• Journal of Veterinary Clinics
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• v.32 no.2
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• pp.158-161
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• 2015

Bacterial dermatitis is common disease that is necessary to treat with antibiotics. In recent, antibiotic-resistant bacteria is being increased in worldwide. The purpose of the present study was to evaluate the prevalence of resistant genes in Staphylococcus (S.) pseudintermedius isolated from dogs, and to compare the resistant gene profile with the result of antibiotic disc diffusion test. A total of seven S. pseudintermedius was included in the study. Bacterial identification was performed by 16S ribosomal RNA gene sequence analysis. S. pseudintermedius isolates had more than one antibiotic resistant gene (mecA, blaZ and aac(6')/aph(2"). While all isolates were PCR positive to blaZ gene, only two isolates were resistant to amoxicillin/clavulanate. Among five isolates harboring gentamicin resistance, one isolate was negative to aac(6')/aph(2")-targeted PCR. Taken together, the results suggest that resistant gene-targeted PCR and disc diffusion test are complementary to detect antibiotic resistance.

• Pediatric Infection and Vaccine
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• v.27 no.3
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• pp.147-157
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• 2020

Purpose: We investigated the trend of antibiotic susceptibility of Haemophilus influenzae over 5 consecutive years. Methods: We analyzed the antibiotic susceptibility of H. influenzae isolated from children aged <18 years, who were admitted to the Asan Medical Center Children's Hospital from March 2014 to April 2019. Antibiotic susceptibility of H. influenzae was determined by the disk diffusion test according to the European Committee on Antimicrobial Susceptibility Testing guidelines. Results: Excluding duplicates, 69 isolates were obtained over the past 5 years. The median age of the patients was 5 years (range, 2.8-8.6 years). The antibiotic susceptibility patterns were as follows: ampicillin (AMP)-susceptible/amoxicillin-clavulanate (AMC)-susceptible (AS/ACS; n=15 [21.7%]), AMP-resistant/AMC-susceptible (AR/ACS; n=21 [30.4%]), and AMP-resistant/AMC-resistant (AR/ACR; n=33 [47.8%]). The prevalence of isolates with AR/ACR phenotype tended to increase from 42.1% in 2014-2015 to 54.5% in 2018-2019 (P=0.342). Compared to 2014-2015, the resistance rates to cefuroxime and ceftriaxone in 2018-2019 increased from 31.6% to 77.3% and from 0.0% to 59.1%, respectively (P=0.003 and P<0.001, respectively). Conclusions: Over the last 5 years, H. influenzae isolates with AR/ACR phenotype and ceftriaxone resistance were frequently observed at our institute. The incidence of resistance to cefuroxime and ceftriaxone has increased significantly.

• Implantology
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• v.22 no.4
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• pp.236-241
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• 2018

This case report is to report an extraordinary case of the spontaneous discharge of a dental implant. A 45-year-old woman was referred to our department complaining of symptoms of acute Maxillary sinusitis. She underwent a computed tomography scan that revealed a dental implant dislocated in the maxillary sinus. A preoperative medical treatment [Amoxicillin - Clavulanate (375 mg) and Streptokinase-Streptodornase (12500IU)] three times a day for two weeks was administered in order to prepare her for surgery. Unexpectedly, she reported that she had discharged the implant from mouth in the early morning. Mucociliary clearance in combination with a local osteolytic inflammatory process and mucolytics therapy are the likely causes of this unusual discharge.

• Journal of Veterinary Clinics
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• v.39 no.2
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• pp.70-74
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• 2022

A 14-year-old intact male captive leopard (Panthera pardus) first presented with a focal alopecic lesion on the dorsal aspect of the distal one-third of its tail. Although itraconazole was administered, the lesion progressed deeper and became ulcerated due to self-trauma. Due to the wild nature of the leopard, daily dressing of the wound and replacing the bandages without anesthesia became too dangerous, and amputation became necessary. A postoperative tissue sample was submitted for histopathological examination, and tramadol, amoxicillin/clavulanate, and gabapentin were administered. In the days following the amputation, the leopard's appetite significantly decreased, and the patient passed away 18 days later. Histopathological examination of the specimen revealed well-differentiated squamous cell carcinoma (SCC). In hindsight, had more cells been collected by a fine-needle aspirate (FNA) biopsy or had additional FNA biopsies been performed, SCC might have been diagnosed based on its cytological features rather than delayed histopathological findings. The current study highlights the critical reasons why clinicians may often misdiagnose SCC and the importance of being more aware of potential tumors in ulcerative lesions, which are often incorrectly treated as infectious skin diseases. This is also the first report of cutaneous SCC in a leopard.

• Journal of Veterinary Clinics
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• v.21 no.1
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• pp.7-14
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• 2004

Bacteria that are resistant to several different groups of antibiotics have increased during the past few years. The importance of surveillance of antimicrobial resistance is now widely recognized. Unfortunately, this development has not been documented continuously in veterinary medicine in Korea. Therefore, the clinical prevalence and trend of antimicrobial susceptibility of aerobic isolates were investigated in this study. Total 121 isolates of aerobic bacteria were isolated from clinical specimens of dogs and cats at Veterinary Medical Teaching Hospital of Seoul National University from May 2001 to October 2002. Among them, the most common isolated species was Staphylococcus spp. (48 isolates), followed by E.coli (26 isolates), Enterococcus spp. (21 isolates), Klebsiella pneumoniae (9 isolates), Streptococcus spp. (6 isolates), Enterobacter cloacae (3 isolates), Pseudomonas aeruginosa (3 isolates), Corynebacterium xerosis (2 isolates), Chryseomonas spp. (2 isolates), and Providencia stuartii (1 isolate). The susceptibility of isolates to antibiotics was determined by the disk diffusion method. Gram-positive bacterial isolates were showed high susceptibilities to amikacin, amoxacillin/clavulanate, ceftazidime, and oxacillin, while Gram-negative bacterial isolates were showed high susceptibilities to amikacin and ceftazidime. Staphylococcus spp. were showed high susceptibilities to amikacin, amoxicillin/clavulanate, ceftazidime, cephalothin, and oxacillin. Streptococcus spp. and E.coli were showed high susceptibilities to amikacin and ceftazidime. Of the 48 staphylococci, seven Methicillin Resistant staphylococci were observed (14.6%), distributed among S. auricularis (1), S. hemolyticus (2), S. sciuri (1), S. saprophyticus (1), S. warneri (2) isolates. One strain of E.coli and one strain of Corynebacterium xerosis were resistant to all antibiotics tested. And, resistance trends between the you 2000 (from July 1999 to September 2000) and 2002 (from May 2001 to October 2002) were compared. Resistance to antibiotics was increased in both Gram-positive and Gram-negative bacterial isolates (p＜ 0.05). The resistance rates of Staphylococcus spp., E.coli and Klebsiella pneumoniae to all antibiotics tested were also increased (p＜0.05). This study investigated increasing resistance between the year 2000 and 2002 in Veterinary Medical Teaching Hospital of Seoul National University. Surveillance resistance is helpful to alert to veterinarian and select of appropriate therapy. Antimicrobial susceptibility surveillance of isolates should urgently be continued in veterinary medicine.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.17 no.4
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• pp.232-238
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• 2014

Purpose: This study investigated the clinical presentations of symptomatic Clostridium difficile infection (CDI) in children. Methods: We reviewed the medical records of 43 children aged <20 years who showed either positive C. difficile culture or C. difficile toxin test results between June 2010 and April 2014. Results: Of the 43 patients (mean age 6.7 years), 22 were boys. Sixteen patients (37.2%) showed both positive C. difficile culture and toxin test results. Seventeen out of 43 children (39.5%) had preexisting gastrointestinal diseases, and 26 children had other medical conditions that were risk factors for CDI. Twenty-eight children had a history of antibiotic treatment for >3 days, and the most frequently prescribed antibiotic was amoxicillin-clavulanate (35.7%). Twenty-eight patients were diagnosed with CDI despite taking probiotic supplements, most commonly Lactobacillus acidophilus (53.6%). The most common symptom was diarrhea (72.1%) at the time CDI was diagnosed. C. difficile was eradicated in 11 patients (25.6%) after treatment with oral metronidazole for 10-14 days, and in the two patients (4.6%) who required two courses of oral metronidazole. Sixteen patients (37.2%) showed clinical improvement without any treatment. Conclusion: This study showed the various clinical characteristics of CDI in children and that preexisting clinical conditions favored the development of CDI. In addition, CDI was found to occur in a number of patients even after probiotic prophylaxis given in conjunction with antibiotic therapy.

• Journal of Veterinary Clinics
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• v.32 no.5
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• pp.473-475
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• 2015

A 12-year-old intact male, Alaskan Malamute dog, which lives in the countryside, was presented with inflammation and pain around perineal areas. Thorough examination revealed maggots and punched-out round holes lesion around the perineal region. Complete blood counts (CBC) and serum biochemical examinations showed no remarkable findings except mild anemia and mild thrombocytosis. The diagnosis was easily done, based on clinical signs and maggots identification. Cleaning with chlorhexidine, povidone-iodine lavage and hair clipping away from the lesions were performed soon after presentation. SNAP 4Dx Test (IDEXX Laboratories, Westbrook, ME, USA) was performed to rule out other vector-borne diseases since the ticks were found on the clipped area and vector-borne pathogens. The test result was negative. The dog in this case was treated with ivermectin (300 mcg/kg SC) one time. Also, treatments with amoxicillin clavulanate (20 mg/kg PO, BID) was established to prevent secondary bacterial infections. Then, myiasis resolved with 2 weeks and the affected area was healed.

• Pediatric Infection and Vaccine
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• v.11 no.2
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• pp.202-207
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• 2004

Group A streptococcus, also known as Streptococcus pyogenes, is a common bacterial pathogens of the upper respiratory tract and skin infections in children, but this organism is a less common cause of pneumonia, pericarditis. However, pneumonia that is caused by Streptococcus pyogenes, may be rapidly progressive course with developing severe consequences. It may be focal but often is bilateral and diffuse involvement of lung. Empyema is commonly developed, and pleurocentesis often yields thin, watery fluid that continues to flow out when a chest tube is inserted. Antimicrobial resistance to the ${\beta}$-lactam antibiotics has not been reported against group A streptococci, whereas increasing resistance to the macrolides seems to be directly related to the consumption of specific antimicrobial agent use in the community. Clindamycin resistance is uncommon but does occur. We experienced one case of group A streptoccoccal pneumonia with empyema and pericardial effusion, and treated successfully with amoxicillin-clavulanate, clindamycin and roxithromycin.

• Archives of Pharmacal Research
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• v.24 no.6
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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.

• Journal of Veterinary Clinics
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• v.38 no.4
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• pp.169-173
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• 2021

A 10-year-old castrated male Shih-tzu dog presented with a history of generalized demodicosis, refractory to conventional therapy with ivermectin and amitraz for a year. The patient was also diagnosed with concurrent deep pyoderma, Malassezia dermatitis, and otitis externa. Treatment with amoxicillin-clavulanate, antifungal drugs (itraconazole, miconazole), and milbemycin oxime resulted in a good response for 90 days. Approximately 4 months later, the first relapse of demodicosis occurred and the miticidal therapy was changed to ivermectin. Additional diagnostic tests were performed to investigate an underlying cause for the recurrence of demodicosis, and endocrinopathies and allergic dermatitis were excluded based on the results. Although ivermectin therapy was sustained for 440 days, a second relapse occurred and amitraz baths were added to the therapy. Despite this therapy, the demodicosis persisted, and the miticidal therapy was changed to oral fluralaner, which led to rapid resolution. Demodicosis did not recur again before death approximately 920 days after administration of oral fluralaner. This case report describes the complete resolution of refractory demodicosis using oral fluralaner in a dog.