lowered infection rate in completely impacted cases. By terms of the manegement of third molar, we should extract or preserve third molar in the line of the mandibular angle fracture according to possibility of infection.

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