• Title/Summary/Keyword: piperacillin

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A Case of Ochrobactrum anthropi Infection after Using Medicinal Plants (약초 복용 후 Ochrobactrum anthropi에 감염 1예)

  • Cho, Seang-Sig;Cheun, Jai-Woo;Jeun, Chun-Bae;Park, Sang-Muk;Jang, Sook-Jin;Moon, Dae-Soo;Park, Young-Jin
    • Korean Journal of Clinical Laboratory Science
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    • v.38 no.1
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    • pp.22-25
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    • 2006
  • Ochrobactrum anthropi, previously known as Achromobacter species biotypes 1 and 2 (CDC groups Vd-1, Vd-2), belong to the groups of non-Enterobacteriaceae- nonfermentative Gram negative bacilli. Achromobacter is not presently a recognized genus. Achromobacter xylosoxidans has been transferred to genus Alcaligenes as A. xylosoxidans subsp. xylosoxidans, and "Achromobacter" sp. group Vd has been named Ochrobactrum anthropi. O. anthropi was isolated from a blood culture. Organisms were identified as O. anthropi by use of the biochemical test and the VITEK 2(bioMerieux, USA). The Organism was susceptible only to colistin, imipenem, meropenem, and tetracycline, but were resistant to amikacin, aztreonam, cefepime, ceftazidime, cefpirome, ciprofloxacin, gentamicin, isepamcin, netilmicin, pefloxacin, piperacillin, piperacillin/tazobactam, ticarcillin, ticarcillin/clavulanic acid, tobramycin, and trimethoprim/sulfamethoxazole. We report the clinical and microbiologic characteristics of O. anthropi infection in the patient. This is the first case of O. anthropi infection after using a plant as medicine at Chosun University Hospital.

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Prevalence of antimicrobial resistance and integrons in extended-spectrum β-lactamases producing Escherichia coli isolated from Nakdong and Gumho river (낙동강과 금호강에서 분리된 광범위 베타 락탐 분해효소 생성 Escherichia coli 내 항균제 내성 및 integrons의 분포)

  • Cho, Jae-Keun;Kim, Hwan-Deuk;Kwon, Soon-Hyo;Kim, Jin-Hyun;Jang, Sung-Il;Park, Choi-Kyu;Kim, Ki-Seuk
    • Korean Journal of Veterinary Service
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    • v.37 no.1
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    • pp.19-27
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    • 2014
  • This study was conducted to investigate the antimicrobial resistance, presence of ${\beta}$-lactamase genes and integrons in 83 ESBL-producing Escherichia coli isolated from Nakdong river and Geumho river in Daegu. Among the ${\beta}$-lactam antimicrobials, all isolates were resistant to ampicillin, cephalothin, cefamandole and cefotaxime, followed by piperacillin (98.8%), ampicillin/sulbactam (86.7%), aztreonam (60.2%) and cefepime (59.0%), whereas resistance to piperacillin/tazobacram, ticarcillin/clavulanic acid and cefoxitin was less than 30%. Many of the ESBL-producing Escherichia coli were also resistant to non-${\beta}$-lactams antimicrobials such as nalidixic acid (83.1%), sulfonamides (72.3%), ciprofloxacin (62.7%) and gentamicin (38.6%). All isolates showed resistance to seven or more antimicrobial agents. The most frequently detected gene was $bla_{TEM+CTX-M}$ (49.4%), followed by $bla_{CTX-M}$ (27.7%), $bla_{TEM}$ (6.0%) and $bla_{OXA}$ (1.2%). But $bla_{SHV}$ was not found. Class 1 integrons were found in 61.4% (51 isolates) of isolates, however, class 2 and 3 integrons were not detected. The results showed water from Nakdong river and Geumho river is contaminated with ESBL-producing E. coli isolates. These results suggest the need for further investigation of antibiotic resistant bacteria to prevent public health impacts in the water environment.

Optimal First-Line Antibiotic Treatment for Pediatric Complicated Appendicitis Based on Peritoneal Fluid Culture

  • Aiyoshi, Tsubasa;Masumoto, Kouji;Tanaka, Nao;Sasaki, Takato;Chiba, Fumiko;Ono, Kentaro;Jimbo, Takahiro;Urita, Yasuhisa;Shinkai, Toko;Takayasu, Hajime;Hitomi, Shigemi
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.24 no.6
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    • pp.510-517
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    • 2021
  • Purpose: Consensus is lacking regarding the optimal antibiotic treatment for pediatric complicated appendicitis. This study determined the optimal first-line antibiotic treatment for pediatric patients with complicated appendicitis based on peritoneal fluid cultures. Methods: This retrospective study examined the cases of pediatric patients who underwent appendectomy for complicated appendicitis at our institution between 2013 and 2019. Peritoneal fluid specimens obtained during appendectomy were cultured for the presence of bacteria. Results: Eighty-six pediatric patients were diagnosed with complicated appendicitis. Of them, bacteria were identified in 54 peritoneal fluid samples. The major identified bacteria were Escherichia coli (n=36 [66.7%]), Bacteroides fragilis (n=28 [51.9%]), α-Streptococcus (n=25 [46.3%]), Pseudomonas aeruginosa (n=10 [18.5%]), Enterococcus avium (n=9 [16.7%]), γ-Streptococcus (n=9 [16.7%]), and Klebsiella oxytoca (n=6 [11.1%]). An antibiotic susceptibility analysis showed E. coli was inhibited by sulbactam/ampicillin in 43.8% of cases versus cefmetazole in 100% of cases. Tazobactam/piperacillin and meropenem inhibited the growth of 96.9-100% of the major identified bacteria. E. coli (100% vs. 84.6%) and P. aeruginosa (100% vs. 80.0%) were more susceptible to amikacin than gentamicin. Conclusion: Tazobactam/piperacillin or meropenem is a reasonable first-line antibiotic treatment for pediatric complicated appendicitis. In the case of aminoglycoside use, amikacin is recommended.

Clinical Features of and Antibiotic Resistance in Recurrent Urinary Tract Infection in Children with Vesicoureteral Reflux

  • Eun, So Hyun;Kang, Ji-Man;Kim, Ji Hong;Kim, Sang Woon;Lee, Yong Seung;Han, Sang Won;Ahn, Jong Gyun
    • Pediatric Infection and Vaccine
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    • v.27 no.1
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    • pp.35-44
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    • 2020
  • Purpose: This study aimed to investigate the clinical features of recurrent urinary tract infection (UTI) in children with vesicoureteral reflux (VUR) and to compare the causative uropathogen and antibiotic susceptibility between the first and recurrent UTI episodes. Methods: We retrospectively reviewed the medical records of children with VUR who had recurrent UTI. Group 1 included patients in whom the same pathogen caused the first and recurrent UTI episodes. Group 2 included patients in whom different pathogens caused the first and recurrent UTI episodes. Results: During a 13-year study period (2005-2018), 77 children with VUR experienced at least one episode of UTI. Among these, 47 patients (61.0%) had recurrent UTI. Of the children with recurrent UTI, 19 (40.4%) were in group 1 and 28 (59.6%) were in group 2. Escherichia coli was the most commonly isolated uropathogen (n=37; 39.4%) in both episodes of recurrent UTIs, followed by Klebsiella pneumoniae (n=18; 19.1%), Enterococcus faecalis (n=14; 14.9%), and Enterobacter aerogenes (n=7; 7.4%). Although the difference was not significant, the rate of resistance to the antibiotics ceftazidime, piperacillin/tazobactam, and trimethoprim-sulfamethoxazole increased in patients with the second episode of E. coli recurrence in group 1, and that to cefotaxime, ceftazidime, piperacillin/tazobactam, and meropenem increased in children with the second episode of E. aerogenes recurrence in group 1. Conclusions: When selecting empirical antibiotics for recurrent UTI in children with VUR, it is important to consider that the pathogen and antimicrobial susceptibility of the previous UTI are not always the same in recurrent UTIs.

$\beta$-Lactamase Inhibitory Activity and Comparative Activity of Sulbactam Derivatives Combined with $\beta$-Lactam Antibiotics (Sulbactam 유도체의 베타락타마제 효소억제력과 베타락탐항생제 병용시 활성비교)

  • 임채욱;박희석;김용현;임철부
    • YAKHAK HOEJI
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    • v.46 no.6
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    • pp.387-391
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    • 2002
  • In vitro $\beta$-lactamase inhibitory activity of 6-exomethylene sulbactam compounds (CH-120, 130, 140, 145, 150, 155) was compared with clavulanic acid, sulbactam and tazobactam. The inhibitory activity of CH-140 was stronger than sulbactam and clavulanic acid against Type II, III, IV, TEM enzymes and stronger than tazobactam against Type IV enzyme. The inhibitory activity of CH-145 was stronger than sulbactam and clavulanic acid against Type I, II, III, IV, TEM enzymes and stronger than tazobactam against Type III, IV enzymes. The in vitro antimicrobial activity of CH-140 and CH-145 combined with piperacillin and ceftriaxone was compared with the sulbactam and tazobactam against $\beta$-lactamase producing 31 strains. But, synergistic activity of CH-140 and CH-145 was inferior to tazobactam.

A Trend of Antibiogram of Escherichia Coli Detected by VITEK ESBL Test in Recently Two Years

  • Kim Yuntae
    • Biomedical Science Letters
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    • v.10 no.4
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    • pp.501-506
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    • 2004
  • Extended spectrum β-lactamase (ESBL) generated Enterobacteriaceae including Escherichia coli is responsible for resisting antibiotics, which is clinical problem. This study was performed to investigate the isolation rates of 111 strains having positive of VITEK ESBL test 111 ESBL-strains in each month and season and statistically to determine their patterns of antibiotic test. One hundred eleven ESBL-strains were collected among 1,688 strains of E. coli isolated from various clinical specimen of one general hospital in Busan during 2002 to 2003. Month rates of ESBL-strains were 0% to 13.3%, while the seasonal rates were highest at autumns during two years. The resistance to ampicillin, cefazolin, azteronam, ceftriaxone, and cefepime were 100% in 2002. In ampicillin and cefazolin the resistances were 100% during the two years. There were significant differences of cefoxitin and piperacillin/tazobactam between the two years but not significant between specimens. Four groups were divided according to the pattern of resistance and then the highest group had 93∼100% of the resistance to 8 drugs but not resistant to imipenem.

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Selection of Clinically Isolated Strains for Evaluation of the Newly Synthesized Antibiotics (새로운 $\beta$-lactam계 항생물질 개발을 위한 검정용 균주의 개발)

  • 김대진;최금화;김숙경;최성숙;김병각;강창율;최응칠
    • YAKHAK HOEJI
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    • v.39 no.2
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    • pp.131-136
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    • 1995
  • Clinically isolated bacterial strains resistant to almost of all the clinically superior .betha.-lactam antibiotics can be used to screen the promising ones among the newly synthesized $\beta$-lactam antibiotics. To select the resistant strains, the susceptibility of 389 strains of S. aureus, 144 strains of coagulase negative staphylococci, 509 strains of E. coli, 115 strains of E. cloacae and 187 strains of P. aeruginosa to methicillin, ampicillin, piperacillin and gentamicin was determined. The susceptibility of 19 bacterial strains selected through the first screening to cefixime, cefotiam, cefotaxime, flomoxef, cepfirome, cefdnir, SCE-2787, panipenem and imipenem was determined. Four strains of S. aureus finally selected have high degree of resistance to almost of all $\beta$-lactam antibiotics used and also produce $\beta$-lactamases. These 4 strains of S. aurues can be used to screen effectively the promising $\beta$-lactam antibiotics among the numerous numbers of the newly synthesized $\beta$-lactam antibiotics.

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A Case of Cysteine-Requiring Escherichia coli Isolated from Urine Specimen (소변 검체에서 분리된 Cysteine 요구성 Escherichia coli 1예)

  • Kang, Ji-Sang;Joo, Sae-Ick;Kim, Eui-Chong
    • Korean Journal of Clinical Laboratory Science
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    • v.41 no.2
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    • pp.47-51
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    • 2009
  • A case of recurrent urinary tract infection by cysteine-requiring Escherichia coli in a 5-years-old child with congenital vesicoureteral reflux is described. This bacterium was not grown on MacConkey agar plate for overnight culture, and after 48hrs, tiny colonies were observed. These colonies were not identified by VITEK2 and Walkaway 96i without cysteine supplementation. The isolate was susceptible for cefotetan, ciprofloxacin and imipenem, and resistant for piperacillin/tazobactam, cephalothin, cefotaxime, ceftazidime, amikacin, gentamicin, and tobramycin.

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Antimicrobial Resistance of Bacteria Isolated from Bronchoalveolar lavage (BAL) in Patients with Lung Infiltrations in Burn and Non-Burn Intensive Care Unit (화상 중환자실과 비화상 중환자실 폐 침윤 환자에서 기관지폐포 세척술(BAL)을 통해 획득한 호흡기 검체에서 분리된 균주에 대한 항균제 내성 실태)

  • Kim, Jong-Yeop;Kim, Cheol-Hong;Park, Soo-Hee;Ko, Yoo-Sang;Kim, Mi-Jung;Kang, Hye-Ryun;Hwang, Yong Il;Park, Yong-Bum;Jang, Seung-Hoon;Woo, Heungjeong;Kim, Dong-Kyu;Lee, Myung-Koo;Hyun, In-Gyu;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.6
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    • pp.506-515
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    • 2007
  • Background: Nosocomial pneumonia in an intensive care unit (ICU) is associated with a high mortality rate. Diagnosing a respiratory tract infection in critically ill patients is still difficult but detailed information for the pathogens is needed to establish an adequate antimicrobial treatment. This study examined the causative organisms and their antimicrobial resistance using bronchoalveolar lavage (BAL) from patients suspected of having pneumonia in the ICU. Methods: From January 2004 to June 2006, ICU patients with diffuse lung infiltration were prospectively enrolled. The BAL was used to diagnose the respiratory infection, with 104 > or = organisms considered a positive result. The most common organisms and their antimicrobial resistances were analyzed from the quantitative BAL cultures in the burn ICU and non-burn ICU. Results: A total 72 patients were included, 35 (M 29, F 6) in the burn ICU and 37 (M 26, F 11) in the non-burn ICU. 27 patients (77.1%) in the burn ICU and 22 patients (59.5%) in the non-burn ICU met the criteria for a positive BAL culture. The major pathogens were Staphylococcus aureus, Acinetobacter species and Pseudomonas aeruginosa. All strains (100%) of Staphylococcus aureus isolated from BAL (9 cases) were methicillin-resistant (MRSA) in the burn ICU, but 5 strains (71.4%, 7 cases) were MRSA in the non-burn ICU. Regarding Pseudomonas aeruginosa, the rate of resistance to amikacin, ciprofloxacin, cefepime, imipenem, ceftazidime, piperacillin/tazobactam in the burn and non-burn ICU ranged from 45.5% to 90% and 25% to 50%, respectively. In addition, the rate of resistance of Acinetobacter species to the above drugs in the burn and non-burn ICU ranged from 81.8% to 100% and 62.5% to 100%, respectively. Conclusions: These results are expected to provide useful guidelines for choosing the effective empirical antimicrobial therapy in patients with lung infiltrations in the burn and non-burn ICU.

Characterization of bft Genes among Enterotoxigenic Bacteroides fragilis Isolates from Extraintestinal Specimens at a University Hospital in Korea (국내 한 대학병원의 임상검체에서 분리된 Bacteroides fragilis 독소 유전자의 특성)

  • Kim, Myungsook;Kim, Hyunsoo;Ji, Seung Eun;Rim, John Hoon;Gwon, Sun Yeong;Kim, Wan Hee;Rhee, Ki-Jong;Lee, Kyungwon
    • Korean Journal of Clinical Laboratory Science
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    • v.48 no.2
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    • pp.82-87
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    • 2016
  • Enterotoxigenic Bacteroides fragilis (ETBF) produces enterotoxins known to be a virulence factor. Three isotypes of the B. fragilis toxin (BFT) gene have been identified: bft-1, bft-2, and bft-3. We investigated the presence of bft isotypes in clinical B. fragilis isolates and the antimicrobial resistance of BFT-negative and BFT-positive isolates. Overall, 537 B. fragilis isolates were collected from extraintestinal specimens over 8 years (2006~2013) from a university hospital in Korea. Samples were analyzed by multiplex PCR to identify the bft gene isotypes. Additionally, the antimicrobial susceptibility of 107 B. fragilis isolates (74 BFT-negative and 33 BFT-positive) was examined by the CLSI agar dilution method. PCR revealed a total bft gene detection rate of 30%, while 33% and 29% of blood and other extraintestinal isolates contained the gene, respectively. Among ETBF isolates, the most common isotype was bft-1 gene, followed by bft-2 and bft-3 (bft-1 77%, bft-2 14%, bft-3 9%). Resistance rates (%) for BFT-negative and positive isolates differed in response to various antimicrobial agents, with 3%, 5%, 1% and 38% of BFT-negative isolates and 3%, 6%, 3% an 42% of BFT-positive isolates being resistant to piperacillin-tazobactam, cefoxitin, imipenem, and clindamycin, respectively. Interestingly, neither BFT-negative nor positive isolates showed antimicrobial resistance to chloramphenicol and metronidazole. Overall, the proportion of ETBF from blood was similar to that of other extraintestinal sites and the bft-1 gene was the predominant isotype. Higher antimicrobial resistance rates were found in BFT-positive isolates than BFT-negative isolates, but these differences were not statistically significant.