• Korean Journal of Clinical Laboratory Science
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• v.49 no.4
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• pp.401-406
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• 2017

In this study, using the VITEK 2 system, 74 samples (22.6%) out of 327 specimens were identified by the growth of Enterococcosel media (EV6 agar) supplemented with $6{\mu}g/mL$ of vancomycin. Enterococcus faecium was identified as 55 strains (74.3%), Enterococcus casseliflavus as 2 strains (2.7%), Enterococcus avium as 1 strain (1.4%), and Enterococcus gallinarum as 16 strains (21.6%). Among the 55 phenotypes of Enterococcus faecium, 42 (76.4%), 9 (16.4%), and 4 strains (7.3%) showed the vanA, vanB, and vanC phenotype, respectively. The 16 strains of Enterococcus gallinarum and 2 strains of Enterococcus casseliflavus showed the vanC phenotype and the 1 strain of Enterococcus avium had the vanB phenotype. The one strain of Enterococcus faecium propagated only in EV4 and was susceptible to both vancomycin and teicoplanin according to the antimicrobial susceptibility test using the VITEK 2 system. The vancomycin resistance phenotype gene was not detected by PCR. A total of 327 specimens were cultured in Enterococcosel broth supplemented with $6{\mu}g/mL$ of vancomycin (EV6 broth), and 120 strains (36.7%) were isolated. These 120 strains were subjected to vancomycin resistant genotyping by a multiplex real-time polymerase chain reaction and 51 strains (42.5%) showed vanA; 5 strains (4.2%) showed vanA and vanC; and 18 strains (15%) showed vanC. Vancomycin resistance genotypes were not detected in the remaining 46 strains (38.3%).

• Clinical and Experimental Pediatrics
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• v.51 no.2
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• pp.156-161
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• 2008

Purpose : Neutropenic enterocolitis is an acute, life-threatening inflammation of the small and large bowel, often seen in children with malignancies during periods of prolonged or severe neutropenia. The optimal management for typhlitis in pediatric oncology patients has been debateful between operative and nonoperative approaches. The purpose of this study was to review the outcome of medical management of patients who were diagnosed as typhlitis. Methods : The records of 207 pediatric cancer patients who were diagnosed and treated at the pediatric department of Yeungnam University Hospital for cancer between August, 2002 and July, 2007 were reviewed. Results : Among 207 patients, 12 (5.7%) children aged 9 to 14 years, were diagnosed clinically to have typhlitis. Clinical symptoms and signs of patients were fever, abdominal pain and tenderness, diarrhea, vomiting and rebound tenderness. Bowel-wall thickening (> 4mm) was seen on CT or ultrasonography. All patients were treated with antibiotics combinations of teicoplanin, carbapenem, aminoglycoside, or other third generation cephalosporin and metronidazole or clindamycin. Eight patients were treated with additional antifungal agents. Other supportive management included bowel rest, total parenteral nutrition, and G-CSF administration. All patients recovered completely and did not need any surgical management. Conclusion : Early diagnosis and aggressive supportive treatment appears to be important for complete recovery and survival of typhlitis.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.22 no.4
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• pp.420-429
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• 2000

Oral & maxillofacial infections are most commonly odontogenic in origin. Although such infections are usually self-limiting, they may occasionally spread deeply into fascial spaces or planes far from the initial site of involvement. If early diagnosis and appropriate therapy is delayed, complications such as mediastinal extension, retropharyngeal spread and airway obstruction could happen to the patients. For the study of the microbiology, we have retrospectively analysed the oral & maxillofacial infected patients in the Dept. of Oral & Maxillofacial Surgery. In-Ha University Hospital from 1997 September to 2000 April. The results were as follows 1. The male patients were more common than female, with male 61.9% and female 38.1%. 2. Dental originated infections were most common cause with the incidence of 62%. 3. Most common fascial space involved was buccal space 42cases(37.2%) followed by submandibular space 13cases(11.5%), infraorbital space 13cases(11.5%), masseteric space 11cases(9.7%), periapical abscess 11cases(9.7%). 4. The causative organisms isolated from the pus culture were Gram Positive Bacterial species, which were 46cases(31.9%) of Streptococcus viridans, 16cases(8.6%) of ${\alpha}$ and ${\beta}-hemolytic$ streptococcus, 4cases(3.1%) of Strep.-group D non enterococci, 7cases(5.1%) of Staphylococcus Coa. neg., 5cases(3.9%) of Staphylococcus aureus, 3cases(2.3%) of Enterococcus faecalis, 1case(0.8%) of Bacillus species, 1case(0.8%) of Peptostreptococcus, 1case(0.8%) of Clostridium and Gram negative bacterial species, which were 4cases(3.1%) of Acinetobacter baumannii, 2cases(1.6%) of Pseudomonas aeruginosa, 2cases(1.6%) of Burkholderia cepacia, 1case(0.8%) of Neisseria species, 1case(0.8%) of Klebsiella pneumoniae, 1case(0.8%) of Klebsiella oxytoca, 1case(0.8%) of Escherichia coli. 5. In drug sensitivity test, high resistant tendency was found in Penicillin system(Penicillin G 83.3%, Ampicillin 60%) and Aminoglycosides (Gentamycin 50%, Tobramycin 45.5%), but tertiary Cephalosporin system(Cefoperazone 9.1%, Ceftazidime 18.2%), and glycopeptides system (Teicoplanin 0%, Vancomycin 0%) showed lower resistancy.

• Korean Journal of Microbiology
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• v.49 no.1
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• pp.90-94
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• 2013

A new Bacillus strain designated as MP56 producing antimicrobial substance has been isolated from the mud flat of Korea. The strain MP56 was found to exhibit broad spectrum of antimicrobial activity against Gram-positive pathogenic microorganisms and MDR (multi drug resistant) strains. The 16S rRNA sequence revealed that the MP56 was closely related to Bacillus subtilis with 99.93% homology. The optimal medium composition for production of antimicrobial substance in the B. subtilis MP56 were 1% mannitol, 1% oat meal, 0.01% $CaCl_2$. Antimicrobial activity of the culture broth against different pathogenic strains was assessed using the antimicrobial spectrum. The result suggests that Bacillus strain MP56 produces high quality antimicrobial substance that might be very useful to control varieties of pathogenic microbial growth.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.34 no.5
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• pp.562-570
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• 2008

Most purulent maxillofacial infections are of odontogenic origin. Treatment of infection includes the surgical intervention, such as incision and drainage, and adjunctive treatment. The use of high-dose antibiotics is also indicated. The choice of an antibiotics should be based on the knowledge of the usual causative microbes and the results of antibacterial sensitivity test. We have undertaken clinical studies on 119 patients in Dept. of Oral and Maxillofacial Surgery, Inha University Hospital from January 2000 to December 2007. Many anaerobic microbes are killed quickly when exposed to oxygen. Thus the needle aspiration techniques and the transfer under inert gas were used when culturing. The aim of this study was to obtain informations for the bacteriologic features and the effective antimicrobial therapy against maxillofaical odontogenic infections. The obtained results were as follows: 1. The most frequent causes of infections were odontogenic (88.3%), and in odontogenic cause, pulpal infections were the most common causes(53.8%). 2. The buccal and submandibular spaces (respectively 23.5%) were the most frequent involved fascial spaces, followed by masticator spaces (14.3%). 3. The most common underlying medical problems were diabetes (17.6%), however the relation with prognosis was not discovered. 4. The complications were the expiry, mediastinitis, necrotizing fasciitis, orbital abscess, and osteomyelitis. 5. The most common admission periods were 1-2 weeks, and the most patients were discharged within 3 weeks. However, patients who admitted over 5 weeks were about 10%. 6. A total of 99 bacterial strains (1.1 strains per abscess) was isolated from 93 patients (78.2%). The most common bacterium isolated was Streptococcus viridans (46.2%), followed by $\beta$-hemolytic group streptococcus (10.1%). 7. Penicillins (penicillin G 58.3%, oxacillin 80.0%, ampicillin 80.0%) have slightly lower sensitivity. Thus we recommend the antibiotics, such as glycopeptides (teicoplanin 100%, vancomycin 100%) and quinolones (ciprofloxacin 90.0%) which have high susceptibility in cases in which peni cillin therapy failed or severe infections.

• Journal of Korean Foot and Ankle Society
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• v.13 no.2
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• pp.150-155
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• 2009

Purpose: To help the empirical antibiotics selection in diabetic foot infection patients, we investigated prevalence of microorganisms and their antibiotics sensitivity results. Materials and Methods: Patients who came to our clinics to treat diabetic foot infections with deep ulceration and were followed up more than 6 months until complete recovery were adopted. From March 2006 to June 2009, there were 140 patients who corresponded with such a inclusion criteria. Wound cultures were done by deep tissue or bone debris at first visit to our clinics. Microorganisms which was documented by wound culture and most susceptible antibiotics by minimum inhibitory concentrations were surveyed retrospectively. Results: Microorganisms were confirmed in 113 cases (80.7%). In the other 27 cases (19.3%), there were no cultured microorganisms. In bacterial growth group, there were 72 cases (63.7%) of gram-positive bacteria and 41 cases (36.3%) of gram-negative bacteria. All of them were aerobic microorganisms and there were no anaerobic microorganisms. Methicillin-sensitive staphylococcus aureus was the most common pathogen and accounted for 35 cases (31.0%). As other common pathogens, there were Enterobacter cloacae (11 cases, 9.7%), pseudomonas aeruginosa (10 cases, 8.8%), Methicillin-resistant staphylococcus aureus (10 cases, 8.8%) and enterococcus faecalis (6 cases, 5.3%), and so on. Common susceptible antibiotics in gram positive microorganism were vancomycin (60 cases, 83.3%), teicoplanin (60 cases, 83.3%), nitrofurantoin (60 cases, 83.3%) and ciprofloxacin (53 cases, 73.6%). In gram negative ones, common susceptible antibiotics were imipenem (35 cases, 85.3%), piperacillin/tazobactam (33 cases, 80.5%) and gentamicin (31 cases, 75.6%). Conclusion: Methicillin-sensitive Staphylococcus aureus in gram positive and enterobacter cloacae in gram negative was the most common pathogen in each group. Ciprofloxacin and gentamicin might be adaptable as a first-line empirical antibiotics in infected diabetic foot patients.

• Korean Journal of Clinical Laboratory Science
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• v.50 no.2
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• pp.85-92
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• 2018

Information on the prevalence of S. aureus and the current antimicrobial resistance profile is necessary in selecting the appropriate treatment of S. aureus infections in any part of the world. This study examined the frequency and antibiotic resistance list of S. aureus isolates obtained from clinical specimens at one hospital in Korea. A total of 1,746 gram positive cocci collected were identified as S. aureus. S. aureus isolates were obtained from different samples including sputum (N=565; 32.4%), endotracheal aspirate (358; 20.5%), wounds (329; 18.8%), blood (137; 7.8%), urine (67; 3.8%), and pus (59; 3.4%). All 1,545 S. aureus (100%) strains screened from sputum (565; 36.6%), endotracheal aspirate (388; 25.1%), wounds (329; 21.3%), blood (137; 8.9%), urine (67; 4.3%), and pus (59; 3.8%) were sensitive to glycopeptide (vancomycin, teicoplanin), oxazolidinone (linezolid) and stretogramin (quinupristin/dalfopristin). The prevalence of resistant S. aureus was significantly (P<0.01) lower in urine, blood, pus, wounds, and sputum than in endotracheal aspirates. As a result, there was a significant difference in the antibiotic resistance of S. aureus according to the clinical specimens.

• Journal of Food Hygiene and Safety
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• v.32 no.2
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• pp.135-140
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• 2017

The aim of this study was to investigate the distribution of genes that encode multi-drug efflux pumps and virulence factors in Enterococcus faecalis isolated from retail meat and antibiotic resistance patterns of these strains. Of the 277 retail meat samples, 93 Enterococcus faecalis were isolated. The strains exhibited resistance to ampicillin (35.5%), chloramphenicol (6.4%), ciprofloxacin (4.3%), erythromycin (18.3%), levofloxacin (0%), quinupristin-dalfopristin (76.3%), tetracycline (45.2%), teicoplanin (0%) and vancomycin (0%). The strains were positive for MFS type eme(A) (100%), ABC type efr(A) (100%), ABC type efr(B) (98.9%) and ABC type lsa (91.4%) efflux pump gene. The strains were positive for gelE (68.8%), ace (90.3%), asa1 (47.3%), efaA (91.4%) and esp (12.9%) virulence gene. This research will help to assess the hazards associated with the occurrence of drug resistance among enterococci from retail meat. Therefore, it is necessary to monitor enterococcus spp. isolated from retail meat continuously.

• Journal of Environmental Health Sciences
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• v.45 no.3
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• pp.222-230
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• 2019

Objectives: This study aims to evaluate water quality in terms of microorganisms and identify the antibiotic resistance of Enterococci isolated from the recycling water in floor fountains at three parks and one reservoir in the Gwangju area. Methods: Water samples were analyzed for Enterococci using membrane Enterococcus indoxyl ${\beta}$ d glucoside agar (mEI) as described in USEPA Method 1600. The vancomycin-resistant Enterococci with VanA and VanB were identified by PCR. An examination of the antibiotic resistance of isolates against 14 antibiotics was performed by the disk diffusion method. Results: The drinking water quality criterion was exceeded for total colony counts in 68% of all recycling water samples. The average concentration of total califorms and fecal coliforms was 139,325 and 413 CFU/100 mL, respectively. VanA and VanB were not detected from the isolates. We found the antibiotic resistant Enterococci strains to be E. faecalis, E. faecium, E. durans, E. mundtii, E. hirae, and E. thailandicus. The isolates were resistant to Rifampin (50%), Erythromycin (25.8%), Tetracycline (10.2%), Nitrofurantoin (8.1%), Minocycline (3.1%), Erythromycin (1.2%), Penicillin (0.7%), Norfloxacin (0.5%), and Teicoplanin (0.5%) among the 14 antibiotics tested. Antibiotic resistance tests for Enterococci from the recycling water of floor fountains resulted in 30.2% showing resistance to two or more antibiotics. Conclusions: These results showed that the multi-antibiotic resistance of Enterococci, E. coli, and others should be investigated continuously in each environment field.

• Pediatric Infection and Vaccine
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• v.17 no.1
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• pp.36-48
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• 2010

Purpose : In children on anticancer chemotherapy, bloodstream infections (BSIs) are a major cause of morbidity and mortality. We investigated febrile episodes and bloodstream infections in pediatric cancer patients to guide proper selection of empiric antibiotics for febrile pediatric hemato-oncologic patients. Methods : All febrile episodes treated in the division of hematology-oncology, the department of pediatrics, Hanyang University Hospital, between July 2005 and June 2008 were reviewed. Episodes with and without bloodstream infections were compared. Results : Forty cases (18.9%, 25 patients) of BSI occurred in 212 febrile episodes (63 patients). Thirty-seven cases (23.6%, 22 patients) of BSI occurred in 157 febrile episodes with neutropenia (54 patients). Microorganisms identified in BSI corresponded to 23 gram-positive bacteria (51.2%), 20 gram-negative bacteria (44.5%), and 2 fungi (4.4%). Rates of BSI between those who had received umbilical cord blood transplantation and those who had received transplantation from other source were significantly different (55.0% vs. 7.7%, P =0.001). No differences in mortality rate were observed among organisms in BSI patients. For febrile episodes the rate of BSI was higher among those with Chemoport than those with Hickman catheter (P =0.029) and gram-positive pathogens were more likely to be associated with Chemoport (P =0.001). Conclusion : The study showed the rate of BSI, distribution of pathogens with regard to neutropenia, transplantation, central venous catheters, and antimicrobial susceptibility of pathogens in order to help guide in the choice of optimal empiric antibiotics in pediatric febrile neutropenic hemato-oncologic patients.