• Korean Journal of Clinical Laboratory Science
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• v.47 no.3
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• pp.140-146
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• 2015

The increase in resistance by pathogenic bacteria to multiple antimicrobial agents has become a significant treat, as the effective antimicrobial agents available for the patients infected by such resistant bacteria are reduced, or even eliminated. Several natural plant extracts have exhibited antibacterial and synergistic activity against various resistant microorganisms. Houttuynia cordata is frequently used by many traditional medicine practicioners for its antimicrobial, antiviral, and anti-inflammatory properties. This study investigated the antibacterial effects of H. cordata extract against clinical multi-resistant bacteria, and compared the two methods used for the antimicrobial susceptibility testing. Thirty isolates of Methicillin-resistant Staphylococcus aureus (MRSA, 10), Vancomycin-resistant Enterococcus faecium (VRE, 10), Carbapenem-resistant Acinetobacter baumannii (CRAB, 10) were included in this study. The antibacterial effect of H. cordata was tested by disk diffusion and microbroth dilution methods as per CLSI guidelines. In disk diffusion, all isolates (30) showed no inhibition to 30,000 ug/mL of H. cordata. But in the microbroth dilution method, $MIC_{90}$ of H. cordata was 4,096 ug/mL, 8,192 ug/mL and 4,096 ug/mL in MRSA, VRE and CRAB, respectively. These results demonstrate that H. cordata exhibits antibacterial activity against MRSA, VRE and CRAB. Moreover, the microbroth dilution method is a more effective method than disk diffusion to evaluate the antibacterial activity of natural products. The Disk diffusion method used to evaluate the antibacterial activity of natural products required new standard guidelines including inoculum concentration of bacteria.

• Journal of Korean Clinical Nursing Research
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• v.17 no.2
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• pp.150-162
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• 2011

Purpose: Multi-drug resistant (MR) infections among intensive care unit (ICU) patients with oral intubation and a ventilator are serious nosocomial infections. This study was done to compare the effects of oral care and ventilator circuit on reduction of MR infections. Methods: A total of 92 participants were recruited from an ICU at C University Hospital in G-city, Korea, assigned to one of 4 groups and evaluated: group I received oral care with sponge and reusable circuit; group II received oral care with tooth brush and reusable circuit; group III received oral care with sponge and disposable circuit; group IV received oral care with tooth brush and disposable circuit. Results: Prevalence rate of MR infections was highest in group I (47.8%), followed by group II (30.4%), group IV (19.0%), and group III (13.6%). Of the four groups, group III showed a significantly decreased MR infections (p=.035) and higher possibility of survival rate as time passes according to survival analysis (p=.019). Conclusion: Results of this study indicate that using disposable ventilator circuit significantly decreases MR infections and raises the possibility of a higher survival rate as time passes. According to this study, the use of disposable ventilator circuit is useful in prevention of MR infections.

• Journal of Home Health Care Nursing
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• v.27 no.3
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• pp.321-329
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• 2020

Purpose: This study was conducted to assess the factors that affect the confidence of nurses at small and medium-sized hospitals in the control of infections caused by multidrug-resistant organisms and to establish basic data for the interventional strategy to improve the nurses' execution of the control of infection caused by multidrug-resistant organisms. Methods: A total of 154 nurses working at four small and medium-sized hospitals situated in City C were selected as participants of this study. Data were collected using a structured questionnaire and analyzed using the IBM SPSS 21.0 software. Results: Confidence in controlling infections caused by multdrug-resistant organisms had a positive correlation with the level of knowledge of this control and the health beliefs of the nurses. Factors that affect nurses' confidence in controlling infections caused by multidrug-resistant organisms included perceived benefits (β=.431, p<.001) and knowledge (β=.354, p<.001) with an explanatory power of 36.4%. Conclusion: It was found that the nurses have higher confidence in executing their duties with higher perceived benefits of and knowledge about the control of infections caused by multidrug-resistant organisms. As such, it is deemed necessary to establish strategies to elevate the advantages of and knowledge about infection prevention activities at the time of training/education on controlling infections caused by multidrug-resistant organisms.

• KSBB Journal
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• v.26 no.6
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• pp.543-551
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• 2011

Bacterial antibiotic resistance is a real and growing problem for both Gram positive and Gram negative bacterial pathogens in the hospital setting. Among Gram negative bacteria, the ubiquitous bacterium Pseudomonas aeruginosa is a particular concern in immunocompromised and burn patients. The present study evaluated antibacterial activity and efficacy of a Korean herbal medicine against eight multi-drug resistant clinical isolates of P. aeruginosa (0225, 0254, 0347, 0826, 1113, 1378, 1731, and 2492) isolated at Daegu Catholic University Hospital. Methanol extracts of Galla rhois (5 and 10 mg/mL) displayed inhibition diameters for isolate 2492 of 10 and 12 mm, respectively, in a conventional disc diffusion assay. In seven kinds of Korean herbal medicines, increased inhibitory power of Lonicera japonica, Gardenia jasminoides, Galla rhois, and Scultellaria baicalensis was evident with the fermentation of six kinds of lactic acid bacteria. Three lactic acid bacteria (Lactobacillus plantarum subsp. plantarum KCTC 3108, L. casei KCTC 3109, and L. fermentum KCTC 3112) were identified as excellent strains for the production of antibacterial materials. In the six Korean herbal medicine extracts, strong inhibitory activity of fermented Forsythia suspensa, Glycyrrhizae radix, Lycium chinense, Platycodon grum, and Schizandra chinensis with five kinds of lactic acid bacteria was evident for seven multi-drug resistant P. aeruginosa isolates.

• KSBB Journal
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• v.26 no.1
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• pp.19-26
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• 2011

Of the 500 Actinomycetes isolates obtained from soil, one isolate grown on maltose as the sole carbon source produced compound BHK-P19, which inhibited the growth of multiple drug resistant P. aeruginosa 0245. Ultraviolet radiation mutagenesis curtailed production of BHK-P19. Mutation of the BHK-P19 producer using N-methyl-N'-nitro-N-nitroso-guanidine obviated the antibacterial activity to P. aeruginosa 0245, but not towards P. aeruginosa 0225. The mixing of BHK-P19 and BHK-S5 culture extracts inhibited P. aeruginosa 0254, 0225 and 1113. The combined application of BHK-P19 culture extract and Schizandra chinensis Baillon extract inhibited P. aeruginosa 0254, 0225, 0826, 1113, 1378, 1731 and 2492. Use of various concentrations of BHK-P19 culture extract and ampicillin markedly increased antibacterial activity against multi-drug resistant P. aeruginose 1113.

• KSBB Journal
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• v.29 no.3
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• pp.210-219
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• 2014

Sayuksan has been widely applied to treat a variety of diseases such as acute hepatitis, gastritis, and colitis. Sayuksan consists of medicinal herbs such as Glycrrhizae uralensis Fischer, Paeonia lactiflora Pallas, Bupleurum falcatum Linne, and Poncirus trifoliata Rafinesqul. Methanol extracts (1 mg/mL) from the four kinds of medicinal herbs did not show antibiotic activities against general test strains and multi-drug resistant strains. The antibacterial activity of fermented medicinal herbs extracts with Lactobacillus spp. strain was confirmed as Gram-positive bacteria which are higher than Gram-negative bacteria. Extracts of Glycrrhizae uralensis Fischer fermented with Lb. casei KCTC 3109 displayed inhibitory diameters of 16 mm against Pseudomonas aeruginosa P01828. Superoxide dismutase (SOD)-like activity of the medicinal herb extracts was not determined, but the extract of Paeonia lactiflora Pallas fermented with six strains of Lactobacillus spp. had the highest antioxidant activity. SOD-like activity of Paeonia lactiflora Pallas extracts fermented by Lb. brevis KCTC 3498 was $41.4{\pm}0.8%$, which was the highest antioxidant activity among the fermented extracts with the other medicinal herbs.

• Child Health Nursing Research
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• v.22 no.3
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• pp.172-181
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• 2016

Purpose: This study was conducted to examine the effect of education on infection control for multidrug resistant organism (MDRO). Methods: One group pre-post time series design was used. Infection control education for MDRO infection was provided to nurses working in the Neonatal Intensive Care Unit (NICU). Knowledge and recognition were evaluated before and after education. Hand hygiene compliance, MDRO isolation rate and central line-associated bloodstream infection (CLABSI) rate were used as outcome variables. Data from 45 nurses was used for analysis. Results: General knowledge about MDRO increased (p=.011). Responses to questions about image of MDRO and MDRO management tended to change in a positive direction (p=.046). Hand hygiene compliance was 100% at pre-test, 79.5% during education period and 98.4% at post-education period. MDRO isolation rate was 6.83 per 1,000 patient days at pre-test, 10.24 during education period and 6.68 at post-education period. CLABSI rate was 3.76 per 1,000 central line days at pre-test, 6.84 during education period and 4.71 at post-education period. Conclusion: Findings indicate that the education program is effective in improving knowledge about MDRO in NICU nurses. However, more reliable indicators should be used to determine long-term effects.

• Journal of Korean Biological Nursing Science
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• v.21 no.4
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• pp.283-291
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• 2019

Purpose: The aim of this study was to identify awareness and competency for Multi-Drug Resistant Organisms (MDRO) infection control in nursing students with experience of clinical practice. Methods: This cross-sectional descriptive study was conducted from March 2019 to May 2019 by including 231 nursing students in four nursing schools located in Seoul, Gyeonggi-do and Chungcheongnam-do. The data were collected using self-report questionnaires. Results: The awareness and the competency for Carbapenem-Resistant Enterobacteriaceae (CRE) infection control were lower than that of Methicillin-Resistant Staphylococcus aureus (MRSA). The agreement between the awareness and the competency of MDRO infection control in participants was low with regard to isolation, contact precautions, and disinfection for MRSA. Also, it was low with respect to disinfection, isolation, contact precautions, and carrier identification for CRE. The awareness and the competency of MDRO infection control exhibited significant positive correlation. Conclusion: The infection control competency is required to prevent MDRO infection. In order to enhance the infection control competency, it is important to raise awareness about MDRO infection control by providing education based on the guidelines and the principles of infection control.

• Journal of Chest Surgery
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• v.30 no.8
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• pp.786-792
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• 1997

A clinical study of 71 cases of pulmonary tuberculosis that had had surgical resection during the period of 7 years and 6months from January 1989 to June 1996 in National Masan Tuberculosis Hospital. The results were as follows. 1. The ratio of male to female was 3.7:1 and in the age incidence the fourth decade was 22%, the third decade 15%. Although medical treatment was performed for more than 3 to 6 months, preoHeratively the conversion failure rate of positive sputum to negative state was 66.2%(47 cases). Of the failure cases, multiple-drug-resistant(MDR) patients were 41 cases(87.2%), 3. In MDR group, preoperatively conversion failure rate was 71.9%. 4. From the view of indica ion for lung resection on the radiographic finding, cavitary lesions were 43 cases(60.6%), destroyed lung lesions were 24 cases(33.8%). 5. The incidence of postoperative complication was 28.2%(20 cases). All cases were MDR 6. group and the most common of complication was tuberculosis spreading. In bilateral lesion, incidence of postoperative tuberculosis spreading was 25%(7 cases). Of the 7 cases, there was the cavitary lesion in 6 cases(86.7%). Total conversion rate of AFB positive sputum to negative state related to resectional sugery was 76.6% and in MDR group conversion rate of AFB positive sputum to negative state was 73.2% Conversion rate of MDR group with bilateral lesion was the lowest(60%). Conversion rate of drug-sensitivity group was 100% regardeless of lesions Slt to. In conclusion, despite of long-standing medical treatment, it is difficult to converse sputum-positive to negative state in multiple-drug resistance patients and that increases postoperative complications su h as tuberculosis relapse as a lack of appropriate drugs postoperatively. Postoperative conversion rate of sputum-positive to negative state was decreased in multiple-drug resistance patients. Because multiple-drug resistance patients have inireased due to several factors in Korea, it is important to prevent spreading of multiple-drug resistnce patients through the aggressive operative treatment. When the first medical therapy is fail or drug-resistance is found, operative treatment should be considered with the secondary medical therapy. The operation should be aggressively attempted even though at first medical treatment if indicated.

• Tuberculosis and Respiratory Diseases
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• v.54 no.4
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• pp.367-377
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• 2003

Background : It is well known that only 10% of those infected with Mycobacterium tuberculosis actually develop clinical disease, indicating the existence of host genetic factors regulating disease expression. In this study, we investigated HLA-DRB1 and -DQB1 gene polymorphisms in Korean patients with pulmonary tuberculosis (PTB). Methods : HLA-DRB1 and -DQB1 gene polymorphisms were investigated in 67 PTB patients without previous treatment history, 38 drug-sensitive (DS) and 29 multidrug-resistant (MDR) cases, and 200 healthy controls. HLA-DRB1 typing was done using reverse SSO (sequence specific oligonucleotide) and PCR-SSCP (single strand conformational polymorphism) methods and DQB1 typing was done using PCR-RFLP (restriction fragment length polymorphism), PCR-SSCP and PCR-SSP (sequence specific primer) methods. Results : Among the PTB patients, MDR-TB cases showed frequencies of DRB1*0701 and *08032 increased by about two-fold compared to those of normal controls, and likewise for their associated DQB1 alleles, DQB1*0202 and *0601 (15.5% vs. 34.5%, p=0.01). The frequency of HLA-DQB1*0609 was significantly increased in PTB patients (4.0% vs. 14.9%, p=0.004), showing similar increases in both DS and MDR cases. There was also an association of HLA alleles with the clinical severity of the disease according to the extent of lung lesion. Significantly increased frequencies of DRB1*08032 (4.2% vs. 32.6%, p=0.007) and DQB1*0601 (12.5% vs. 34.9%, p=0.047) were observed in more advanced (moderately & far advanced/DS and far advanced/MDR), compared with less advanced (minimal/DS and moderately advanced/MDR) lung lesions. Although DRB1*0701, DQB1*0202 and DQB1*0609 showed significant increases in different subsets of the disease, these HLA alleles did not show consistent association with disease severity. Conclusion : HLA-DRB1*08032 and DQB1*0601 alleles were associated with genetic susceptibility to MDR-TB in Korean patients, and also with disease severity and progression of PTB.