• 제목/요약/키워드: Multidrug resistant bacteria

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충청지역의 임상검체로부터 분리된 대장균에 Aminoglycoside-Modifying Enzymes 확산 (Spreading of Aminoglycoside-Modifying Enzymes among Escherichia coli Isolated from Clinical Specimens in Chungcheong Province)

  • 성지연;권필승
    • 대한임상검사과학회지
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    • 제52권2호
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    • pp.136-142
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    • 2020
  • 세균의 항균제 내성율은 지난 몇십년 동안 지속적으로 상승하였으며 mobile genetic elements를 통한 항균제내성인자들의 전파는 다제내성세균의 출현 및 확산을 가중시켰다. 본연구에서는 임상검체에서 분리된 aminoglycoside에 비감수성 대장균 33주를 대상으로 mobile genetic elements를 통해 전파될 수 있는 aminoglycoside 내성인자를 조사하였다. 16S ribosomal RNA methyltransferases (RMTases)와 aminoglycoside-modifying enzyme (AME)유전자가 PCR과 DNA 염기서열분석을 통해 검출되었다. 그 결과 aac(3')-II 유전자(54.5%)를 포함하고 있는 균주가 제일 많았으며 그 다음으로 aph(3')-Ia 유전자(18.2%)가 많았고 aac(6')-Ib 유전자(15.2%)를 포함하는 균주도 있었다. RMTase 유전자는 본 연구에서는 검출되지 않았다. aac(3')-II 유전자를 포함하고 있는 18균주 중 17균주가 gentamicin에 내성을 보였으며 이중 16균주는 tobramycin에도 내성을 보였다. aac(6')-Ib 유전자를 포함하고 있는 5균주는 모두 tobramycin에 내성을 보였다. 본 연구에서 AME 유전자를 획득하는 것은 사람에서 분리된 대장균이 aminoglycoside에 내성을 나타내는 중요한 기전 중 하나임이 확인되었다. 사람으로부터 분리된 세균을 대상으로 지속적으로 항균제 내성인자를 조사하는 것은 내성세균의 확산을 막는데 필요할 것으로 사료된다.

단일 3차 의료기관에 내원한 당뇨병성 족부병변 환자의 창상 배양검사를 통한 세균 검출 현황 (The Current Status of Bacterial Identification by Wound Culture for Diabetic Foot Lesions in a Single Tertiary Hospital in South Korea)

  • 정성윤;이명진;이승엽;이상윤
    • 대한족부족관절학회지
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    • 제25권2호
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    • pp.100-107
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    • 2021
  • Purpose: The present study aimed to develop guidelines regarding initial choice of antibiotics for diabetic foot ulcers (DFU) by investigating bacterial isolates. Materials and Methods: This study included 223 DFU patients that visited a single tertiary hospital and underwent bacterial culture between January 2016 and February 2020. The study was conducted in two parts: 1) to compare bacterial isolates and wound healing according to comorbidities such as chronic kidney disease (CKD) and peripheral artery disease (PAD), and 2) to compare bacterial isolates according to wound depth using the Wagner classification. Results: Of the 223 patients, 43 had CKD (group A), 56 had PAD (group B), 30 had CKD and PAD (group C), and 94 had none of these comorbidities (group D). The isolation rate for multidrug-resistant gram-negative bacteria (MRGNB) and gram-negative to gram-positive bacteria ratio were highest in group C (p=0.018, p=0.038), and the proportion that achieved wound healing was lowest in group C (p<0.001). In the second part of the study, subjects were classified into 5 grades by wound depth using the Wagner classification; 13 grade I, 62 grade II, 60 grade III, 70 grade IV, and 17 grade V. No significant difference was observed between these grades in terms of isolation rates or gram-negative to gram-positive bacteria ratios. Conclusion: This study suggests antibiotics that cover gram-negative bacteria including MRGNB produces better results in the presence of CKD and PAD and that initial antibiotic choice should be based on the presence of CKD and PAD rather than wound depth.

Antimicrobial Activity of a Bacteriocin Produced by Enterococcus faecalis KT11 against Some Pathogens and Antibiotic-Resistant Bacteria

  • Abanoz, Hilal Seval;Kunduhoglu, Buket
    • 한국축산식품학회지
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    • 제38권5호
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    • pp.1064-1079
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    • 2018
  • In this study, the antimicrobial activity of a bacteriocin produced by Enterococcus faecalis KT11, isolated from traditional Kargı Tulum cheese, was determined, and bacteriocin KT11 was partially characterized. The results showed that bacteriocin KT11 was antagonistically effective against various Gram-positive and Gram-negative test bacteria, including vancomycin- and/or methicillin-resistant bacteria. The activity of bacteriocin KT11 was completely abolished after treatment with proteolytic enzymes (proteinase K, ${\alpha}$-chymotrypsin, protease and trypsin), which demonstrates the proteinaceous nature of this bacteriocin. Additionally, bacteriocin KT11 remained stable at pH values ranging from 2 to 11 and after autoclaving at $121^{\circ}C$ for 30 min. In addition, the activity of bacteriocin KT11 was stable after treatment with several surfactants (EDTA, SDS, Triton X-100, Tween 80 and urea) and organic solvents (chloroform, propanol, methanol, ethyl alcohol, acetone, hexane and ethyl ether). Cell-free supernatant of E. faecalis KT11 was subjected to ammonium sulfate precipitation and then desalted by using a 3.5-kDa cut-off dialysis membrane. The bacteriocin activity was determined to be 711 AU/mL in the dialysate. After tricine-SDS-PAGE analysis, one peptide band, which had a molecular weight of ~3.5 kDa, exhibited antimicrobial activity. Because the bacteriocin KT11, isolated from E. faecalis KT11, exhibits a broad antimicrobial spectrum, heat stability and stability over a wide pH range, this bacteriocin can be used as a potential bio-preservative in foods. Additionally, bacteriocin KT11 alone or in combination with conventional antibiotics may provide a therapeutic option for the treatment of multidrug-resistant clinical pathogens after further in vivo studies.

다제내성 Acinetobacter baumannii의 생장을 억제하는 항생물질을 생산하는 방선균의 분리.동정 및 항균효과 (Isolation and Identification of a Streptomyces sp. that Produces Antibiotics Against Multidrug - Resistant Acinetobacter baumannii)

  • 이기형
    • 한국미생물·생명공학회지
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    • 제39권1호
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    • pp.37-42
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    • 2011
  • 계룡산 지역에서 토양시료를 채취하여 항생제 다제내성균을 효과적으로 제어할 수 있는 항생물질 생산균주를 분리, 탐색하는 과정에서 Streptomyces sp. KH223균주를 선별하였다. 분리균주의 생화학적 특징과 16S ribosomal DNA 유전자 염기서열 분석 결과, 분리균주가 Streptomyces galbus에 속함이 확인되었다. 분리균주의 배양 상등액은 49종의 Acinetobacter baumannii 외 다양한 세균과 진균 등에 항균 활성을 가지고 있었으며 특히 분리균주의 부탄올, 에틸아세테이트 분획물은 10여종의 A. baumannii에 최소생육저해농도 범위 0.8 ${\mu}g$/mL에서 5.0 ${\mu}g$/mL 으로 강한 항균력을 보였으며 기 분리된 cyclo(trp-trp)의 최소생육저해농도 범위 12.5 ${\mu}g$/mL 보다도 강한 항균활성을 나타내었다. 또한 각각의 유기용매 분획물과 cyclo(trp-trp)은 Candida albicans IFO 6258, Bacillus subtilis IAM 1069, Micrococcus luteus JCM 1464, Aspergillus niger ATCC 9642, Streptomyces murinus JCM 4333 등 5종의 세균과 진균에 대해 2.5 ${\mu}g$/mL에서 50 ${\mu}g$/mL 범위의 비교적 강한 항균력을 나타내었다. 본 실험을 통하여 얻은 결과는 분리균주의 유용성과 앞으로 추가적인 정제, 물질동정 실험을 통하여 새로운 항생물질을 탐색하는 기초를 제공할 수 있을 것으로 판단된다.

Subeschar culture using a punch instrument in unstageable wounds

  • Jung, Han Byul;Lee, Yong Jig
    • Archives of Plastic Surgery
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    • 제47권3호
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    • pp.228-234
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    • 2020
  • Background A patient's overall condition sometimes does not allow for the complete removal of a dead eschar or injured slough in cases involving a pressure-injury skin lesion. This frequently occurs in clinical practice, particularly in bedridden and older patients receiving home care or intensive care. Even after debridement, it is also difficult to manage open exudative wounds in these patients. Nevertheless, when a mature or immature eschar is treated without proper debridement, liquefaction necrosis underneath the eschar or slough tends to reveal a large, open wound with infectious exudates. We hypothesized that if the presence of any bacteria under the eschar can be evaluated and the progression of the presumed infection of the subeschar can be halted or delayed without creating an open wound, the final wound can be small, shallow, and uninfected. Methods Using a punch instrument, we performed 34 viable subeschar tissue cultures with a secure junction between the eschar and the normal skin. Results The bacterial study had 29 positive results. Based on these results and the patient's status, appropriate antibiotics could be selected and administered. The use of suitable antibiotics led to relatively shallow and small exposed wounds. Conclusions This procedure could be used to detect potentially pathogenic bacteria hidden under black or yellow eschars. Since subeschar infections are often accompanied by multidrug-resistant bacteria, the early detection of hidden infections and the use of appropriate antibiotics are expected to be helpful to patients.

Antagonistic Potentiality of Actinomycete-Derived Extract with Anti-Biofilm, Antioxidant, and Cytotoxic Capabilities as a Natural Combating Strategy for Multidrug-Resistant ESKAPE Pathogens

  • Mohamed H. El-Sayed;Fahdah A. Alshammari;Mohammed H. Sharaf
    • Journal of Microbiology and Biotechnology
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    • 제33권1호
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    • pp.61-74
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    • 2023
  • The global increase in multidrug-resistant (MDR) bacteria has inspired researchers to develop new strategies to overcome this problem. In this study, 23 morphologically different, soil-isolated actinomycete cultures were screened for their antibacterial ability against MDR isolates of ESKAPE pathogens. Among them, isolate BOGE18 exhibited a broad antibacterial spectrum, so it was selected and identified based on cultural, morphological, physiological, and biochemical characteristics. Chemotaxonomic analysis was also performed together with nucleotide sequencing of the 16S rRNA gene, which showed this strain to have identity with Streptomyces lienomycini. The ethyl acetate extract of the cell-free filtrate (CFF) of strain BOGE18 was evaluated for its antibacterial spectrum, and the minimum inhibitory concentration (MIC) ranged from 62.5 to 250 ㎍/ml. The recorded results from the in vitro anti-biofilm microtiter assay and confocal laser scanning microscopy (CLSM) of sub-MIC concentrations revealed a significant reduction in biofilm formation in a concentration-dependent manner. The extract also displayed significant scavenging activity, reaching 91.61 ± 4.1% and 85.06 ± 3.14% of 2,2-diphenyl-1-picrylhydrazyl (DPPH) and 2,2'-azinobis(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS), respectively. A promising cytotoxic ability against breast (MCF-7) and hepatocellular (HePG2) cancer cell lines was obtained from the extract with IC50 values of 47.15 ± 13.10 and 122.69 ± 9.12 ㎍/ml, respectively. Moreover, based on gas chromatography-mass spectrometry (GC-MS) analysis, nine known compounds were detected in the BOGE18 extract, suggesting their contribution to the multitude of biological activities recorded in this study. Overall, Streptomyces lienomycini BOGE18-derived extract is a good candidate for use in a natural combating strategy to prevent bacterial infection, especially by MDR pathogens.

Cathelicidin-related Antimicrobial Peptide Contributes to Host Immune Responses Against Pulmonary Infection with Acinetobacter baumannii in Mice

  • Min-Jung Kang;Ah-Ra Jang;Ji-Yeon Park;Jae-Hun Ahn;Tae-Sung Lee;Dong-Yeon Kim;Do-Hyeon Jung;Eun-Jung Song;Jung Joo Hong;Jong-Hwan Park
    • IMMUNE NETWORK
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    • 제20권3호
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    • pp.25.1-25.13
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    • 2020
  • Acinetobacter baumannii is known for its multidrug antibiotic resistance. New approaches to treating drug-resistant bacterial infections are urgently required. Cathelicidin-related antimicrobial peptide (CRAMP) is a murine antimicrobial peptide that exerts diverse immune functions, including both direct bacterial cell killing and immunomodulatory effects. In this study, we sought to identify the role of CRAMP in the host immune response to multidrug-resistant Acinetobacter baumannii. Wild-type (WT) and CRAMP knockout mice were infected intranasally with the bacteria. CRAMP-/- mice exhibited increased bacterial colony-forming units (CFUs) in bronchoalveolar lavage (BAL) fluid after A. baumannii infection compared to WT mice. The loss of CRAMP expression resulted in a significant decrease in the recruitment of immune cells, primarily neutrophils. The levels of IL-6 and CXCL1 were lower, whereas the levels of IL-10 were significantly higher in the BAL fluid of CRAMP-/- mice compared to WT mice 1 day after infection. In an in vitro assay using thioglycollate-induced peritoneal neutrophils, the ability of bacterial phagocytosis and killing was impaired in CRAMP-/- neutrophils compared to the WT cells. CRAMP was also essential for the production of cytokines and chemokines in response to A. baumannii in neutrophils. In addition, the A. baumannii-induced inhibitor of κB-α degradation and phosphorylation of p38 MAPK were impaired in CRAMP-/- neutrophils, whereas ERK and JNK phosphorylation was upregulated. Our results indicate that CRAMP plays an important role in the host defense against pulmonary infection with A. baumannii by promoting the antibacterial activity of neutrophils and regulating the innate immune responses.

면역저하 소아에서 발생한 다제내성 녹농균 균혈증을 ceftolozane-tazobactam으로 성공적으로 치료한 증례보고 (Treatment of Multidrug-resistant Pseudomonas aeruginosa Bacteremia in a Immunocompromised Child With Ceftolozane-tazobactam)

  • 유혜선;신아름;김두리;최재영;주희영;조중범;강철인;김예진
    • Pediatric Infection and Vaccine
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    • 제30권1호
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    • pp.47-54
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    • 2023
  • 최근 광범위 항생제 사용의 증가로 인한 다제내성 그람 음성균의 출현이 전 세계적으로 문제가 되고 있다. 특히 다제내성 녹농균(multidrug-resistant Pseudomonas aeruginosa) 감염의 치료는 어려우며 중환자의 사망률을 증가시키는 원인이 된다. 세프톨로잔-타조박탐(ceftolozane-tazobactam, ZerbaxaTM)은 5세대 세팔로스포린과 베타락탐 분해효소저해제로 다제내성 녹농균에 의한 복잡성 요로감염과 복잡성 복강내 감염의 치료에 효과가 있는 것으로 입증되었다. 본지에서 저자들은 소아청소년 혈액암 환자에서 발생한 다제내성 녹농균에 의한 균혈증을 세프톨로잔-타조박탐을 사용하여 성공적으로 치료한 국내 첫 번째 사례를 보고하고자 한다.

CTX-M-15형 Extended Spectrum β-lactamase와 ArmA 동시 생성 Enterobacter cloacae의 출현 (Emergence of CTX-M-15 Extended Spectrum β-lactamase and ArmA-Producing Enterobacter cloacae)

  • 성지연
    • 디지털융복합연구
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    • 제13권12호
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    • pp.313-318
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    • 2015
  • 본 연구에서는 세균의 항균제 내성기전을 연구하기 위해 일개의 대학병원에서 분리된 Enterobacter cloacae를 대상으로 extended spectrum ${\beta}$-lactamase (ESBL) 및 16S rRNA methyltransferase 유전자를 검출하고 항균제 감수성 양상을 조사하였다. 대상균주 중 총 8 균주가 CTX-M-15형 ESBL을 생성하는 것으로 확인되었으며 이 균주들 중 3 균주는 16S rRNA methyltransferase의 한 종류인 armA 유전자도 동시에 가지고 있는 것으로 나타났다. CTX-M-15형 ESBL 유전자와 armA 유전자를 동시에 가지고 있는 E. cloacae는 3세대 cephalosporin 계열 및 aminoglycoside 계열의 항균제 뿐 만 아니라 fluoroquinolone 계열의 항균제에도 내성을 보였다. 더구나 이러한 항균제 내성 유전자들은 플라스미드를 통해 다른 세균으로 전달 될 수 있어 다제내성 세균의 출현 및 확산을 촉진 할 수 있다. 따라서 E. cloacae를 대상으로 지속적인 항균제 내성 유전자를 모니터링 하는 것은 항균제 내성 확산방지를 위해 중요할 것으로 사료된다.

ESKAPE Pathogens in Oral and Maxillofacial Infections

  • Lee, Hye-Jung;Moon, Seong-Yong;Oh, Ji-Su;Choi, Hae-In;Park, Sang-Yeap;Kim, Tae-Eun;You, Jae-Seek
    • Journal of Oral Medicine and Pain
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    • 제47권1호
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    • pp.52-61
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    • 2022
  • Purpose: Most cases of oral and maxillofacial infections are usually easily treated by proper diagnosis, elimination of causative factors, and antibiotic therapy. However, the emergence and the increase of multidrug-resistant bacteria make treatment challenging. "ESKAPE" pathogens are the most common opportunistic organisms in nosocomial infections and have resistant to commonly used antibiotics. There are many medical reviews of ESKAPE pathogens, but few in dentistry. This study focuses on oral and maxillofacial infection especially with ESKAPE pathogens. The purpose of this study is to prepare feasible data about tracing and treatment of infection related to pathogens that may be beneficial to clinicians. Methods: A total of 154 patients with oral and maxillofacial infections were reviewed by analyzing retrospectively hospitalized data in the Department of Oral and Maxillofacial surgery, Chosun University Hospital, Korea, past 5 years from January 2014 to December 2018. Based on the medical records and microbiological tests, the results were divided into two groups: infections with ESKAPE pathogens and other bacteria. Results: A total of 22 species were isolated from 154 patients. The proportion of ESKAPE pathogens among all bacterial isolates collected from infected patients was 39.6%. Causative factors, especially in post-operative infection, showed a statistically significant correlation to ESKAPE infections (29 cases). And average of treatment period in ESKAPE group was longer than non-ESKAPE groups. Overall, Klebsiella pneumoniae (60.7%) was the most frequently isolated ESKAPE pathogen. And high antibiotic resistance rates had been detected in the ESKAPE during the five-year period. Conclusions: Infections with ESKAPE pathogens are now a problem that can no longer be overlooked in Dentistry. Based on results of this study, ESKAPE pathogens were highly associated with post-operative or opportunistic infections. Clinicians should be careful about these antibiotic resistant pathogens and use appropriate antibiotics to patients while having dental treatments.