• 제목/요약/키워드: Sulfamethoxazole Drug Combination

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A Case of Nocardia farcinica Pneumonia and Mediastinitis in an Immunocompetent Patient

  • Kim, Jinyoung;Kang, Minkyu;Kim, Juri;Jung, Sohee;Park, Junhung;Lee, Dongkyu;Yoon, Heejung
    • Tuberculosis and Respiratory Diseases
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    • 제79권2호
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    • pp.101-103
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    • 2016
  • Nocardia species are aerobic, gram-positive pathogens found worldwide in soil. Nocardia is considered an opportunistic pathogen, and its infection mostly occurs in immunocompromised patients. We report a case of Nocardia farcinica induced mediastinitis and pneumonia that occurred in a 64-year-old male patient who had no significant medical history except for hypertension. He visited another hospital with a complaint of dyspnea and left chest wall pain. The symptoms arose 7 days ago without any trauma and they worsened. A mediastinal mass was found on computed tomography scan. After being transferred to our hospital for further evaluation, he was diagnosed with mediastinitis and pneumonia. As N. farcinica was found to be the causative organism by 16S rRNA sequencing, proper antibiotic therapy including trimethoprim/sulfamethoxazole was initiated immediately. After this, the patient improved and he was discharged. If an infection has a disseminating course, nocardiosis cannot be excluded even in immunocompetent patients. Once the diagnosis is established, prompt antibiotic therapy should be performed based on the severity.

Isolation of methicillin-resistant Staphylococcus aureus from a Shih-Tzu dog with canine distemper virus infection

  • Pak, Son-il;Hwang, Cheol-yong;Youn, Hwa-young;Han, Hong-ryul
    • 대한수의학회지
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    • 제39권2호
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    • pp.376-382
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    • 1999
  • A methicillin-resistant Staphylococcus aureus (MRSA) isolate was recovered from a 9-month-old female Shih-Tzu dog with canine distemper virus infection. We performed in vitro antimicrobial susceptibility test to determine the most effective antimicrobial drug against the isolate and thus, to emphasize its potential clinical importance in animal practices. Isolate was confirmed MRSA by oxacillin agar screening test. The isolate was fully resistant to all $\beta$-lactam antibiotics and was susceptible to glycopeptides. Of the other antibiotics, mupirocin, TMP/SMZ (trimethoprim-sulfamethoxazole), and chloramphenicol showed inhibitory effect at the concentration of 4x MIC. The MICs ranged 0.25->$128{\mu}g/ml$, and MBCs ranged 0.5->$128{\mu}g/ml$. The combined TMP/SMZ with cefamandole or novobiocin showed synergistic effect, whereas the combination of novobiocin plus cefamandole or teicoplanin resulted in antagonistic effects. Although MRSA in animals so far has been reported in the geographically limited countries, at least theoretically, it could be occurred in the future more frequently through either human or animal origin. The use of this combination may be of value in this situation. As with all antimicrobial agents, inappropriate or unnecessarily prolonged therapy may contribute to the emergence of resistance strains and loss of efficacy.

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이질균(痢疾菌) 및 살모내라의 약제내성(藥劑耐性), 내성화방지(耐性化防止) 및 제거(除去) (Drug resistance of Shigella and Salmonella and the inhibition and elimination of drug resistance)

  • 전도기;설성용
    • 대한미생물학회지
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    • 제14권1호
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    • pp.27-37
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    • 1979
  • 1978년(年)에 분리(分離)한 9주(株)의 Shigella, 70주(株)의 Salmonella paratyphi A 및 230주(株)의 S. typhi의 약제내성(藥劑耐性), 내성화방지(耐性化防止) 및 제거(除去)에 대(對)하여 실험(實驗)하여 다음과 같은 성적(成績)을 얻었다. Shigella는 79주(株)가 Sh. flexneri, 16주(株)가 Sh. sonnei였는데 1주(株)를 제외(除外)한 94주(株)가 chloramphenicol tetracycline, streptomycin, sulfisomidine에 다약제내성(多藥劑耐性)이었으며 그중(中) 70주(株)는 ampicillin과 carbenicillin에, 80주(株)는 trimethoprim-sulfamethoxazole에, 22주(株)는 nalidixic acid에, 1주(株)는kanamycin에도 내성(耐性)이었다. Gentamicin, amikacin, cephaloridine, rifampin에 내성(耐性)인 균주(菌株)를 없었다. S. paratyphi A와 S. typhi는 공시약제(供試藥劑)에 감수성(感受性)이었으나 다만 rifampin, 또는 sulfisomidine에 약(弱)한 내성(耐性)을 가진 것이 있었다. 다약제내성(多藥劑耐性)인 shigella의 약(約) 80%가 전달성(傳達性) R plasmid를 가지고 있어서 그 내성(耐性)을 E. coli에 전달(傳達)시킬 수 있었다. 내성전달빈도(耐性傳達頻度)는 공시균주(供試菌株) 및 피전달균(被傳達菌)에 따라 차이(差異)가 있었다. 보존(保存)한 내성균주(耐性菌株)는 그 비율(比率)은 균주(菌株)에 따라 차이(差異)가 있으나 내성균(耐性菌)과 감수성균(感受性菌)으로 구성(構成)되어 있었으며 계대배양(繼代培養)에 의하여 내성(耐性)이 쉽게 탈락(脫落)되지는 안하였다. Acriflavine은 내성(耐性)을 탈락(脫落)시키는 효과(效果)는 있었으며 균주(菌株)에 따라 그 차이(差異)가 심(甚)하였고 atabrine은 효과(效果)가 없었다. 약제(藥劑)의 병용(倂用)은 Shigella에 대(對)한 작용(作用)을 증강(增强)시키는 경우(境遇)가 많으며 대체(大體)로 상승작용(相乘作用)을 나타냈고 상가작용(相加作用)을 나타내는 경우(境遇)가 있었으나 길항작용(拮抗作用)은 볼 수 없었다.

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가축의 설사변에서 분리한 대장균과 살모넬라균의 항균물질 감수성과 마우스에서의 치료효과 (Antimicrobial drug susceptibility and treatment efficacy in mice against Escherichia coli and Salmonella spp isolated from feces of diarrheal animals)

  • 김종만;진남섭;김종완;진영화;이희수;권창희;우승룡;이해천;박종명;김재학;이재진
    • 대한수의학회지
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    • 제37권2호
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    • pp.389-403
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    • 1997
  • Survey on MIC of antimicrobial drugs and its treatment efficacy in mice were conducted for the strains of Escherichia coli and Salmonella spp isolated from feces of young domestic animals with diarrhea in 1996. A total of 338 strains of E coli and 61 strains of Salmonella spp were examined for the susceptibility to 20 antibiotics and 7 synthetic antimicrobial drugs. The results indicated that the majority of strains were susceptible to amikacin(93.5%), cefoperazone/sulbactam(93.5%), cefotaxim(93.3%), cefomandole(92.8%), cefoperazone(91.6%) and ciprofloxacin(85.1%), in order. Although gentamicin, ciprofloxacin and norfloxacin showed the relatively low MIC distributions, erythromycin, doxycycline, sulfamethoxazole and oxytetracycline revealed the high MIC distributions to most of isolates. The $MIC_{90}$ of antimicrobials for E coli were > $62.5{\mu}g/ml$ in gentamicin, $2.0{\mu}g/ml$ in ciprofloxacin, $1.0{\mu}g/ml$ in norfloxacin, > $500{\mu}g/ml$ in erythromycin, $125{\mu}g/ml$ in doxycycline, > $1000{\mu}g/ml$ in sulfamethoxazole and > $250{\mu}/ml$ in oxytetracycline. In general, the MIC of E coli isolates was higher than that of Salmonella spp isolates. Although variation in synergism or additivity of antibiotic combinations were demonstrated, ampicillin-gentamicin was the most efficacious combination both against E coli and Salmonella spp with the fluctuation of 7.7-77.5%. In the experiment of treatment efficacy in mice, the highest survival ratio(83.3%) after challenge with pathogenic E coli and Salmonella typhimurium was detected in the group treated with gentamicin.

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개와 고양이에서 분리된 Enterobacteriaceae와 Pseudomonas aeruginosa의 항균제 내성 및 내성 유전자의 분포 (Antimicrobial resistance and distribution of resistance gene in Enterobacteriaceae and Pseudomonas aeruginosa isolated from dogs and cats)

  • 조재근;김진현;김정미;박최규;김기석
    • 한국동물위생학회지
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    • 제36권3호
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    • pp.171-180
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    • 2013
  • This study was carried out to investigate the antimicrobial resistance pattern and distribution of resistance gene in 44 Enterobacteriaceae and 21 Pseudomonas (P) aeruginosa isolated from hospitalized dogs and cats in animal hospital from 2010 to 2011 in Daegu. Among Enterobacteriaceae, Escherichia (E) coli was highly resistant to ampicillin (56.7%), followed by tetracycline (53.3%), cephalothin, streptomycine, sulfamethoxazole/trimethoprim, gentamicin and norfloxacin (40.0~43.3%). The remaining isolates of Enterobacteriaceae had high resistance to ampicillin (64.3%) and streptomycin (42.9%). Whereas, P. aeruginosa was low resistant to all antimicrobials tested (less than 15%). int I 1 gene was detected in 20 (57.1%) of 35 antimicrobial resistant Enterobacteriaceae and 2 (9.5%) of 21 P. aeruginosa., but int I 2 gene was not detected in all isolates. The eight resistance genes were found either alone or combination with other gene (s): $bla_{TEM}$, aadA, strA-strB, clmA, tetA, tetB, sul I and sul II. About 78% of integron-positive isolates were resistance to more than four antimicrobial agents. The findings suggest that class I integrons are widely distributed in E. coli among Enterobacteriaceae from dogs and cats and multi-drug resistance related to the presence of class I integrons. The prudent use of antimicrobials and continuous monitoring for companion animals are required.