• 대한임상검사과학회지
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• 제48권4호
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• pp.335-342
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• 2016

일반적으로 지역사회 관련 경로로 감염되기 쉬운 S. aureus는 대부분이 MSSA로 알려져 있었으나 최근 CA-MRSA가 증가하고 있다. 항생제와 glycopeptides의 지속적인 남용은 VISA, VRSA가 더욱 증가할 가능성이 있다. 본 연구는 최근 10년간 일개 대학병원의 상처에서 분리한 황색 포도상 구균의 항생제 감수성 패턴과 항생제 내성의 유병률의 변화를 조사하기 위하여 실시 하였다. 본 연구에서는 남성이 여성보다 항생제 내성이 높게 나타났다. 그리고 연령에 따라 항생제 내성률이 증가하였다. 2006년 항생제 내성률은 penicillin, oxacillin, erythromycin, gentamicin, clindamycin, tetracycline, ciprofloxacin, fusidic acid, trimethoprim/sulfamethoxazole, clindamycin, rifampicin에서 각각 97.7%, 60.5%, 57.4%, 48.8%, 41.1%, 44.2%, 44.2%, 14.7%, 13.2%, 3.9% 나타났으며, 2016년 항생제 내성률은 penicillin, oxacillin, erythromycin, gentamicin, clindamycin, tetracycline, ciprofloxacin, fusidic acid, trimethoprim/sulfamethoxazole, clindamycin, rifampicin에서 각각 95.9%, 62.6%, 55.7%, 28.6%, 50.3%, 34.7%, 38.8%, 34.0%, 2.7%, 8.2%로 나타났다. Vancomycin, linezolid, quinupristin/dalfopristin, teicoplanin 는 항생제 감수성에서 100%를 나타내었다. 특히, fusidic acid는 2006년에 비하여 2016년에 내성이 19.3% 증가하였고, 감수성이 12.4% 감소하였으며, 통계적으로 유의하였다. 따라서, 미생물 및 항생제 변화의 주기적인 검토와 이해를 통해 적절한 항생제 감수성을 지속적으로 연구해야 할 것으로 사료된다.

• 대한미생물학회지
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• 제35권2호
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• pp.171-180
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• 2000

Ninety two strains of Streptococcus pyogenes were isolated from patients with pharyngitis, scarlet fever, skin infection, and invasive streptococcal infections in Seoul, Korea from January to December, 1998. All isolates were epidemiologically characterized by T protein serotype, and serum opacity factor (OF) detection to phenotypes. To analyze the genetic relationship, fifty two isolates including 32 erythromycin-clindamycin (Em-Cm) resistant strains, 20 antimicrobial susceptible strains were attempted to the pulsed-field gel electrophoresis (PFGE). T protein serotype showed 16 kinds in distribution including T12 and T4. Among the total isolates, 40 strains (43.5%) belonged to the T12 serotype and twenty strains (21.7%) to T4 serotype. On the other hand, when infection aspect of S. pyogenes isolates were analysed by T serotype distribution, T12 type was predominant for pharyngitidis which contributed to 21 strains (53%) and for skin infection isolates which contributed to 11 strains (28%), respectively. In case of T4 type, it was the most predominant pharyngitidis isolates which contributed to 8 strains (40%). In T serotype distribution of Em-Cm resistant strains, 27 strains (84%) of the thirty two showed T12 serotype. In minimum inhibitory concentration (MIC) values of Em-Cm resistance isolates, thirty two isolates showed resistant to erythromycin 27 strains (84%), had high MIC of >$128\;{\mu}g/ml$. And also to clindamycin, twenty two strains (69%) had high MIC of >$128\;{\mu}g/ml$. When OF detection of Em-Cm resistance of S. pyogenes isolates were analyzed by T serotype distribution, T12 serotype isolates revealed that all of the isolates except one strain were OF negative. In PFGE profile analysis to Em-Cm resistance isolates, of the twenty seven, Em-Cm resistance of T12 serotype isolates, 26 strains showed identical PFGE profile and all of these isolates revealed that OF negative. Eighty four percent of Em-Cm resistance S. pyogenes isolates had identical phenotype and PFGE profile. These results strongly suggested that the Em-Cm resistant S. pyogenes isolates from Seoul area showed close genetic correlation and PFGE could be available tool for molecular epidemiology.

• 대한약학회:학술대회논문집
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• 대한약학회 2003년도 Proceedings of the Convention of the Pharmaceutical Society of Korea Vol.1
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• pp.127.1-127.1
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• 2003

The purpose of this study is to investigate the prevalence of resistance to macrolide, lincosamide, streptogramin and ketolide antibiotics in Korea. The antibiotic susceptibility test was performed to the macrolide erythromycin, clarithromycin, azithromycin, josamycin, the lincosamide clindamycin, the streptogramin synercid and the ketolide ABT -773 against 337 clinical Staphylococcus aureus(SAU). Coagulase-negative Staphylococci (CNS) and Enterococci isolates exhibited an average percentage of 64％, 56％, and 81 ％ of resistance to erythromycin, respectively.

• 약학회지
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• 제36권5호
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• pp.486-490
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• 1992

The clinical isolate Staphylococcus aureus SA2 was resistant to ampicillin, Chloramphenicol, clindamycin, erythromycin, gentamicin, kanamycin, methicillin, streptomycin, and tobramycin and harboured more than two kinds of plasmids. Transformation experiment demonstrated that 40.98-kb plasmid(pKH2) encoded resistance to ampicillin, clindamycin, erythromycin, kanamycin, and streptomycin. The cleavage map of a pKH2 was determined by restriction enzyme mapping techniques. Cleavage map is given for BamHI, BglI, BstEII, SalI and XhoI.

• 대한임상검사과학회지
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• 제38권1호
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• pp.38-44
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• 2006

A simple and easy modification of AST by disk diffusion was tested for the detection of induced clindamycin resistant Staphylococci and their antimicrobial susceptibility at the same time. The incidence of inducible clindamycin resistant staphylococci in blood culture and their MIC characterization at Seoul National University Hospital was analyzed by an AST contained disk approximation test (D-zone test) and Etest, respectively. Of the total 309 staphylococcal isolates, 139 (45%) isolates presented constitutive resistance to ERY and CLI (ERY-R, CLI-R phenotype), and 59 were ERY-I/R and CLI-S phenotypes. Of the 59 isolates, 19 (32%) isolates were inducible resistant to CLI. The incidence was higher in S. aureus (66.7%) than coagulase-negative staphylococci (CNS, 26.0%). Especially, methicillin-resistant staphylococci (MRSA, 100%; MRCNS, 45.5%) presented higher inducibility than methicillin susceptible (MSSA, 50%; MSCNS, 20%). For most of the inducible clindamycin resistant staphylococci (15 of 19 isolates), their ERY MIC were high (>$128_{\mu}g/mL$) and were methicillin resistant. The remaining 4 isolates were methicillin susceptible and their ERY MIC were of intermediate concentrations ($1-4_{\mu}g/mL$). We concluded that suscetibility testing of staphylococci, especially methicillin resistant, should include the D-zone test.

• 약학회지
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• 제34권2호
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• pp.122-125
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• 1990

Antibiotic resistance patterns were determined for 14 strains of Staphylococcus aureus isolated at a hospital in Pusan during summer in 1989. Resistance to chloramphenicol or clindamycin was recorded in 100% of strains. Resistance to the other compounds tested was as follows: tetracycline 86%, gentamicin 79%, tobramycin 71%, kanamycin 71%, erythromycin 57%, ampicillin 57%, methicillin 50%, streptomycin 29%, cephalothin 29%, and trimethoprim 21%. All strains were sensitive to vancomycin and rifampicin. All strains showed multiple resistance to more than 3 antibiotics.

• 대한임상검사과학회지
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• 제48권3호
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• pp.202-209
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• 2016

본 연구는 methicillin-resistant Staphylococcus aureus(MRSA)로부터, 독소 유전자형과 항생제 내성의 상관 관계를 결정하는 것을 목표로 하였다. 2014년 1월~12월까지 전남 순천의 한 병원 중환자실의 임상검체 2,664건에서 얻어진 MRSA 52균주를 분리하였다. 유전자들이 암호화하고 있는 mecA, 장독소(staphylococcal enterotoxins; sea, seb, sec, seg, seh, sei, sej), 독성 쇼크 증상독소-1 (toxic shock syndrome toxin-1; tst-1), 표피박탈성독소(exfoliative toxin; eta, etb), 백혈구 용해 독소(Panton-Valentine leukocidin; pvl)를 특이적 프라이머를 이용한 multiplex PCR로 증폭 검출 하였다. 독소 유전자 seg와 sei 유전자가 각각 40균주(76.9%)로 가장 많은 보유율을 나타냈으며 다음으로 tst 34균주(65.4%) 순으로 검출 되었으며 eta, etb, sea, sed, see, seh, sej와 pvl 유전자들은 검출 되지 않았다. 2개 이상의 독소 유전자를 동시에 보유한 조합의 MRSA는 40균주(76.9%) 였는데 5개 유전자(seb, sec, seg, sei, tst)를 동시 보유한 조합이 28균주(53.8%)로 가장 많은 분포를 보였으며 다음으로 seg, sei 유전자 동시 보유 조합으로 6균주(11.5%)에서 나타났다. 유전자들 간의 동시 보유율은 72.5~100%로서 특정한 독소 유전자 seb, sec, seg, sei와 tst 유전자간의 상관성이 높게 나타났다. 특정 다수의 독소유전자(seb, sec, seg, sei, tst)를 동시에 보유한 균주들이 개별적 독소 유전자를 보유한 균주(seb, sec, tst)와의 항생제 내성의 상관성은 ciprofloxacin, clindamycin, erythromycin 항생제에 100% 내성을 보임으로서 공통적으로 포함된 seb, sec, tst 유전자와 이 항생제의 내성과는 밀접한 연관이 있음을 알았다.

• 한국미생물·생명공학회지
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• 제49권3호
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• pp.449-457
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• 2021

The aim of the present study was to survey the frequency of inducible and constitutive phenotypes and inducible cross-resistant genes by regulating the methylation of 23S rRNA (ermA, ermB, and ermC) and macrolide efflux-related msrA gene in Staphylococcus aureus and S. epidermidis strains. A total of 172 bacterial isolates (identified based on standard tests), were examined in this study. Antibiotic susceptibility was determined by the disk diffusion method, and all isolates were evaluated with respect to inducible and constitutive phenotypes. The presence of ermA, ermB, ermC, and msrA genes was investigated by a PCR assay. The constitutive resistance phenotypes showed a higher distribution among the isolates. R phenotype was detected more among S. epidermidis isolates (46.25%). ermB, ermC, and msrA genes were detected more in methicillin-resistant S. aureus (MRSA) and methicillin-resistant S. epidermidis (MRSE) isolates that had R and HD phenotypes (>77% strains). The ermA gene had the lowest frequency among MRSA, MRSE, MSSA, and MSSE strains (<14% isolates). Distribution of inducible resistance genes in MRSA and MRSE strains, and possibly other species, leads to increased constitutive resistance to erythromycin, clindamycin, and other similar antibiotics. Therefore, it can be challenging to treat infections caused by these resistant strains.

• Journal of Microbiology
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• 제45권5호
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• pp.447-452
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• 2007

In this study, we compared the phenotypic and genotypic characteristics of 138 MRSA isolates obtained from adult and pediatric patients (adult, 50; children, 88). The resistance rates against gentamicin, clindamycin, and ciprofloxacin were much higher in the adult MRSA isolates than in the pediatric MRSA isolates. The ermC gene, which is responsible for inducible clindamycin resistance, was detected in 52(59.1%) of the 88 pediatric MRSA isolates but in only 5(10.0%) of the 50 adult MRSA isolates. MRSA isolates of clonal type ST5 with an integration of SCCmec type II/II variants was the most predominant clone among the adult isolates, while clonal type ST72 with an integration of SCCmec IV/IVA was the most predominant clone among the pediatric MRSA isolates. Staphylococcal enterotoxin A and toxic shock syndrome toxin-1 were prevalent among the adult MRSA isolates but not among the pediatric MRSA isolates. The results of this study demonstrated remarkable differences between adult and pediatric MRSA isolates in terms of their antimicrobial susceptibility profiles, SCCmec type, multilocus sequence type, staphylococcal toxin genes, and erythromycin resistance genes.

• 대한임상검사과학회지
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• 제36권2호
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• pp.89-97
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• 2004

Many strains of Staphylococcus aureus were isolated from pus samples from primary, secondary, and tertiary medical institutions and were subjected to an antibiotic sensitivity test. Ciprofloxacin, clindamycin, erythromycin, gentamicin, oxacillin penicillin, tetracycline, trimethoprim/sulfamethoxazole, vancomycin and teicoplanin were used for the antibiotic sensitivity test. The strains showed hightest resistance to penicillin(91%), but all of strains tested were susceptible to vancomycin and teicoplanin. The isolated multi-drug(penicillin-tetracycline-ciprofloxacin-clindamycin-erythromycin- oxacillin-gentamicin) resistant S. aureus were analyzed genotypically using an AP-PCR(Arbitrarily Primed polymerase chain reaction) with an arbitrary 3 primers. Based on the result for genotype analysis, the genotypes identified by S1 primer did not coincide with those of S2 or E2 primers. Genotypes identified by S2 primer did not coincide with those of S1 or E2 primers. Also genotypes identified by the E2 primer did not coincide with those of S1 or S2 primers. Therefore, an analysis of AP-PCR test with multiple primers will provide more sensitive identification. A strain from a secondary medical institution and a strain from a tertiary medical institution which showed the same genotype for S1, S2, and E2 primers are required for further epidemiological study.