• Journal of Food Hygiene and Safety
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• v.35 no.4
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• pp.391-397
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• 2020

Human infections with livestock-associated methicillin-resistant/-susceptible Staphylococcus aureus (LA-MRSA/LA-MSSA) have recently been increasing significantly. These LA-MRSA and LA-MSSA strains can be transmitted to individuals who have frequent contact with livestock animals and foods of animal origin. In this study, major virulence potentials of S. aureus such as biofilm formation, antimicrobial peptide resistance, and in vitro hydrogen peroxide (H₂O₂) resistance were assessed using 20 MRSA and MSSA strains isolated from raw milk, beef cattle, and workers in the livestock industry. Static biofilm formation assays revealed that there is no difference in levels of biofilm production between MRSA versus MSSA or bovine- versus human-associated strains. In vitro BMAP (bovine myeloid antimicrobial peptide)-28 susceptibility assays also revealed no difference in the resistance to the antimicrobial peptide between MRSA versus MSSA or bovine- versus human-associated S. aureus strains. However, LA-MRSA strains displayed increased resistance to H₂O₂, which may play an important role in survival and dissemination of the pathogen in livestock. These results provide an important basis for understanding pathogenic potentials of LA-MRSA and LA-MSSA strains in human and animal hosts.

• Journal of Environmental Health Sciences
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• v.38 no.3
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• pp.213-222
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• 2012

Objectives: This study was undertaken in order to evaluate by work space zoning and structure the concentrations of biological contaminants in the indoor air of domestic office buildings. Methods: Air samples were collected in the office spaces of 15 office buildings in Seoul from June 28 to July 28, 2011. Prior to the sampling, each office was classified into 'open-plan office', 'cellular office' and 'mixed office' according to the work space zoning. To evaluate the biological contamination of indoor air, total suspended bacteria (TSB), Gram positive bacteria (GPB), Staphylococcus aureus (S.A), Methicillin-resistant Staphylococcus aureus (MRSA), Gram negative bacteria (GNB) and fungi were investigated. During the sampling, temperature, relative humidity and carbon dioxide ($CO_2$) were measured. Results: The TSB concentrations ($GM{\pm}GSD$) were $452({\pm}1.3)cfu/m^3$ in open-plan offices, $366({\pm}1.3)cfu/m^3$ in cellular offices and $287({\pm}1.5)cfu/m^3$ in mixed offices, and there were significant differences between the three groups (p<0.05). The highest concentrations ($GM{\pm}GSD$) of fungi were found in the indoor air of cellular offices $128({\pm}1.0)cfu/m^3$, which was at least three times higher than the concentrations in mixed offices $43({\pm}1.0)cfu/m^3$ (p<0.05). Conclusions: Microbiological contamination in the indoor air of office buildings by work space structure was the highest with the open-plan office layout which includes no high walls or doors separating the occupants.

• Journal of Environmental Health Sciences
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• v.40 no.4
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• pp.304-312
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• 2014

Objectives: This study was performed to examine bioaerosols in indoor air in public restrooms, as well as to assess the effects of air temperature and relative humidity on bioaerosol levels. Methods: A cross-sectional survey was performed in ten male and ten female restrooms. An air sampler (Anderson type) was used for sampling total suspended bacteria (TSB), Gram-negative bacteria (GNB), Gram-positive bacteria (GPB), opportunistic bacteria (OP), Staphylococcus spp., and total suspended fungi (TSF). Results: The levels of TSB were $10-10^2CFU/m^3$ and TSF $10-10^2CFU/m^3$, respectively. The GNB level was $0-10CFU/m^3$, and GPB and OP levels were $10-10^2CFU/m^3$. Staphylococcus aureus and methicillin-resistant S. aureus (MRSA) were detected in 90% of the restrooms. The GPB level was higher in the female restrooms than in the male restrooms (p < 0.05). TSB, GNB, and TSF showed higher levels in restrooms in buildings over 30 years old (p < 0.01). The main effect of air temperature or relative humidity and interaction effect of the two factors on the TSB level were significant (p < 0.05), while the effect of relative humidity on the TSF level was significant (p < 0.001). Conclusions: These results indicate that there is a wide variation in the bioaerosol levels among different restrooms. The observed differences in bioaerosol levels reflect different building histories. The effects of air temperature and/or relative humidity reveal that bioaerosol levels may vary according to season or time of day. Future research is needed to further characterize the relation between the bioaerosol levels and surface contamination in restrooms.

• Tuberculosis and Respiratory Diseases
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• v.52 no.3
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• pp.207-218
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• 2002

Background : Intensive care units (ICUs) are generally considered epicenters of antibiotic resistance and the principal sources of multi-resistant bacteria outbreaks. The antibiotic resistance in newly opened intensive care unit that has no microbial colonization on and around the devices was investigated. Materials and Methods : The authors analyzed the antibiotic resistance patterns for common hospital acquired-pneumonia pathogens in the ICUs(Staphylococcus aureus, Pseudomonas aeruginosa, Acinetobacter spp.) at the newly opened ICU of Hanyang University Medical Center, Kuri Hospital during 6 years(1995-2000). Results : 1) Regarding Staphylococcus aureus, the resistance rate to methicillin was 15% at 1995, 21% at 1996, 20% at 1997, 23% at 1998, 22% at 1999, 55% at 2000. 2) Regarding Pseudomonas aeruginosa, the resistance rate to $3^{rd}$ cephalosporin was 50% at 1995, 50% at 1996, 78% at 1997, 40% at 1998, 77% at 1999, 39% at 2000. Imipenam was 0% at 1995, 27% at 1996, 65% at 1997, 12% at 1998, 16% at 1999, 12% at 2000. Ciprofloxacin was 0% at 1996, 56% at 1997, 36% at 1998, 57% at 1999, 58% at 2000. Tobramycin was 7% at 1995, 10% at 1996, 67% at 1997, 36% at 1998, 65% at 1999, 12% at 2000. Gentamycin was 14% at 1995, 36% at 1996, 67% at 1997, 36% at 1998, 65% at 1999, 12% at 2000. Amikacin was 14% at 1995, 30% at 1996, 61% at 1997, 16% at 1998, 39% at 1999, 18% at 2000. 3) Regarding Acinetobacter spp., the resistance rate to $3^{rd}$ cephalosporin was 92% at 1996, 89% at 1997, 88% at 1998,84% at 1999, 77% at 2000. Imipenem was 50% at 1996, 48% at 1997, 45% at 1998, 49% at 1999, 50% at 2000. Ciprofloxacin was 0% at 1996, 48% at 1997, 33% at 1998, 27% at 1999, 71% at 2000. Tobramycin was 67% at 1995, 100% at 1996, 89% at 1997, 95% at 1998, 87% at 1999, 77% at 2000. Gentamycin was 67% at 1995, 100% at 1996, 89% at 1997, 95% at 1998, 87% at 1999, 83% at 2000. Amikacin was 33% at 1995, 83% at 1996, 82% at 1997, 88% at 1998, 75% at 1999, 69% at 2000. Conclusion : The S.aureus resistance to methicillin, the Pseudomonas aeruginosa resistance to ciprofloxacin, and the Acinetobacter spp. resistance to ciprofloxacin have rapidly increased during 6 years. There is a need to pay speicial attention when using the the antibiotics for the above pathogens. This data may be useful in antibiotic therapy in newly opened intensive care units.

• Journal of Yeungnam Medical Science
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• v.16 no.2
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• pp.347-356
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• 1999

Background: Exit site/tunnel infection causes considerable morbidity and technique failure in CAPD patients. We presently use a unique revision method for the treatment of refractory ESI/TI in CAPD patients and mupirocin prophylaxis for high risk patients. Materials and Methods: We reviewed 139 CAPD patients about the ESI/TI from October 1993 to February 1999 at Yeungnam University Hospital. At the beginning of the ESI. we usually started medications with rifampicin and ciprofloxacin and then changed the antibiotics according to the sensitivity test. If the ESI had persisted and there were TI symptoms (purulent discharge, abscess lesion around exit site). we performed catheter revision(external cuff shaving, disinfection around tunnel and new exit site on opposit direction) with a combination of proper antibiotics. We applied local mupirocin ointment at the exit site three times per week to the 34 patients who had the risk of ESI starting from October 1998. Results: The total follow-up was 2401 patient months(pt. mon). ESI occurred on 105 occasions in 36 out of 139 patients, and peritonitis occurred on 112 occasions in 67 out of 139 patients. The total number of incidences of ESI and peritonitis was 1 per 23.0 pt. mon and 1 per 2l.6 pt.mon. The most common organism responsible for ESI was Staphylococcus aureus (26 of 54 isolated cases, 48%), followed by the Methicillin resistant S. aureus(MRSA) (13 cases, 24%). Seven patients(5: MRSA. 2: Pseudomonas) had to be treated with a revision to control infection. Three patients experienced ESI relapse after revision. One of them improved with antibiotics, while another needed a second revision and the remaining required catheter removal due to persistent MRSA infection with re-insertion at the same time. But, there was no more ESI in these 3 patients who were received management to relapse (The mean duration: 14.0 months). The rates of ESI were significantly reduced after using mupirocin than before(1 per 12.7 vs 34.0 pt.mon, P<0.01). Conclusions: In summary, revision technique can be regarded as an effective method for refractory ESI/TI before catheter removal. Also local mupirocin ointment can play a significant role in the prevention of ESI.

• Pediatric Infection and Vaccine
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• v.19 no.3
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• pp.141-148
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• 2012

Purpose : Ventriculoperitoneal (VP) shunt insertion is an important treatment modality in children with hydrocephalus. VP shunt infection is a major complication and an important factor that determines the surgery outcome. This 15-year study was performed to evaluate the epidemiology of VP shunt infections in pediatric patients treated at our center. Methods : A retrospective review of medical records was performed in patients 18 years old or younger who underwent VP shunt insertion surgery from April 1995 to June 2010. Results : Three hundred twenty-seven VP shunt surgeries were performed in a total of 190 pediatric patients (83 females, 107 males). The median age of the patients was 2.4 years (range, 0.02-17.9 years). Having a malignant brain tumor was the most frequent cause for VP shunt insertion. The shunt infection rate was 6.7% (22/327) per 100 operations and 9.5% (18/190) per 100 patients, and the incidence rate was 0.45 infection cases per 100 shunt operations-year. The most common pathogen was coagulase-negative staphylococcus (n=7) followed by methicillin resistant Staphylococcus aureus (n=1). Ten cases were treated with vancomycin and beta-lactam antibiotic (cephalosporin or carbapenem) combination therapy and 7 cases were treated with vancomycin monotherapy. The median duration of antibiotic treatment was 26 days (range, 7 to 58 days). Surgical intervention was performed in 18 cases (18/22, 81.8%). Conclusion : Epidemiologic information regarding VP shunt infections in pediatric patients is valuable that will help guide proper antibiotic management. Additional studies on the risk factors for developing VP shunt infections are also warranted.

• Clinical and Experimental Pediatrics
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• v.56 no.5
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• pp.224-226
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• 2013

Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is characterized by a severe idiosyncratic reaction including rash and fever, often with associated hepatitis, arthralgias, lymph node enlargement, or hematologic abnormalities. The mortality rate is approximately 10%, primarily owing to liver failure with massive or multiple disseminated focal necrosis. Here, we report a case of a 14-year-old girl treated with vancomycin because of a wound infection by methicillin-resistant Staphylococcus aureus, who presented with non-specific symptoms, which progressed to acute liver failure, displaying the hallmarks of DRESS syndrome. With the presence of aggravated hepatic encephalopathy and azotemia, the patient was refractory to medical treatments, she received a living-donor liver transplantation, and a cure was achieved without any sign of recurrence. Vancomycin can be a cause of DRESS syndrome. A high index of suspicion and rapid diagnosis are necessary not to miss this potentially lethal disease.

• Clinical and Experimental Pediatrics
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• v.49 no.12
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• pp.1287-1295
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• 2006

Purpose : The importance of staphylococcal infections in NICU has been emphasized in terms of increased resistant strains and increased incidence of morbidity and mortality. In this study, we inrestignted the clinical characteristics and risk factors for staphylococcal infections, and looked into sensitivity trends of antibiotics in the era of a high rate of methicillin-resistant staphylococcus aureus (MRSA) in our society. Methods : This study included 240 neonates with positive blood, urine and other sites cultures for staphylococci who were admitted to NICU of Hanil General Hospital and Kyunghee University Hospital from January 2000 to December 2004. The analyses included clinical characteristics of staphylococcal infections and the relationship of incidence rate among various factors, including invasive procedures. Results : For 5 years, 3,593 patients were hospitalized in the NICU and 7,481 specimens were cultured from blood, urine, and other sites. During the study period, staphylococci were isolated from 240 patients, of whom 88 patients had MRSA, 41 patients methcillin sensitive staphylococcus aureus (MSSA), 63 patients S. epidermidis, 48 patients coagulase-negative staphylococcus (CNS) except S. epidermidis infections. The risk factors associated with staphylococcal infections were less than 37 weeks of gestational age, less than 7 on a 5 minutes Apgar score, receiving TPN, applied mechanical ventilation, use of central venous catheters and other tubes. The sensitivity to vancomycin was 100 percent. A relatively high sensitivity against teicoplanin, trimethoprim-sulfamethoxazole, chloramphenicol, clindamycin and low sensitivity against gentamicin and erythromycin were shown. Conclusion : To reduce staphylococcal infections in NICU, we need to monitor and manage premature neonates from the beginning of the birth process and to avoid as many invasive procedures as possible in NICU. Considering MRSA, control of preceding factors and early use of appropriate antibiotics is expected to reduce the morbidity and mortality caused by MRSA infections.

• The Korean Journal of Food And Nutrition
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• v.11 no.3
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• pp.347-353
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• 1998

An antibiotic for methicillin resistant Staphylococcus aureus(MRSA) produced by Streptomyces lydicus YSK-681 was extracted by chloroform, and then purified by the C18 reversed-phase HPLC and silica gel column HPLC. The molecular weight of the purified antibiotic was determined from the FAB analysis MS an m/z 1022.4 and 1036.4(M+H)+, indicating that the isolated antibiotic consisted of two similar compounds with the molecular weight difference of 14 m/z value. With the aid of the various nuclear magnetic resonance(NMR) spectroscopic techniques such as 1H NMR, 13C NMR, DEPT and HMQC spectroscopy, the characteristics of function al groups were deduced as the hydroxyl group and leucine. The MIC values of the purified antibiotic were observed at 1∼32 $\mu\textrm{g}$/$m\ell$ against Gram-positive bacteria compared to > 125 $\mu\textrm{g}$/$m\ell$ against Gram-negative bacteria or fungi. The antibiotic was active at 8 $\mu\textrm{g}$/$m\ell$ of MIC90 and S180 at the concentration of 500 $\mu\textrm{g}$/$m\ell$.

• Journal of Korean Biological Nursing Science
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• v.5 no.2
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• pp.21-30
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• 2003

The effect of hand hygiene was measured by hand culture before and after hand hygiene for 86 nurses, doctors, and nurses aide/housekeepers in Surgical Intensive Care Unit. The subjects were asked to press their dominant hand in hand-shaped Mannitol salt agar immediately after patient contact and then washed their hand by preferred hand hygiene agents [soap and water, waterless alcohol gel, or 4% chlorhexidine gluconate detergent (CHG)], and cultured one hand again Amount of isolated microorganism was calculated by counting the number of divided areas ($1{\times}1cm$) which is culture positive in hand culture plate. The amount of microorganisms were significantly reduced from 58.1(${\pm}38.59$) to 27.4(${\pm}30.4$) cells after hand hygiene. The staff nurse's hand hygiene was more effective compared to medical doctors and nurses aide/housekeepers. Methicillin-resistant Staphylococcus aureus(MRSA) was isolated in 41(47.1%) subjects ; but only removed 100% in 28(32.2%) subjects. When the amount of hand microorganisms was compared by subject's preferred hand hygiene agents, it was decreased in order of 4% CHG, waterless alcohol solution, soap and water, and water. The hand hygiene practice was inadequate to reduce hand microorganisms and significantly different by occupations. Further research and development of hand hygiene improvement program which emphasize the quality of hand hygiene is recommended.