• Title/Summary/Keyword: 약제내성

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Statistical method for testing synergism among several compounds (여러 약제의 상승효과 검정을 위한 통계적 기법)

  • 김병수;김주항;김경미;최정주
    • The Korean Journal of Applied Statistics
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    • v.6 no.2
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    • pp.383-391
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    • 1993
  • Interaction between anti-cancer agents and various modulators of multidrug resistance in producing their joint effects are of fundamental interest in the chemtherapeutic treatment of cancer. We generate a dose-response curve for each combination of several anti-cancer agents and modulators based on an in-vitro experiment on each of several human cancer cell lines. We employ a log-linear model developed by Wahrendorf et al (1981) and Piegorsch et al (1988) to detect synergism among several compounds. We show two examples of the data analysis and their results. We believe that these results encourage further experiment in-vivo studies.

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Mono-Rifampicin-Resistant Pulmonary Tuberculosis (Rifampicin단독내성 폐결핵)

  • Shim, Tae-Sun;Lee, Ki-Man;Lim, Chae-Man;Lee, Sang-Do;Koh, Youn-Suck;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.5
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    • pp.618-627
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    • 1999
  • Background : Rifampicin (RFP) is a key component of the antituberculous short-course chemotherapy. Usually the RFP resistant M.tuberculosis is also resistant to isoniazid (INH), so the RFP resistance is the marker of multi-drug resistant (MDR) tuberculosis. But unusual cases of mono-RFP-resistant tuberculosis have been recently reported with increasing frequency, especially associated with HIV infection in western countries. Therefore, we conducted a retrospective study to investigate the frequency, causes, and the clinical characteristics of mono-RFP-resistant tuberculosis in Korea. Methods : Of the bacteriologically confirmed and susceptibility-proven 699 pulmonary tuberculosis patients (921 isolates) who visited Asan Medical Center from January 1990 to August 1997, eighteen patients with INH-susceptible and RFP-resistant tuberculosis were evaluated. Previous history of tuberculosis, antituberculous drug compliances, associated systemic illness, drug susceptibility patterns, and clinical outcomes were analysed. And rpoB gene sequencing was done in 6 clinical isolates of M. tuberculosis. Results : The mean age of 18 patients was $43{\pm}14$ years, and the sex ratio is 12:6 (M : F). Sixteen (89%) patients had previous history of tuberculosis. None had diagnosed gastrointestinal disorders, and 2 HIV tests that were performed came out negative. Susceptibility tests were done repeatedly in eleven patients, and six (55%) were mono-RFP resistant repeatedly while five (45%) evolved to MDR tuberculosis. Eight (44%) patients were cured, six (33%) failed, three (17%) were lost to follow-up, and the other one is now on treatment. rpoB gene sequencing showed 5 mutations, codon 531 TCG to TIG mutation in 4 isolates and 526 CAC to TAC in 1 isolate. Conclusion : The clinical characteristics of mono-RFP resistant tuberculosis were similar to that of MDR tuberculosis in Korea where the HIV infection rate is lower than western countries. But some patients with mono-RFP-resistant tuberculous could be cured by primary drug regimens including RFP, suggesting that mono-RFP-resistant tuberculous is a different entity from MDR tuberculosis.

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Antibiotic Resistance Among Salmonella spp. Isolated from Feces of Patients with Acute Diarrhea in Gwangju Area, Korea, during 2000-2009 (2000년-2009년 광주 광역시 지역의 급성설사환자의 분변에서 분리한 살모넬라 균주에서의 항생제 내성률 조사)

  • Kim, Tae Sun;Kim, Min Ji;Kim, Sun Hee;Seo, Jin-Jong;Kee, Hye Young;Chung, Jae Keun;Kim, Eun Sun;Moon, Yong Woon;Ha, Dong Ryong;Kim, Min Kyeong;Lim, Suk Kyung;Nam, Hyang-Mi
    • Korean Journal of Microbiology
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    • v.49 no.2
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    • pp.118-125
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    • 2013
  • Antibiotic susceptibility was examined for 596 Salmonella isolates from patients with acute gastroenteritis during 2000-2009 in Gwangju area in South Korea. Of 16 antibiotics tested, ampicillin resistance (43%) was the most commonly observed resistance among the 596 Salmonella sp. isolates, followed by tetracycline (35.9%), nalidixic acid (31.5%), and chloramphenicol (26.2%). Antibiotic resistance varied among serotypes: The highest resistance of S. Enteritidis and S. Typhimurium was to ampicillin (51.1%) and tetracycline (77.9%), respectively. A total of 89 resistance patterns were observed, and 26% (155/596) of Salmonella isolates were susceptible to all antibiotics tested in this study. About 21% (127/596) and 15% (87/596) of the isolates were resistant to one and two antibiotics, respectively. The rest of Salmonella isolates (227/596, 38%) were resistant to three or more antibiotic agents. The highest multi-drug resistance (MDR) was observed in serotype S. Paratyphi B (76.5%), followed by S. Typhimurium (58.2%), and S. Enteritidis (40.2%). The most common resistance pattern of MDR isolates was ampicillin-chloramphenicol-nalidixic acid-ticarcillin (36/227, 15.8%), most of which (35/36, 97.2%) were S. Enteritidis.

수그러졌던 결핵 다시 살아난다 - (1)당국방심 - 내성간한 변종균 -에이즈 만연 탓

  • 대한결핵협회
    • 보건세계
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    • v.40 no.6 s.442
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    • pp.4-7
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    • 1993
  • 과거 몇십년간 세계적으로 감소추세에 있던 결핵이 보건 당국의 감시소홀과 에이즈의 확산 및 약제내성 결핵균에 힘입어 다시 살아나고 있다. 현재 해마다 800만명의 결핵환자 발병. 사망자 300만명으로 이런 추세로 간다면 2000년에는 370만명에 달하는 사람이 결핵으로 사망할 것으로 WHO는 추정했다. 다시 고개든 결핵균은 인체면역결핍 바이러스양성인 집단 제3세계의 가난한 국가와 서방의 특수고립집단을 새로운 번식처로 자리잡고 있어 그 실태를 알아본다.

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Comparison of PCR-Line Probe and PCR-SSCP Methods for the Detection of Rifampicin Resistant Mycobacterium Tuberculosis (Rifampicin 내성 결핵균의 검출에 있어서 PCR-line Probe법과 PCR-SSCP법의 비교)

  • Kim, Ho-Joong;Suh, Gee-Young;Chung, Man-Pyo;Kim, Jong-Won;Shim, Tae-Sun;Choi, Dong-Chull;Kwon, O-Jung;Rhee, Chong-H;Han, Yong-Chol
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.4
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    • pp.714-722
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    • 1998
  • Background: Rifampicin (RFP) is a key component of the antituberculous short-course chemotherapy and the RFP resistance is a marker of multi-drug resistant (MDR) tuberculosis. RPoB gene encodes the $\beta$-subunit of RNA polymerase of M. tuberculosis which is the target of RFP. And the mutations of rpoB gene have been found in about 96% of rifampicin resistant clinical isolates of M. tuberculosis. So in order to find a rapid and clinically useful diagnostic method in identifying the RFP resistance, we compared the PCR -line probe method with PCR-SSCP for the detection of the rpoB gene mutation in cultured M. tuberculosis. Methods: 45 clinical isolates were collected from patients who visited Sung Kyun Kwan University Hospital. The RFP susceptibility test was referred to the referral laboratory of the Korean Tuberculosis Institute. 33 were rifampicin resistant and 12 were rifampicin susceptible. The susceptibility results were compared with the results of the PCR-BSCP and PCR-line probe method. Results: We could find rpoB mutations in 27/33(81.8%) RFP-resistant strains by PCR-line probe method, and in 23/33 (69.7%) by PCR-SSCP and there was no significant difference between two methods. There was no mutation in rifampicinn susceptible strains by both methods. Conclusion: PCR-line probe method would be a rapid, sensitive and specific method for the detection of rifampicin resistant Mycobacterium tuberculosis.

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Transferable R plasmid of Streptococci Ioslation from Diseased Olive Flounder (Paralichthys olivaceus) in Jeju (제주도 양식넙치병어에서 분리된 연쇄상구균의 약제내성 전이성 plasmid)

  • Kim, Jong-Hun;Lee, Chang-Hoon;Kim, Eun-Heui
    • Journal of fish pathology
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    • v.19 no.3
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    • pp.267-276
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    • 2006
  • Seventy-five streptococci were isolated from diseased olive flounder, Paralichthys olivaceus in Jeju. Their drug susceptibility and transferable multiple drug resistance were characterized. All isolates were resistant to flumequine (AR) and oxolinic acid (OA) and 26 isolates (34.7%) showed 4~6 multiple resistance of ampicillin (ABPC), AR, doxycycline (DOXY), erythromycin (EM), norfloxacin(NOR), OA and oxytetracycline (OTC) in various combinations. pST9 of a transferable R plasmid was detected from a multiple drug resistance strain, Streptococcus sp., ST9 originated from diseased flounder in Jeju, previously. We performed DNA hybridization to know the distribution of plasmid with the same DNA structure as pST9 in streptococci. Thirteen out of 60 isolates analyzed were positive in colony DNA hybridization and the part of bacteria isolated from raw meal was also hybridized with pST9. It suggested that raw meal is one of the origin of the resistance plasmid and R plasmid with DNA structure differing from pST9 is also involving in multiple drug resistance of the streptococci. In conjugation experiment, we found transferable R plasmid carrying OTC, DOXY and/or EM resistance determinant in the 13 resistance strains. all of the streptococci carrying the transferable R plasmid were similar in RAPD patterns. However, pST -type R plasmid was rare in S. iniae most frequently appearing in flounder farm.

Comparison of Clinical Characteristics between Pulmonary Tuberculosis Patients with Extensively Drug-resistance and Multi-drug Resistance at National Medical Center in Korea (국립의료원에 내원한 광역내성 폐결핵 환자와 다제내성 폐결핵 환자의 임상적 특성 비교)

  • Kim, Chong Kyung;Song, Ha Do;Cho, Dong Il;Yoo, Nam Soo
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.6
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    • pp.414-421
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    • 2008
  • Background: Recently, in addition to multi-drug resistant tuberculosis (MDR-TB), extensively drug-resistant tuberculosis (XDR-TB) has become rapidly growing public health threat. This study examined the clinical differences between pulmonary TB patients with extensively drug resistance (XDR) and multi-drug resistance (MDR) at the National Medical Center in Korea in order to determine the clinical characteristics associated more with XDR-TB than MDR-TB. Methods: Patients who received a diagnosis of culture-confirmed pulmonary TB and a drug sensitivity test (DST) for anti-TB drugs at the National Medical Center between January 2000 and August 2007 were enrolled in this study. The patients were identified into the XDR-TB or MDR-TB group according to the DST results. The clinical characteristics were reviewed retrospectively from the medical records. Statistical analysis for the comparisons was performed using a ${\chi}^2$-test, independent samples t-test or binary logistic regression where appropriate. Results: A total 314 patients with culture-confirmed pulmonary TB were included. Among them, 18 patients (5.7%) had XDR-TB and 69 patients (22%) had MDR-TB excluding XDR-TB. A comparison of the clinical characteristics, revealed the XDR-TB group to have a higher frequency of a prior pulmonary resection for the treatment of TB (odds ratio [OR], 3.974; 95% confidence interval [CI], 1.052~15.011; P value 0.032) and longer average previous treatment duration with anti-TB drugs, including a treatment interruption period prior to the diagnosis of XDR, than the MDR-TB group (XDR-TB group, 72.67 months; MDR-TB group, 13.09 months; average treatment duration difference between two groups, 59.582 months; 95% CI, 31.743~87.420; P value, 0.000). In addition, a longer previous treatment duration with anti-TB drugs was significantly associated with XDR-TB (OR, 1.076; 95% CI, 1.038~1.117; P value, 0.000). A comparison of the other clinical characteristics revealed the XDR-TB group to have a higher frequency of male gender, diabetes mellitus (DM), age under 45, treatment interruption history, cavitations on simple chest radiograph and positive result of sputum AFB staining at the time of diagnosis of XDR. However, the association was not statistically significant. Conclusion: Pulmonary TB patients with XDR have a higher frequency of a prior pulmonary resection and longer previous treatment duration with anti-TB drugs than those with MDR. In addition, a longer previous treatment duration with anti-TB drugs is significantly associated with XDR-TB.

Clinical Meaning of INNO-LiPA Test in the Diagnosis of Rifampin Resistant Tuberculosis (Rifampin 내성 결핵의 진단에서 INNO-LiPA 검사법의 임상적 의미)

  • Chang, Yoon Soo;Kim, Young;Lee, Chang Youl;Choi, Jong Rak;Kim, Hyung Jung;Ahn, Chul Min;Kim, Sung Kyu
    • Tuberculosis and Respiratory Diseases
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    • v.55 no.4
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    • pp.344-352
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    • 2003
  • Background : The prevalence of multidrug resistant tuberculosis (MDR-TB), resistant to isoniazid (INH) and rifampin (RFP), was 5.3% worldwide in 1995 and its increment has raised important public health problems. Resistance to RFP, one of the key drugs in the treatment of tuberculosis, results in grim clinical outcome. Recently rapid detection of RFP-resistant mutations in rpoB gene based on PCR method has become available. This study evaluated the prevalence of RFP resistance in first diagnosed, treatment failure, and recurred patients using INNO-LiPA test, and compared the results of INNO-LiPA with those of conventional mycobacterial drug susceptibility test. Methods : Forty-six patients, who were diagnosed of pulmonary tuberculosis and had revealed positive sputum AFB smear, were enrolled in this study from 1998 to 2002. The cases were classified as one three groups; first diagnosed, treatment failure, or recurred. RFP resistance was studied using an INNO-LiPA Rif. TB kit and compared with that obtained from drug susceptibility based on M. tuberculosis culture study. Results : Twenty-one out of 46 patients were enrolled under first diagnosis of pulmonary tuberculosis, 17 under treatment failure with first line drugs, and 8 under recurrence. The positive and negative predictive values of INNO-LiPA test in diagnosis in RFP resistant tuberculosis compared with conventional mycobacterial drug susceptibility test were 85.7% and 76.0%, respectively. INNO-LiPA result revealed rpoB gene mutation in 20 (80.0%) out of 25 patients who were diagnosed as treatment failure or recurrence, but in only 4 (19.0%) out of 21 patients who were first diagnosed as pulmonary tuberculosis. Conclusion : This study showed that RFP resistance could be diagnosed rapidly and accurately using INNO-LiPA test and that this test might be helpful for choosing second line anti-mycobacterial drugs. It might be of great help in clinical diagnosis and decision when used in complimentarily with drug susceptibility test based on M. tuberculosis culture.