• Title/Summary/Keyword: antibiotics

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Lung Complications After Allogenic Bone Marrow Transplantaion (동종골수이식 후 폐합병증)

  • JeGal, Yang-Jin;Lee, Je-Hwan;Lee, Kyoo-Hyung;Kim, Woo-Kun;Shim, Tae-Sun;Lim, Chae-Man;Koh, Youn-Suck;Lee, Sang-Do;Kim, Woo-Sung;Kim, Won Dong;Kim, Dong-Soon
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.2
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    • pp.207-216
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    • 2000
  • Background : The occurrence of lung complications after allogenic bone marrow transplantation(BMT) has been reported as 40-60 percent. The risk factors for lung complications are whole body irradiation, high dose chemotherapy, graft versus host disease, old age and CMV infection. The prevalence of graft versus host disease is less in Korea than in Western countries, but frequency of CMV infection is higher. Therefore, the pattern of lung complications may be different in Korea from those in Western countries. Methods : A retrospective cohort study was performed on one hundred consecutive adult patients who underwent allogenic bone marrow transplantation from December, 1993 to May, 1999 at Asan Medical Center. Lung complications were divided into two groups by the time of development, within 30days (pre-engraftment) and beyond 30 days (post-engraftment), and then subdivided into infectious and non-infectious complication. Infectious complications were defined as having the organism in blood, BAL fluid, pleural fluid or sputum, or compatible clinical findings in patients, which improved with antibiotics or an anti-fungal therapy. Result: 1) Eighty three episodes of lung complications had occurred in 54 patients. 2) Within thirty days after BMT, non-infectious complications were more common than infections, but this pattern was reversed after 30 days. After one year post-BMT, there was no infectious complication except in cases of recurrence of underlying disease or development of chronic GVHD. 3) Among the non-infectious complications, pleural effusion (27 episodes) was most common, followed by pulmonary edema (8 episodes), bronchiolitis obliterans(2 episodes), diffuse alveolar hemorrhage (1 episode) and bronchiloitis obliterans with organizing pneumonia (1 episode). 4) The infectious complications were pneumonia (bacterial: 9 episodes, viral: 4 episodes, fungal : 5 episodes, pneumocystis carinii : 1 episode), pulmonary tuberculosis(3 episodes) and tuberculous pleurisy (3 episodes). 5) Lung complications were more frequent in CMV positive patients and in patients with delayed recovery of neutrophil count. 6) The mortality was higher in the patients with lung complications. Conclusion : Lung complications developed in 54% after allogenic BMT and were associated with higher mortality.

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Clinical Investigation of Tuberculous Pneumonia (결핵성 폐렴환자의 임상적 고찰)

  • Lee, Seung Heon;Hur, Gyu Young;Jung, Ki Hwan;Lee, Sung Yong;Lee, Sang Yeub;Kim, Jae Hyung;Park, Sang Myun;Shin, Chul;Shim, Jae Jeong;In, Kwang Ho;Kang, Kyung Ho;Ryu, Sae Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.1
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    • pp.19-24
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    • 2004
  • Background : It is difficult to differentiate between tuberculous pneumonia and Community Acquired Pneumonia, so the diagnosis and treatment of tuberculous pneumonia can be delayed frequently. In this study, we attempted to retrospectively evaluate the clinical and radiologic characteristics of tuberculous pneumonia. Methods : We conducted a retrospective analysis of clinical characteristics of 58 patients diagnosed with tuberculous pneumonia from Nov. 1997 to May 2001 at Korea university kuro hospital. Result : The male to female ratio was 1:1 and the mean age at diagnosis was $54.5{\pm}18.6$ years. Fifty five patients were confirmed microbiologically and three patients pathologically. There were 20 patients(34.5%) who had diabetes mellitus(8cases), chronic obstructive pulmonary disease(3cases), malignancy(3cases), bronchiectasis(2cases), chronic renal failure(1cases) or long term history of corticosteroid treatment(3cases). Many patients had multilobar infiltration in chest X-ray, dominantly in the lower lobe. thirty two patients(55.2%) had infiltration in more than 2 lobes and 5 patients in more than 4 lobes. The significant correlation between the diabetes mellitus and the infiltrated Rt lower lobe(RLL) was found on the borders of confidence limit.(P=0.07<0.1). There was significant correlation between woman and infiltrated lobe(RML, RLL, LLL) excluding the both upper lobe(P=0.029). Conclusion : We must consider tuberculous pneumonia when lobar pneumonia with consolidation resistant to antibiotics, especially in the patients who have diabetes mellitus, chronic obstructive pulmonary disease, malignancy, bronchiectsis, chronic renal failure or long term history of corticosteroid treatment.

Drugs Most Frequently Used in OPD of Yeungnam University Hospital: March to August, 1985 (영남대학교 의과대학 부속병원 외래환자에 대한 약물처방 동향의 분석)

  • Lee, Kwang-Youn;Kim, Won-Joon;Kim, Sung-Hoon
    • Journal of Yeungnam Medical Science
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    • v.2 no.1
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    • pp.95-102
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    • 1985
  • This report offers descriptive data about the drugs utilized in out patient department (OPD) of Yeungnam University Hospital (YUH) in the period of march to august in 1985. The data in this report were produced by the computerized totalization of the number of mentions of individual drugs included in the prescriptions. The 100 drug entries that were most frequently recorded are listed in rank order. The listing is arbiturarily restricted to the drugs that were prescribed as single preparations, the drugs of basis of compound preparations and the drugs of adjuvent or corrective of compound preparations that have significant therapeutic effects either by generic names. And in addition, the listing also involves the compound preparations used in relatively large frequency, and the individual components of which have the unique pharmacological actions each other by proprietary names. And all routes of administrations were allowed. The 10 drugs most frequently named are diazepam, aluminum compounds, acetaminophen, isoniazid, metoclopramide, $polaramine^{(R)}$, carboxymethylcystem, ephedrine, codeine and caroverine in order. The 521,855 drug mentions listed as above are described by the chief therapeutic usage that each is intended to apply generally. The drugs which account the largest proportion of total mentions were those acting on the central nervous system (20.57%), including tranquilhzers and sedative hypnotics (11.71%), analgesic antipyretics (5.55%), antidepressants (2.15%) etc. Gastrointestinal drugs and smooth muscle preparations (18.64%) included antacids and anti-ulcer drugs (9.24%), antiemetics (3.57%), spasmolytics (3.14%) and others. Respiratory drugs (16.11%) included expectorants and cough preparations (10.99%) and bronchodilators (5.12%). Chemotherapeutic agents (15.12%) included the antiTbc drugs (7.09%) most frequently, and the penicillins (3.33%) accounted the largest proportion among the antibiotics. Cardiovascular drugs (5.64%) included cardiac drugs and coronary vasodilator (4.12%) and antihypertensives and vasodilators (1.06%). And anti-inflammatory drugs (4.33%), vitamins of single preparations (3.76%), hormones and their antagonists (3.29%), common cold preparations (3.12%), diuretics (2.81%), drugs supporting liver function (2.02%), drugs affecting autonomic nervous system(1.89%) including anti-glaucomas, atropine and cerebral vasodilators, antihistamine drugs (1.02%) and disinfectants (0.74%) were following in order. The data in this report were compared to those reported by H. Koch, et al. in United States (US), 1981 as "Drugs Most Frequently Used in Office Practice:National Ambulatory Medical Case Survey, 1981." Cardiovascular drugs prescribed in YUH were much less in proportion than in US (10.56%), but gastrointestinal drugs accounted the larger proportion than in US (3.72%). Expectorants and cough preparations in YUH also accounted the larger proportion than in US (2.74%). In conclusion, in the period of march to august, 1985, OPD of YUH prescribed the CNS drugs including diazepam most frequently, and gastrointestinal, repiratory and chemotherapeutic drugs in next orders. It is supposed that the eating habits of Koreans and a unique atmospheric condition in Taegu as a basin were some important factors that affected the proportions of drugs acting on gastrointestinal and respiratory tracts.

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Comparative Study of Intrauterine Irrigation and Intravenous Injection with Cephradine at Cesarean Section (제왕절개술시 감염예방을 위한 Cephradine자궁내 세척법과 정맥내 주입법의 비교연구)

  • Choi, Jai-Dong;Kim, Jong-Wook;Lee, Tae-Hyung;Park, Wan-Seok;Lee, Sung-Ho;Chung, Wun-Yong
    • Journal of Yeungnam Medical Science
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    • v.2 no.1
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    • pp.203-210
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    • 1985
  • Febrile morbidity after cesarean section is one of the major problems in obstetric practice. This morbidity is most often due to endometritis. Although parenteral prophylactic antibiotics or antibiotic irrigation has been reported to reduce the incidence of endometritis after cesarean section, its incidence remains high. Among the patients who were undergoing cesarean section at Yeungnam University Hospital from the beginning of March, 1985, three group were evaluated in the orders. 1) 30 cases as intrauterine irrigation group with cephradine solution, 2) 35 cases as intravenous injection group with cephradine, 3) 35 cases as control group are neither irrigated nor injected. Febrile morbidity was also evaluated by means of a fever index. The incidence of clinically diagnosed endometritis in the three group were 6.7%, 2.9%, and 22.9%. As these results, two study groups were markedly reduced the incidence of endometritis than control group. There was no significant difference between the intrauterine irrigation with cephradine and control, but significant difference between the intravenous cephradine injection and control (P<0.05). With the results of fever index analysis, both prophylactic intrauterine irrigation and intravenous injection markedly reduce the incidence of endometritis after cesarean section with stastical significance (P<0.05), and also markedly reduce the febrile degree.

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Antibacterial Effect of Colloidal Silver on Some Oral Bacteria (콜로이드상 은이 수종의 구강 세균에 미치는 항균 효과)

  • Kang, Kee-Hyun;Lee, Kyong-Eun
    • Journal of Oral Medicine and Pain
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    • v.30 no.1
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    • pp.1-14
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    • 2005
  • The maintenance of good oral health in adults is often hindered by oral malodor and periodontal diseases which are known to be commonly caused by some species of Gram-negative anaerobic bacteria, with low sensitivity to common synthetic antibiotics or antibacterial chemical agents. Therefore the development of a nonharmful natural antibacterial oral rinsing remedy against the causative bacteria is thought to be very important. The purpose of this study is to obtain the basic data for development of a nonharmful natural antibacterial oral rinsing remedy using colloidal silver. The author applied colloidal silver solution with concentration of 10, 30, 50, 80 ppm to some strains in species of Prevotella intermedia, Porphyromonas gingivalis, Fusobaterium nucleatum, and evaluated the effects of colloidal silver on the growth of experimental bacterial strains in aspects of minimal inhibitory concentration (MIC), minimal bactericidal concentration (MBC) and growth pattern after incubation for 24, 48, 72 hours. The obtained results were as follows: MIC of colloidal silver solution against experimental strains was 30 ppm in P. intermedia, 10 or 30 ppm in P. gingivalis, and 30, 50, or 80 ppm in F. nucleatum. And MBC of colloidal silver solution against experimental strains was 30 ppm in P. intermedia, 30 or 50 ppm in P. gingivalis, 30 or 80 ppm in F. nucleatum. Therefore it was concluded that colloidal silver exhibited bacteriostatic or/and bacteriocidal effects against some experimental strain. And the inhibition of growth of experimental strains were markedly or considerably exhibited under 30 ppm$\sim$50 ppm of colloidal silver solution for 48 hours$\sim$72 hours in P. intermedia, 10 ppm$\sim$30 ppm for 24 hours$\sim$48 hours in P. gingivalis, 30 ppm for 24 hours in F. nucleatum. These results indicate that the colloidal silver inhibited effectively the growth of some species of Gram-negative anaerobic bacteria by exhibition of bacteriostatic or/and bacteriocidal effects, and can be used as a possible major ingredient of the nonharmful natural antibacterial oral rinsing remedy to oral malodor and periodontal diseases.

Percutaneous Catheter Drainage of Lung Abscess (폐농양의 경피적 카테타 배농법)

  • Kim, Chang-Ho;Cha, Seoung-Ick;Han, Chun-Duk;Kim, Yeon-Jae;Lee, Yeung-Suk;Park, Jae-Yong;Jung, Tae-Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.2
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    • pp.158-164
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    • 1993
  • Background: Recently, lung abscess tends to be increased in patients with underlying disease, most of whom are unsuitable for surgery when medical treatment fails. The patients with giant lung abscesses do not frequently respond to antibiotics and often have life-threatening complications. Therefore, more intensive cares are required in these patients. We studied the results and effects of percutaneous catheter drainage in these patients. Method: We performed fluoroscopy-guided percutaneous pigtail catheter (8.3 F) drainage by Seldinger technique in 9 cases of lung abscess (in 7 cases, intractable to medical treatment for an average of 8.4 days and in 2 cases, catheter drainage immediately performed due to a large cavity that was initially 10 cm in diameter). We compared 10 cases of lung abscess as control group which had receieved conventional medical treatment alone. Results: Seven of the 9 patients in study group of percutaneous drainage and 7 of the 10 patients in control group of medical treatment alone clinically improved in the average of 1.8 and 8.7 days, respectively. The mean duration of drainage was 13.2 days. There were 3 cases of death from massive hemoptysis, asphyxia of pus, and sepsis in control group, as compared with 2 cases of death from hepatic encephalopathy and sepsis in study group. The malfunctions of catheter occurred in these 2 cases, obstruction and dislodgement. But there were no significant pleuropulmonary complications of percutaneous drainage. Conclusion: Percutaneous drainage is effective and relatively safe in the management of lung abscesses refractory to medical therapy or giant lung abscesses.

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A Case of Rifampicin Induced Pseudomembranous Colitis (Rifampicin에 의한 위막성 대장염 1예)

  • Yun, Jong-Wook;Hwang, Jung-Hye;Ham, Hyoung-Suk;Lee, Han-Chul;Roh, Gil-Hwan;Kang, Soo-Jung;Suh, Gee-Young;Kim, Ho-Joong;Chung, Man-Pyo;Kwon, O-Jung;Rhee, Chong-H.;Son, Hee-Chung
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.6
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    • pp.774-779
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    • 2000
  • Pseudomembranous colitis, although uncommon, is an important complication of antibiotics that is related to a variety of deleterious effects on the gastrointestinal tract. Rifampicin is one of the 1st line agents in the treatment of tuberculosis and a large number of patients are exposed to its potential adverse effects. We report upon a patient that had diarrhea due to pseudomembranous colitis after receiving antitubeculous medication, and which was probably caused by rifampicin. A 77-year-old man was admitted with diarrhea of three weeks duration. One month previously, he suffered from left pleuritic chest pain and left pleural effusion was noticed at chest X-ray. One week prior to the onset of diarrhea, he was started on empirically isoniazid, rifampicin, ethambutol and pyrazynamide as antituberculous medication. On admission, he complained of diarrhea, left pleuritic chest pain, dyspnea and sputum. On physical examination, breathing sound was decreased in the left lower lung field and bowel sound increased. Pleural biopsy revealed chronic granulomatous inflammation, which was compatible with tuberculosis, Sigmoidoscopy showed whitish to yellowish pseudomembrane with intervening normal mucosa, and his stool was positive for C.difficle toxin. He was diagnosed as pseudomembranous colitis and treated with oral metronidazole and vancomycin. The diarrhea did not recur after reinstitution of the anti-tuberculous medication without rifampicin inpatients with severe diarrhea receiving anti-tuberculous medication, rifampicin induced pseudomembranous colitis should be excluded.

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Clinical Characteristics and Prognosis of Acinetobacter Nosocomial Pneumonia between MDR and non-MDR (Acinetobacter 병원내 폐렴에서 다제 내성군과 약제 감수성군 간의 임상적 특징과 예후)

  • Park, In-Il;Kim, Ick-Keun;Koo, Hyun-Cheol;Han, Jae-Pil;Kim, Young-Mook;Lee, Myung-Goo;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.1
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    • pp.13-19
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    • 2006
  • Background: Acinetobacter baumannii has emerged as an important nosocomial pathogen worldwide. The incidence of these infections has recently begun to increase. The mortality rate associated with these infections is high (bacteremia; 52%, pneumonia: 23%~73%) and multidrug resistance has been reported. For the effective control of multidrug-resistant Acinetobacter baumannii(MDR-AB), the impact of these organisms in clinical practice should be determined. This study compared the clinical characteristics, mortality and morbidity of Acinetobacter nosocomial pneumonia between MDR strain and non-MDR strain. Methods: From Jan. 1, 2002 to Nov. 1. 2004, 47 adult patients with Acinetobacter nosocomial pneumonia in Chuncheon Sacred Heart Hospital were recruited and analyzed retrospectively. MDR-AB was defined as showing in vitro resistance to all commercially available antibiotics against A. baumannii. Results: There were 47 patients with Acinetobacter nosocomial pneumonia. MDR-AB and non MDR-AB was the cause of the pneumonia in 17 and 30 patients, respectively. Mean age of the former was $69{\pm}11$ years old and the latter was $70{\pm}13$ years old. The mean APCHE II score, ICU days and mortality were not different between the two groups ($16.1{\pm}5.4$ vs. $14.9{\pm}4.8$, P=0.43, $25.1{\pm}13.6$ vs. $39.1{\pm}31.0$, P=0.2, 58.8% vs. 40%, P=0.21). Conclusion: There are no significant differences in mortality and morbidity between MDR and non-MDR Acinetobacter baumannii. The mortality of the two groups is surprisingly high, therefore proper infection control practices are essential.

Analysis of Epidemiological Characteristics, PFGE Typing and Antibiotic Resistance of Pathogenic Escherichia coli Strains Isolated from Gyeonggi-do (경기도에서 분리한 병원성대장균의 역학적 특성 및 PFGE, 항생제 내성 연구)

  • Kim, Kyung-A;Yong, Kum-Chan;Jeong, Jin-A;Huh, Jeong-Weon;Hur, Eun-Seon;Park, Sung-Hee;Choi, Yun-Sook;Yoon, Mi-Hye;Lee, Jong-Bok
    • Korean Journal of Microbiology
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    • v.50 no.4
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    • pp.285-295
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    • 2014
  • This study was conducted to survey the epidemiological characteristics and the isolated strains for pathogenic E. coli which was the major causative organisms for food poisoning occurred at school food services in the Gyeonggi-do area during the past three years. We investigated 19 accidents of food-borne disease outbreaks by pathogenic E. coli at school food services from 2010 to 2012. Food-borne disease outbreaks by pathogenic E. coli were usually occurred at direct management type (18 accidents, 95%) and high schools. For the seasonal factors, 13 accidents (65%) were occurred in June to September, especially the end of August and September after the summer holidays. The first patients were occurred on Wednesday (7 accidents, 37%) and Thursday (7 accidents, 37%), and they were mainly reported on Thursday (7 accidents, 37%) and Friday (5 accidents, 26%). The exposure of risk was estimated in Monday (4 accidents, 21%), Tuesday (7 accidents, 37%) and Wednesday (4 accidents, 21%), and kimchi (5 accidents, 50%) was estimated as the food of the high risk responsible for the outbreaks. 98 isolates of pathogenic E. coli consisted of PEC (50%), ETEC (34%), EAEC (15%), and EHEC (1%). The antibiotic resistance of pathogenic E. coli showed in the descending order of ampicilline (40%), nalidixic acid (37%), trimethoprim/sulfamethoxazole (24%), and tetracycline (19%). The antibiotics of second and third generation cephalosporins, cabarpenem, aminoglycosides, and second generation quinolones had antimicrobial susceptibilities and cefalotin, ampicillin/sulbactam and chloramphenicol showed medium resistance at 29%, 25%, and 6% respectively, and 70% of isolates were resistant to more than one antibiotic. By the PFGE analysis, they were classified into nine major groups and 31 profiles with 57% pattern similarity. It was very difficult to find the correlation of antimicrobial susceptibilities and genotype in the small scale-food poisoning, but the similarity of antimicrobial resistance and PFGE patterns in the large scale-food poisoning enabled the outbreaks to estimate the same pathotype of E. coli derived from identical origins.

In Vitro Evaluation of Swine-Derived Lactobacillus reuteri: Probiotic Properties and Effects on Intestinal Porcine Epithelial Cells Challenged with Enterotoxigenic Escherichia coli K88

  • Wan, Zhilin;Wang, Li;Chen, Zhuang;Ma, Xianyong;Yang, Xuefen;Zhang, Jian;Jiang, Zongyong
    • Journal of Microbiology and Biotechnology
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    • v.26 no.6
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    • pp.1018-1025
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    • 2016
  • Probiotics are considered as the best effective alternatives to antibiotics. The aim of this study was to characterize the probiotic potential of lactobacilli for use in swine farming by using in vitro evaluation methods. A total of 106 lactic acid bacterial isolates, originating from porcine feces, were first screened for the capacity to survive stresses considered important for putative probiotic strains. Sixteen isolates showed notable acid and bile resistance, antibacterial activity, and adherence to intestinal porcine epithelial cells (IPEC-1). One isolate, LR1, identified as Lactobacillus reuteri, was selected for extensive study of its probiotic and functional properties in IPEC-1 cell models. L. reuteri LR1 exhibited good adhesion to IPEC-1 cells and could inhibit the adhesion of enterotoxigenic Escherichia coli (ETEC) to IPEC-1 cells. L. reuteri LR1 could also modulate transcript and protein expression of cytokines involved in inflammation in IPEC-1 cells; the Lactobacillus strain inhibited the ETEC-induced expression of proinflammatory transcripts (IL-6 and TNF-α) and protein (IL-6), and increased the level of anti-inflammatory cytokine (IL-10). Measurement of the permeation of FD-4 showed that L. reuteri LR1 could maintain barrier integrity in monolayer IPEC-1 cells exposed to ETEC. Immunolocalization experiments showed L. reuteri LR1 could also prevent ETEC-induced tight junction ZO-1 disruption. Together, these results indicate that L. reuteri LR1 exhibits desirable probiotic properties and could be a potential probiotic for use in swine production.