• Clinical and Experimental Pediatrics
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• 제54권2호
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• pp.79-85
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• 2011

Purpose: We studied the differences in the antibiotic susceptibilities of the microorganisms that causeing urinary tract infections (UTI) in children to obtain useful information on appropriate drug selection for childhood UTI. Methods: We retrospectively analyzed the antibiotic susceptibilities of 429 microorganisms isolated from 900 patients diagnosed with UTI in the Department of Pediatrics, Chungbuk National University Hospital, from 2003 to 2008. Results: The most common causative microorganisms for UTI were Escherichia coli (81.4%), Klebsiella pneumoniae (8.4%), Enterobacter spp. (1.7%), and Proteus spp. (0.4%). E. coli showed relatively high susceptibility as compared to imipenem (100%), amikacin (97.7%), aztreonam (97.9%), cefepime (97.7%), and ceftriaxone (97.1%), while it showed relatively low susceptibility to gentamicin (GM) (79.0%), trimethoprim/sulfamethoxazole (TMP/SMX) (68.7%), ampicillin/sulbactam (33.0%), and ampicillin (AMP) (28.6%). There were no significant differences in the image findings for causative microorganisms. Conclusion: Gram-negative organisms showed high susceptibility to amikacin and third-generation cephalosporins, and low susceptibility to AMP, GM, and TMP/SMX. Therefore, the use of AMP or TMP/SMX as the first choice in empirical and prophylactic treatment of childhood UTI in Korea should be reconsidered and investigated further.

• Journal of Microbiology and Biotechnology
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• 제16권6호
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• pp.889-895
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• 2006

To investigate the antibiotic-resistant patterns and the gene types of extended-spectrum $\beta$-lactamase (ESBL)-producing Klebsiella pneumoniae, we collected 226 Klebsiella pneumoniae strains from three general hospitals with more than 500 beds in Busan, Korea from September 2004 to October 2005, The minimum inhibitory concentration (MIC) of antibiotics was measured using the Gram-negative susceptibility (GNS) cards of Vitek (Vitek system, Hazelwood Inc., MO, U.S.A.). Of the 226 K, pneumoniae isolates, 65 ESBL-producing K. pneumoniae strains were detected by the Vitek system and confirmed by the double-disk synergy test. TEM (Temoniera) type, SHV (sulfhydryl variable) type, and CTX-M (cefotaxime) type genes were detected by polymerase chain reaction. All 65 K. pneumoniae strains were resistant to ampicillin, cefazolin, cefepime, ceftriaxone, and aztreonam, and 83.0% of the organisms were resistant to ampicillin/sulbactam, 66.1% to tobramycin, 67.6% to piperacillin/tazobactam, 61.5% to ciprofloxacin, and 47.6% to trimethoprim/sulfamethoxazole, and 43.0% to gentamicin. TEM-type ESBLs (TEM-1 type, -52 type) were found in 64.6% (42 of 65) of the isolates, SHV-type ESBLs (SHV-2a type, -12 type, -28 type) in 70.7% (46 of 65) of isolates, and CTX-M-type ESBLS (CTX-M-15 type) in 45% (29 of 65) of isolates. Of the 65 ESBL-producing K. pneumoniae strains, two strains were found to harbor blaSHV-28, which were detected in Korea for the first time. Therefore, more investigation and research on SHV-28 are needed in order to prevent the ESBL type-producing K. pneumoniae from spreading resistance to oxyimino cephalosporin antibiotics.

• Tuberculosis and Respiratory Diseases
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• 제42권1호
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• pp.105-109
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• 1995

저자들은 53세 여자 환자에서 Salmonella Group B에 의한 농흉 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• Tuberculosis and Respiratory Diseases
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• 제78권3호
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• pp.289-292
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• 2015

Lemierre syndrome (LS) is a septic thrombophlebitis of the internal jugular vein (IJV) following an oropharyngeal infection. LS is commonly caused by normal anaerobic flora and treated with appropriate antibiotics and anticoagulation therapy. Although the incidence of disease is very rare, 15% cases of LS are fatal even in the antibiotic era because of disseminated septic thromboemboli. We reported a case of extensive bilateral LS due to methicillin-resistant Staphylococcus epidermidis in a 63-year-old female with lung adenocarcinoma. Initial examination revealed a retropharyngeal abscess; hence, intravenous ceftriaxone and steroid were initiated empirically. However, pulmonary thromboembolism developed and methicillin-resistant S. epidermidis was identified in the bacterial culture. Despite intensive antibiotic and anticoagulation therapies, extensive septic thrombophlebitis involving the bilateral IJV and superior vena cava developed. Adjunctive catheter-directed thrombolysis and superior vena cava stenting were performed and the patient received antibiotic therapy for an additional 4 weeks, resulting in complete recovery.

• 대한의생명과학회지
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• 제12권3호
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• pp.267-274
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• 2006

Klebsiella pneumoniae is the leading cause of nasocomial infection and the most commonly isolated from clinical specimens. $Extended-spectrum-{\beta}-lactamase$ (ESBL) producing K. pneumoniae infection was associated with a significantly longer duration of hospital stay and greater hospital charges. The purpose of this study is to investigate the antibiotic resistant patterns and the DNA fingerprint types of extended-spectrum ${\beta}-lactamase$ (ESBL) producing K. pneumoniae. 223K. pneumoniae strains were collected from three general hospitals with more than 500 beds in Busan, Korea from September 2004 to October 2005. The minimum inhibitory concentration (MIC) of antibiotics was measured using the Gram negative susceptibility (GNS) cards of VITEK (Vitek system, Hazelwood Inc., MO). Random amplified polymorphic DNA method was used to detect DNA fingerprint of the organisms. Of the 226 K. pneumoniae isolates 65 ESBL-producing K. pneumoniae strains were detected by the Vitek system and confirmed by the double-disk synergy test. All the 65K. pneumoniae strains were resistant cefazolin, cefepime, ceftriaxone and aztreonam, and 83.0% of the organisms were resistant to ampicillin/sulbactam, 66.1% to tobramycin, 67.6% to piperacillin/tazobactam, 61.5% to ciprofloxacin, and 47.6% to trimethoprim/sulfamethoxazole and 43.0% to gentamicin. The RAPD patterns were distincted as 10 types by three random 10-mer primers (208, 272, 277). Among ten type patterns, three types (Ic, IIb, IIIe) were remarkably represented at patient of internal department, nerve surgery department, general surgery department, and neonatal room. These results indicate that RAPD can be useful for DNA of strains typing in the epidemiological investigations. Therefore more investigation are needed in order to prevent the ESBL type-producing K. pneumoniae from spreading resistance to oxyimino cephalosphorin antibiotics.

• 대한의생명과학회지
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• 제11권3호
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• pp.389-396
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• 2005

Resent studies have reported increased isolation of extended-spectrum $\beta-lactamase$ (ESBL) producing strains at several hospital in Korea. We studied to investigate the isolation rates of ESBL strains from clinical isolates of Klebsiella pneumoniae and to characterize differences in types using analyses of genotyping and antibiotic susceptibility test. Antibiotic susceptibility test with confirmation of ESBL by double disk synergy test was performed on the 54 ESBL strains of Klebsiella pneumoniae from a hospital in Busan. Transfer of resistant gene in ESBL strains resistant to 3rd generated antibiotics was confirmed by transconjugation test using E. coli $RG176^{nal(r)}$. blaTEM, blaSHV, blaCTX-M genes were detected by PCR. ESBL producing strains had 100% of resistant rate to ampicillin, azteronam, cefazolin, cefepime and ceftriaxone ($\beta-lactam$ antibiotics). Forty strains of bla TEM$(74\%)$, 41 strains of bla SHV $(76\%)$, 23 strains of bla CTX-M $(43\%)$ were found, respectively. The strains had one or more genes. They had high resistant rates to $\beta-lactam$ antibiotics including cephalosporin. The resistant rates of strains with multiple resistant genes were higher than those of strains with single resistant gene.

• Childhood Kidney Diseases
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• 제16권2호
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• pp.146-149
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• 2012

평소 건강했던 아이들에서 육안적 혈뇨는 드물게 나타나며, 수신증과 동반된 경우 또한 드물다. 3세 남아가 육안적 혈뇨와 배뇨통을 주소로 내원하였다. 소변검사에서 농뇨, 혈뇨 보였으나 소변 배양 검사에서 균이 배양되지 않았으며, 혈액검사와 신체 검진상에서는 특이 소견 관찰되지 않았다. 초음파 검사상 양쪽 수신증과 함께 방광 벽이 두꺼워진 소견 보였다. 배뇨 요도 방광 조영술상 방광 요관 역류는 관찰되지 않았으나 방광 벽 비후가 심했으며, 방광 용적이 줄어들고 모양이 찌그러져있었다. 진단 후 ceftriaxone을 2주간 치료하였다. 항생제 치료 일주일 후 혈뇨 소실되어 초음파 검사를 다시 시행하였고 양쪽 수신증의 호전과 방광 용적 및 모양이 정상으로 호전됨을 관찰하였다. 환아의 배뇨통 증상도 호전되어 퇴원하였다. 외래 추적 관찰 중에 역류 검사 재 시행하였으며 정상 소견 보였다. 육안적 혈뇨 및 현미경적 혈뇨는 더 이상 관찰되지 않았다. 본 저자들은 육안적 혈뇨를 보인 소아에서 양측성 수신증을 동반한 방광염 1례를 경험하여 보고하는 바이다.

• 한국미생물·생명공학회지
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• 제48권2호
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• pp.230-235
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• 2020

The global evolution of antibiotic resistance has threatened the efficacy of available treatment options with ravaging impacts observed in developing countries. As a result, investigations into the prevalence of antibiotic resistance and the role of plasmids are crucial. In this study, we investigated the presence and distribution of bla_TEM and gyrA genes, plasmid profiles, and the antimicrobial susceptibility pattern of Salmonella strains isolated from raw meat and stool sources across Niger State, Nigeria. Ninety-eight samples, comprising 72 raw meat and 26 stool samples, were screened for Salmonella spp. The antimicrobial susceptibility of Salmonella isolates to 10 commonly used antimicrobial agents was determined using the KirbyBauer disc diffusion method. Isolates were further analyzed for plasmids, in addition to PCR amplification of beta-lactamase (bla_TEM) and gyrA genes. A total of 31 Salmonella spp. were isolated, with 22 from raw meat (70.97%) and 9 from stool (29.03%). Salmonella spp. with multiple resistance patterns to ceftazidime, cefuroxime, ceftriaxone, erythromycin, ampicillin, cloxacillin, and gentamicin were detected. Ofloxacin and ciprofloxacin were found to be the most effective among the antibiotics tested, with 67.7% and 93.5% susceptible isolates, respectively. Nine (29.03%) isolates harbored plasmids with molecular sizes ranging between 6557 bp and 23137 bp. PCR amplification of gyrA was detected in 1 (3.23%) of the 31 isolates while 28 isolates (90.32%) were positive for bla_TEM. This study shows the incidence of antibiotic resistance in Salmonella isolates and the possible role of plasmids; it also highlights the prevalence of ampicillin resistance in this local population.

• 미생물학회지
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• 제36권3호
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• pp.221-227
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• 2000

본 연구는 등전점과 PCR 생성물을 통하여 광범위 $\beta$-Lactamase(ESBL) 를 생성하는 Klebsiella pneumoniae의 ESBL 유형을 결정하였다. 부산시내 소재 3개 종합병원의 임상검체로부터 20균주의 ESBL 을생성하는 Klebsiella pneumoniae를 분리하였다. 제 3세대 cephalosporin인 cefotaime, cef-tazidime, ceftriaxone으로 double disk synergy test를 시행하여 ESBL 생성균주를 확인하였다. 등전점 및 PCR결과 TEM 형 (pI 5.2~6.0, 1080 bp), TEM+SHV 혼합형(pI 5.2~6.0 및 pI 7.0~7.4 로 1080 bp, 599bp), SHV형 (pI 7.0~ 7.4, 599 bp) , 그리고 PCR결과는 SHV형으로 나타났으나 등전점을 나타내지 않는 것과 등전점 및 PCR 결과 어느 쪽에도 속하지 않는 non TEM non SHV 형 등 5개군으로 나뉘어 졌다.

• Archives of Pharmacal Research
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• 제24권6호
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• pp.590-596
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• 2001

A new extended-spectrum ${\beta}-lactamase$ with an isoelectric point (pl) of 6.2 was detected in Klebsiella pneumoniae Fl 61 that was isolated from a patient with infection. This strain was highly resistant to the third or fourth generation cephalosporins such as cceftazidime ceftriaxone, cefoperzaone, and cefpirome. Analysis of this strain by the double disk diffusion test showed synergies between amoxicillin-clavulanate (AMX-CA) and cefotaxime, and AMX-CA and aztreonam, which suggested that this strain produced a extended-spectrum ${\beta}-lactamase$ (ESBL). Cenetic analysis revealed that the resistance was due to the presence of a 9.4-kb plasmic, designated as pkpl 61, encoding for new ${\beta}-lactamase$ gene (bla). Sequence analysis showed that a new bla gene of pkpl 61 differed from $bla_{TEM-1}$ by three mutations leading to the following amino acid substitutions: $Val_{84}{\rightarrow}lie,{\;}Ala_{184}{\rightarrow}Val,{\;}and{\;}Gly_{238}{\rightarrow}Ser$. These mutations have not been reported previously in the TIM type ${\beta}-lactamases$ produced by clinical strains. The novel ${\beta}-lactamase$ was overexpressed in E. coli and purified by ion exchange chromatography on Q-Sepharose and CM-Sepharose, and then further purified by gel filtration on Sehadex G-200. The catalytic activity of th8 purified ${\beta}-lactamase$ was confirmed by the nitrocefin disk.