• 제목/요약/키워드: drug resistance, multiple

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Tigecycline Treatment for Infections Caused by Multidrug-Resistant Pathogens (다약제내성 균주 감염에 대한 Tigecycline의 치료)

  • Lee, Mi-Jung;Seo, A-Young;Bae, Sang-Soo;Jeong, Dong-Hyong;Yoon, Kyung-Hwa;Hwang, Byung-Sik;Kang, Sung-Hoon;Oh, Dae-Myung;Kwon, Ki-Tae;Lee, Shin-Won;Song, Do-Young
    • Journal of Yeungnam Medical Science
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    • v.28 no.2
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    • pp.133-144
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    • 2011
  • Background: Tigecycline (TIG), a new broad-spectrum glycylcycline with anti-multidrug-resistant-(MDR)-pathogen activity, was launched in March 2009 in South Korea, but there are insufficient clinical studies on its use in the country. As such, this study was performed to analyze cases of severe MDR-pathogen-caused infections treated with TIG. Methods: Patients treated with TIG within the period from May 2009 to June 2010 were enrolled in this study. Their clinical and microbiologic data were reviewed retrospectively. Results: Twenty-one patients were treated with TIG for complicated skin and soft-tissue infections (cSSTIs) (42.9%), complicated intra-abdominal infections (cIAIs) (38.1%), or pneumonia (19.1%) caused by MDR pathogens like carbapenem-resistant $Acinetobacter$ $baumannii$ (76.2%), methicillin-resistant $Staphylococcus$ $aureus$ (61.9%), extended-spectrum beta-lactamase-producing $Escherichia$ $coli$ and $Klebsiella$ $pneumoniae$ (38.1%), and penicillin-resistant $Enterococcus$ species (33.3%). Thirteen patients (61.9%) had successful clinical outcomes while five (23.8%) died within 30 days. The rate of clinical success was highest in cSSTI (77.8%), followed by cIAI (50%) and pneumonia (50%), and the mortality rate was highest in pneumonia (50%), followed by cIAI (25%) and cSSTI (11.1%), Conclusion: Tigecycline therapy can be an option for the treatment of severe MDR-pathogen-caused infections in South Korea, Due to its high risk of failure and mortality, however, prudence is required in its clinical use for the treatment of severe infections like nosocomial pneumonia.

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Epidemiological properties of salmonellosis of poultry farms in Kyongbuk province at recent year (최근 경북지역의 양계농장에서 발생한 salmonellosis의 역학적 특성)

  • 오강희;박노찬;김영환;조민희;이준규;신상희;손재권;정종식
    • Korean Journal of Veterinary Service
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    • v.23 no.1
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    • pp.45-59
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    • 2000
  • The present study was conducted to investigate the epidemiological properties of salmonellosis of poultry farms in Kyongbuk province during the relied from November 1998 to November 1999 And antibiotic susceptibility and biochemical characteristics of 120 Salmonella cultures isolated from chicken samples were also investigated. The results obtained through this study were summarized as follows, 1. Among 667,200 chickens of 31 flocks in 17 layer farms and 9 broiler farms, 61,350 chickens of 31 flocks were died with salmonellosis. The death rate of 25 farms varied from 0.1% to 75.0%, and the average death rate was 9.2%. 2. According to etiological agents, fowl typhoid was shown the most predominant outbreak among the salmonellosis during a year, which accounted for 8R.0%(22/25) of the total case 3. The serotypes of 120 Salmonella isolates were identified as 7 strains(5.8%) of S pullorum, 10 strains(8.4%) of S typhimurium and 103 strains(85.8%) of S gallinarum. 4. Most outbreak of fowl typhoid were prevalent on the layer chicken farms(77.1%), and the summer season(45.5%) also appeared the most hazardous season during the year. 5. It seemed that the Hyline breed(70.6%) was the most susceptible among the layer chicken breeds, and followed by Isabrown(23.5%), Tetra(5.9%) in order. 6. In layers, 76.4% of fowl typhoid occurred commonly from 14 to 40 weeks including the early laying peroid, but in broiler farms, all cases was outbreak within first second weeks. 7 All the strains of S pullorum were resistant to lincomycin(Lm), penicillin(Pm), and steptomycin(Sm), but sensitive to amikacin(Ak), ampicillin(Am), cephalothin(Ce), ciprofloxacin (CiP), chloramphenicol(Cm), colistin(Co), enrofloxacin(Enr), furazolidone(Fu), gentamicin(Gm), kanamycin(Km), neomycin(Nm), polymyxin(Po), and teracycline(Tc). All the strains of S typhimurium were resistant to Lm(100%), Pm(100%), Po(90%), and Sm(90%), but were sensitive to Ak, Am, Ce, CiP, Cm, Co, Enr, Fu, Gm, Km, Nm, and Tc. 8. Minimum inhibitory concentration(MIC) of 103 strains of S gallinarum were also evaluated and their patterns were much more variable than others. All the strains of S gallinarum were sensitive to Ak, Am, Ce, Cip, Cm, Enr, Fu, Km, and Nm, but resistant to Lm(100%), and Sm(100%), 99(96.1%) to Co, 83(80.6%) to Pm, and 83(80.6%) to Po, 55(53.4%) to Gm, and 33(32.0%) to Tc. 9. The multiple drug resistance patterns of 120 Salmonella strains were CoLmPmPo Sm pattern(34.2%), CoGmLmPmPoSmTc(20.8%), CoGmLmPmPoSm(13.3%), CoGmLmSm(7.5%), LmPmSm(7.5%), LmPm(6.7%), CoLmSmTc(3.3%),, CoGmLmSmTc(1.7%), GmLmSmTc(1.7%), CoGmLmPoSm(0.1%), LmPmPo(0.1%), CoLm Sm(0.1%), and LmSm(0.1%), in order.

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The Pathogenic Role of Enterobacteria(Salmonella, Shigella and E. coli spp) Isolated in Korea (한국에서 분리된 장내세균(Salmonella, Shigella, E. coli 균속)의 병원적 역할에 관한 연구)

  • Jung, Tae-Hwoa;Lee, Yun-Tai;Lee, Myung-Won;Lee, Bok-Kwon;Kim, Ki-Sang
    • The Journal of the Korean Society for Microbiology
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    • v.21 no.1
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    • pp.73-95
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    • 1986
  • A total of 5,462 isolates suspicious of Salmonella, Shigella and E. coli which were isolated during 1983 to 1985 by 12 City Hygine Laboratories and General Hospital Laboratories were received and identified at the National Salmonella Center, Seoul, Korea. The result of identification of these strains were summarized as follows: 1. It was confirmed that the total organisms broke down into 2,014 strains of Salmonella 1,294 of which were S. typhi, 887 strains of Shigella and 2,561 strains of E. coli. 2. For seasonal distribution of enteric pathogens, July was the month with the highest out breaks of salmonellosis, May was the month of Shigellosis, and April was of the highest month it in the case of E. coli. 3. Salmonella typhi with the highest incidence of isolation was shown to belong to various phage types, especially with the strains detected in Seoul. M1 type was widely distributed all over the country, but the majority was E1 type in 1983. 4. For age distribution of patients, the 20-29 age group had the highest incidence of salmonellosis whileas the 1 to 9 age group had the highest incidence of Shigellosis. 5. For sexuly distribution of Salmonella and Shigella infections seemed to be relatively higher in the female than in the male. However, E. coli. had no relationship to both sex. 6. The antibiotic sensitivity patterns of S. typhi cultures showed a tendancy to be resistant to colistin, gentamycin, neomycin, tetracycline and streptomycin. 7. The isolates of S. paratyphi-A, S. typhimurium and S. enteritidis seemed to have a tendency of multiple drug resistance. 8. 93.9 percent of 1,568 E. coli strains showed negative reactions to the antisera of enteropathogenic E. coli and 15.6 percent of them produced a heat-labile enterotoxin, but positive reaction to the antisera was 6.1 percent and 11.6 percent of them producled the enterotoxin.

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Cytotoxicity of natural killer cells on canine mammary carcinoma cells (개 유선종양세포에 대한 자연살해세포 독성)

  • Jeong, Da-Un;Byeon, Jeong Su;Gu, Na-Yeon;Jung, Moonhee;Kim, Eun Hee;Kim, Hyung-Seok;Cho, In-Soo;Song, Jae-Young;Hyun, Bang-Hun;Lee, Jienny
    • Korean Journal of Veterinary Research
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    • v.60 no.1
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    • pp.25-32
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    • 2020
  • Natural killer (NK) cells play have a crucial role in the early phase of immune responses against various pathogens. We compared characteristics of canine NK cells against two canine mammary carcinoma cell lines, REM134 and CF41.Mg. REM134 showed higher expression of progesterone receptor, proliferative cell nuclear antigen, Ki67, multiple drug resistance, Bmi-1, c-myc, E-cadherin, and human epidermal growth factor receptor type-2 than that of CF41.Mg. For specific expansion and activation of NK cells, we isolated CD5 negative cells from canine peripheral blood mononuclear cells and co-cultured K562 cells in the presence of interleukin (IL)-2, IL-15, and IL-21 for 21 days. As a result, we found that expression markers of activated NK cells such as NKp30, NKp44, NKp46, NKG2D, CD244, perforin, granzyme B, and tumor necrosis factor alpha were highly upregulated. In addition, we found there was upregulated production of interferon gamma of activated NK cells against target cells such as REM134 and CF41.Mg. Specifically, we observed that cytotoxicity of NK cells against target cells was more sensitively reacted to CF41.Mg than REM134. Based on the results of this study, we recommend the development of an experimental application of CF41Mg, which has not been reported in canine mammary carcinoma research.

Treatment of Multidrug-resistant Pseudomonas aeruginosa Bacteremia in a Immunocompromised Child With Ceftolozane-tazobactam (면역저하 소아에서 발생한 다제내성 녹농균 균혈증을 ceftolozane-tazobactam으로 성공적으로 치료한 증례보고)

  • Hyesun Yu;Areum Shin;Doo Ri Kim;Jaeyoung Choi;Hee Young Ju;Joongbum Cho;Cheol-In Kang;Yae-Jean Kim
    • Pediatric Infection and Vaccine
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    • v.30 no.1
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    • pp.47-54
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    • 2023
  • With the widespread use of broad-spectrum antibiotics in clinical practice, the emergence of multidrug-resistant (MDR) gram-negative bacteria has become a global problem. The MDR Pseudomonas aeruginosa infection is especially difficult to treat and increases mortality in critically ill patients. Ceftolozane-tazobactam (ZerbaxaTM) is a fifth-generation cephalosporin and beta-lactamase inhibitor that has proved to be effective for treating complicated urinary tract infections and complicated intra-abdominal infections caused by MDR P. aeruginosa. Herein, we report the first case of pediatric hematologic cancer in Korea that was successfully treated for MDR P. aeruginosa bacteremia with Ceftolozane-tazobactam.

Clinical Study of Pulmonary Resection for Tuberculosis(V) (폐결핵의 외과적 치료)

  • 김우식;배윤숙;정성철;정승혁;유환국;이정호;김병열
    • Journal of Chest Surgery
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    • v.35 no.11
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    • pp.799-806
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    • 2002
  • In spite of the establishment of chemotherapy and the gradual decrease in prevalence, pulmonary tuberculosis is still mainly treated with an operation. Through analyzing and examining some cases of surgical treatment, we hope to provide some help in treating of pulmonary tuberculosis in the future. Material and Method: By comparing four journals previously published in our department with 144 cases of lung surgery during ten years from January of 1991 to December of 2000 performed by the department of thoracic and cardiovascular surgery of the National Medical Center, we analyzed and reviewed the most recent trends and the results of the surgical treatment. Annual frequency of the operation, distribution of age, examination of sputum, adaptability and types of techniques, complications, and results of the postoperative follow-up were used as methods. Result: It was found that the annual frequency of operations had decreased. The ratio of men to women, 2:1 indicates that there are more incidences in men. Aging of patients could be speculated by the .results that the decrease in the incidence rate in the 20s age range and increase rate in the 50s age range. The range of preoperative lesions belonged mostly to far advanced and moderately advanced tuberculosis. By monitoring the period of use in preoperative antituberculosis drugs, cases for more than 3 years remarkably increased from 16.0 % to 55.6 %. The positive reactive rate for preoperative sputum examinations were drastically decreased from 91 % to 27 %. Total pulmonary destruction and partial destruction were the most common cases in terms of adaptability to the operations and there were significant increases in forming empyema accompanied by parenchymal lesions from 4.0 % to 20.1 %. Pneumonectomy and pulmonary lobectomy were the major type of operations. Especially, there were increases in the incident rate of empyema and recurrence of tuberculosis resulted. Post operative follow-up indicates that the rate of complete recovery was more than 70 % and the rate of gradual increase in treating with persistent antituberculosis drug was from 5.8 % to 18.0 %. Conclusion: In recent cases, there is an increasing number of patients showing tolerance to chemotherapy. Patients with pleural tuberculosis and severe lesions were typically increased. It is important to accurately analyze those complaints accurately that are mostly difficult to be treated medically. Surgical treatment is strongly recommended Before multiple drug resistance occurs.

The Etiologic Agents and Clinical Outcomes of Adult Community-acquired Pneumonia in Jeju (제주지역 성인 지역사회획득 폐렴의 원인균 및 임상양상)

  • Jeon, Bong-Hee;Kim, Miok;Kim, Jeong Hong;Shin, Sang Yop;Lee, Jaechun
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.5
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    • pp.358-364
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    • 2009
  • Background: The appropriate empirical antimicrobial choice in the treatment of community-acquired pneumonia (CAP) should be advocated by community-based information on the etiologic pathogens, their susceptibility to antimicrobials, clinical characteristics and outcomes. Jeju is a geographically isolated and identical region in Korea. However, there is no regional reference on adult CAP available. This study investigated the etiologic agents and clinical outcomes of adult patients diagnosed with CAP in Jeju, Korea, to help guide the empirical antimicrobial choice. Methods: A prospective observational study for one year in a referral hospital in Jeju, Korea. Patients diagnosed with CAP were enrolled with their clinical characteristics. Microbiological evaluations to identify the etiologic agents in the adult patients with CAP were performed with blood culture, expectorated sputum smear and culture, antibody tests for mycoplasma, chlamydophila, and antigen tests for legionella and pneumococcus. The clinical outcomes of the initial empirical treatment were analyzed. Results: Two hundred and three patients with mean age of 64 and 79 females were enrolled. Ten microbials from 90 cases (44.3%) were isolated and multiple isolates were confirmed in 30. Among the microbial isolates, S. pneumoniae (36.3%) was the most common, followed by M. pneumoniae (23.0%), C. pneumoniae (17.0%), S. aureus (9.6%) and P. aeruginosa (5.9%). The initial treatment failure (23.8%) was related to the isolation of polymicrobial pathogens, elevated inflammatory markers, and the presence of pleural effusion. Among the 30 isolates of S. pneumoniae, 16 (53.3%) were not susceptible to penicillin, and 19 isolates (63.3%) to erythromycin and clarithromycin. However, 29 isolates (96.7%) were susceptible to levofloxacin and ceftriaxone. Conclusion: S. pneumoniae, M. pneumoniae, S. aureus, and P. aeruginosa are frequent etiologic agents of adult CAP in Jeju, Korea. The clinical characteristics and antibiotic resistance should be considered when determining the initial empirical antimicrobial choice. Respiratory quinolone or ceftriaxone is recommended as an empirical antimicrobiotic in the treatment of adult CAP in Jeju, Korea.

Plasma Levels of High Molecular Weight Adiponectin are Associated with Cardiometabolic Risks in Patients with Hypertension (고혈압 환자에서 혈장 고분자량 아디포넥틴 농도와 심장-대사위험인자와의 관련성 연구)

  • Chung, Hye-Kyung;Shin, Min-Jeong
    • Journal of Nutrition and Health
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    • v.41 no.8
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    • pp.733-741
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    • 2008
  • In the present study, we comprehensively examined the associations of plasma levels of total adiponectin and high molecular weight (HMW) adiponectin with the features of cardiometabolic risks including body fat distribution, dyslipidemia, insulin resistance and inflammatory markers in a cross-sectional study of 110 treated hypertensive patients. Blood lipid profiles, high sensitivity C-reactive protein (hsCRP) and homeostasis model assessment of insulin resistance (HOMA- IR) derived from fasting glucose and insulin concentrations were determined. Plasma levels of tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$), interleukin-6 (IL-6) and intercellular adhesion molecule-1 (ICAM-1) were analyzed using ELISA. The results showed that plasma levels of HMW-adiponectin were negatively associated with body mass index (BMI, r = - 0.203, p < 0.05) and waist circumference (r = -0.307, p < 0.01), which was not shown in total adiponectin. Plasma levels of HMW-adiponectin were negatively associated with triglyceride (r = -0.223, p < 0.05) and positively associated with HDL-cholesterol (r = 0.228, p < 0.05). Plasma levels of adiponectin were positively associated with HDL-cholesterol (r = 0.224, p < 0.05). Plasma levels of HMW-adiponectin were negatively associated with hsCRP (r = -0.276, p < 0.01) and IL-6 (r = -0.272, p < 0.01). In addition, there were weak associations between plasma levels of HMWadiponectin and TNF-${\alpha}$ (r = -0.163, p = 0.07) and ICAM-1 (r = -0.158, p = 0.09). However, there were no significant associations of total adiponectin with inflammatory markers except hsCRP (r = -0.203, p < 0.05). Stepwise multiple linear regression analysis showed that only plasma levels of HMW-adiponectin was an independent factor influencing serum levels of hsCRP, a marker of systemic low grade inflammation, after adjusting for age, gender, BMI, waist circumference, alcohol intake, smoking status, blood lipids, total adiponectin and drug use (p < 0.01). These results suggest that HMW-adiponectin, rather than total adiponectin, is likely to be closely associated with the features of cardiometabolic risks in treated hypertensive patients and might be effective biomarker for the prediction of cardiovascular disease.

Anti-diabetic effect and mechanism of Korean red ginseng extract in C57BL/KsJ db/db mice

  • Yuan, Hai-Dan;Shin, Eun-Jung;Chung, Sung-Hyun
    • Proceedings of the Ginseng society Conference
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    • 2007.12a
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    • pp.57-58
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    • 2007
  • Purpose: Ginseng is a well-known medical plant used in traditional Oriental medicine. Korean red ginseng (KRG) has been known to have potent biological activities such as radical scavenging, vasodilating, anti-tumor and anti-diabetic activities. However, the mechanism of the beneficial effects of KRG on diabetes is yet to be elucidated. The present study was designed to investigate the anti-diabetic effect and mechanism of KRG extract in C57BL/KsJ db/db mice. Methods: The db/db mice were randomly divided into six groups: diabetic control group (DC), red ginseng extract low dose group (RGL, 100 mg/kg), red ginseng extract high dose group (RGH, 200 mg/kg), metformin group (MET, 300 mg/kg), glipizide group (GPZ, 15 mg/kg) and pioglitazone group (PIO, 30 mg/kg), and treated with drugs once per day for 10 weeks. During the experiment, body weight and blood glucose levels were measured once every week. At the end of treatment, we measured Hemoglobin A1c (HbA1c), blood glucose, insulin, triglyceride (TG), adiponectin, leptin, non-esterified fatty acid (NEFA). Morphological analyses of liver, pancreas and white adipose tissue were done by histological observation through hematoxylin-eosin staining. Pancreatic islet insulin and glucagon levels were detected by double-immunofluorescence staining. To elucidate an action of mechanism of KRG, DNA microarray analyses were performed, and western blot and RT-PCR were conducted for validation. Results: Compared to the DC group mice, body weight gain of PIO treated group mice showed 15.2% increase, but the other group mice did not showed significant differences. Compared to the DC group, fasting blood glucose levels were decreased by 19.8% in RGL, 18.3% in RGH, 67.7% in MET, 52.3% in GPZ, 56.9% in PIO-treated group. With decreased plasma glucose levels, the insulin resistance index of the RGL-treated group was reduced by 27.7% compared to the DC group. Insulin resistance values for positive drugs were all markedly decreased by 80.8%, 41.1% and 68.9%, compared to that of DC group. HbA1c levels in RGL, RGH, MET, GPZ and PIO-treated groups were also decreased by 11.0%, 6.4%, 18.9%, 16.1% and 27.9% compared to that of DC group, and these figure revealed a similar trend shown in plasma glucose levels. Plasma TG and NEFA levels were decreased by 18.8% and 16.8%, respectively, and plasma adiponectin and leptin levels were increased by 20.6% and 12.1%, respectively, in the RGL-treated group compared to those in DC group. Histological analysis of the liver of mice treated with KRG revealed a significantly decreased number of lipid droplets compared to the DC group. The control mice exhibited definitive loss and degeneration of islet, whereas mice treated with KRG preserved islet architecture. Compared to the DC group mice, KRG resulted in significant reduction of adipocytes. From the pancreatic islet double-immunofluorescence staining, we observed KRG has increased insulin production, but decreased glucagon production. KRG treatment resulted in stimulation of AMP-activated protein kinase (AMPK) phosphorylation in the db/db mice liver. To elucidate mechanism of action of KRG extract, microarray analysis was conducted in the liver tissue of mice treated with KRG extract, and results suggest that red ginseng affects on hepatic expression of genes responsible for glycolysis, gluconeogenesis and fatty acid oxidation. In summary, multiple administration of KRG showed the hypoglycemic activity and improved glucose tolerance. In addition, KRG increased glucose utilization and improved insulin sensitivity through inhibition of lipogenesis and activation of fatty acid $\beta$-oxidation in the liver tissue. In view of our present data, we may suggest that KRG could provide a solid basis for the development of new anti-diabetic drug.

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