• 한국동물위생학회지
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• 제40권1호
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• pp.41-46
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• 2017

The purpose of this study was to investigated the fluoroquinolone (FQ) resistance and presence of gyrA and grlA gene in 87 Staphylococcus pseudintermedius isolates obtained from clinical samples of dogs and cats. Also, the profiles of FQ resistance compared with methicillin resistant S. pseudintermedius (MRSP) isolates. FQ resistance was observed for enrofloxacin (41.4%), ciprofloxacin (39.1%), norfloxacin (36.8%), ofloxacin and levofloxacin (32.2%, respectively), and moxifloxacin (31.0%). Thirty-eight (43.7%) of 87 S. pseudintermedius isolates were resistant to more than one FQ. Twenty-six (64.5%) of 38 FQ resistant isolates were resistant to all the six FQ tested. Of 38 FQ resistant isolates, gyrA gene was detected in all isolates but grlA gene was not found. Moreover, 19 MRSP isolates were resistant to enrofloxacin (63.2%), ciprofloxacin (57.9%), norfloxacin (52.6%), and ofloxacin, levofloxacin and moxifloxacin (47.4%, respectively). FQ resistance were highly prevalence in S. pseudintermedius isolates from dogs and cats. Our results emphasize the prudent use of antimicrobial agents to companion animals is necessary for prevent antimicrobial resistance.

• Tuberculosis and Respiratory Diseases
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• 제80권2호
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• pp.143-152
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• 2017

Background: Fluoroquinolones are considered important substitutes for the treatment of tuberculosis. This study investigates the current status of fluoroquinolone for the treatment of tuberculosis. Methods: In 2009, a retrospective analysis was performed at one tertiary referral center for 953 patients diagnosed with tuberculosis. Results: A total of 226 patients (23.6%), who received fluoroquinolone at any time during treatment for tuberculosis, were enrolled in this study. The most common reasons for fluoroquinolone use were adverse events due to other anti-tuberculosis drugs (52.7%), drug resistance (23.5%), and underlying diseases (16.8%). Moxifloxacin (54.0%, 122/226) was the most commonly administered fluoroquinolone, followed by levofloxacin (36.3%, 82/226) and ofloxacin (9.7%, 22/226). The frequency of total adverse events from fluoroquinolone-containing anti-tuberculosis medication was 22.6%, whereas fluoroquinolone-related adverse events were estimated to be 2.2% (5/226). The most common fluoroquinolone-related adverse events were gastrointestinal problems (3.5%, 8/226). There were no significant differences in the treatment success rate between the fluoroquinolone and fluoroquinolone-$na{\ddot{i}}ve$ groups (78.3% vs. 78.4%, respectively). Conclusion: At our institution, fluoroquinolones are commonly used for the treatment of both multidrug-resistant tuberculosis and susceptible tuberculosis, especially as a substitute for adverse event-related drugs. Considering the low adverse event rates and the comparable treatment success rates, fluoroquinolones seem to be an invaluable drug for the treatment of tuberculosis.

• 대한임상검사과학회지
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• 제49권4호
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• pp.427-434
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• 2017

Acinetobacter calcoaceticus-baumannii (Acb) complex에 속한 종들은 빈번하게 병원감염 및 기회감염을 일으킨다. 또한 다제내성인 경우가 많아 이 균들의 감염증 치료를 위한 항균제 선택이 매우 제한적이다. 본 연구에서는 ciprofloxacin 내성 Acinetobacter species 53균주를 대상으로 fluoroquinolone 내성기전을 조사했다. 항균제 감수성 양상을 조사하기 위해 디스크확산법이 시행되었다. Fluoroquinolone 내성과 관련된 유전자 및 돌연변이 검출을 위해 PCR과 염기서열분석이 이루어졌다. 본 연구에서 수집된 53균주의 ciprofloxacin 내성 Acinetobacter 중 47균주가 gyrA 유전자의 83번째 serine 아미노산 잔기와 parC 유전자의 80번째 serine 아미노산 잔기가 leucine 잔기로 치환된 sense mutations 가지고 있는 것으로 나타났다. gyrA와 parC 유전자에 sense mutations을 가지고 있는 47균주 중 44균주가 A. baumannii 였고 3균주는 A. pittii였다. 본 연구에서 조사대상이 되었던 Acb complex 균주들 중 plasmid-mediated quinolone resistance (PMQR) determinants를 가지고 있는 균주는 한나도 없었다. 46 균주의 ciprofloxacin 내성 A. baumannii 는 A, B, 또는 F형의 banding pattern을 보였는데 이는 충청지역에 위치한 일개의 병원에 ciprofloxacin 내성 A. baumannii가 수평확산 되어 있음을 의미한다. Fluoroquinolone 내성 Acb complex 균주의 집락화 및 확산을 막기 위해서 다제내성 균주들을 대상으로 항균제 내성인자들을 지속적으로 조사하고 모니터링할 필요가 있을 것으로 사료된다.

• Asian Pacific Journal of Cancer Prevention
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• 제17권1호
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• pp.285-287
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• 2016

Background: The efficacy of standard treatment of Helicobacter pylori (H. pylori) is declining because of antibiotic resistance. Clarithromycin resistance is also increasing in many Asian countries. The aim of this study was to determine the antibiotic susceptibility patterns of H. pylori infection and clinical association in Laos. Materials and Methods: A total of 329 Lao dyspeptic patients who underwent gastroscopy at Mahosot Hospital, Vientiane, Laos during December 2010-March 2012 were enrolled in this study. During gastroscopy, 4 biopsies were collected (2 each from the antrum and body) for CLO-test and histopathology. Only the positive CLO-test gastric tissues was stored at $-80^{\circ}C$ in a freezer until DNA was extracted and a GenoType$^{(R)}$HelicoDR test was conducted for detecting mutations in the rrl gene encoding 23S rRNA (clarithromycin resistance) and mutations in gyrA gene (fluoroquinolone resistance). Results: Of the total, 119 Lao patients (36.2%) were infected with H. pylori including 59 males (49.6%) and 60 females (50.4%) with a mean age of 46 years. Clarithromycin and fluoroquinolone resistance of H. pylori infection was demonstrated in 15 (12.6%) and 16 strains (13.4%) respectively. In clarithromycin resistance, the number of patients who had education above primary school and $BMI{\geq}25kg/m^2$ were significantly higher than those who had education below primary school and BMI<$25kg/m^2$ (23.1% vs 7.5%, P-value= 0.036 and 20.5% vs 8%, P-value= 0.048, respectively). In fluoroquinolone resistance, the number of lowland Lao was significantly higher than those of non-lowland (highland and midland) Lao ethnic groups (16.7% vs 0%, P-value= 0.039). Conclusions: H. pylori infections remain common in Laos. Clarithromycin and fluoroquinolone resistance with H. pylori infection are growing problems. Education above primary school and $BMI{\geq}25kg/m^2$ might be predictors for clarithromycin resistance and lowland Lao ethnicity might be predictors for fluoroquinolone resistance with H. pylori infection in Laos.

• 대한임상검사과학회지
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• 제48권2호
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• pp.74-81
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• 2016

Fluoroquinolone 계 항생제의 광범위한 사용으로 인해 이 약제에 대한 내성 Ureaplasma 종의 분리 비율이 높아지고 있다. Fluoroquinolone 계 항생제 내성은 주로 DNA gyrase와 topoisomerase IV 유전자의 돌연변이로 인해 발생하는 것으로 알려져 있다. DNA gyrase는 A와 B 2개의 소단위로 이루어져 있으며, gyrA와 gyrB 유전자에 의해 암호화되어 있고, Topoisomerase IV는 parC와 parE 유전자에 의해 암호화되어 있다. 본 연구가 진행된 서울의 1개 3차 병원에서 2012년부터 2013년까지 1년동안 Ureaplasma 종의 fluoroquinolone 계 항생제인 OFL과 CIP의 항생제검사 감수성 결과를 분석한 결과 내성과 중등도를 합산할 경우 66.08%, 92.69%로 매우 높은 내성 비율을 보였다. 이에 Ureaplasma 종을 OFL과 CIP에 대한 감수성을 기준으로 4개 그룹으로 분류하여 gyrA, gyrB, parC, parE 유전자의 돌연변이 여부를 검사하여 항생제 내성과의 관련성을 밝히고자 하였다. 그 중 parC 유전자의 돌연변이 빈도가 높아 topoisomerase IV의 돌연변이가 fluoroquinolone 계 약제에 대한 내성과 밀접한 관련이 있음을 확인할 수 있었다. 본 연구를 통해 GyrB의 Asn481Ser, ParC의 Phe149Leu, Asp150Met, Asp151Ile, Ser152Val, ParE의 Pro446Ser, Arg448Lys을 추가로 발견할 수 있었다. 최근 fluoroquinolone 계 항생제의 사용이 증가하고 있기 때문에 추후 Ureaplasma 종의 fluoroquinolone 계 항생제 내성에 대한 지속적인 모니터링이 필수적일 것으로 사료되며, 이와 관련한 유전자의 돌연변이 양상과의 상관관계를 분석하여 기존 배양검사의 단점을 보완할 수 있는 분자 진단학적 검사법의 추가적인 분석이 필요할 것으로 사료된다.

• 대한미생물학회지
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• 제35권5_6호
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• pp.337-339
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• 2000

MRSA, erythromycin-resistant S. pyogenes, penicillin non-susceptible pneumococci, PPNG, ESBL-producing E. coli and K. pneumoniae, class C ${\beta}$-lactamase-producing E. coli, fluoroquinolone-resistant E. coli, aminoglycoside-resistant A. baumannii and P. aeruginosa are all prevalent in Korea, which suggest the presence of high levels of antimicrobial selective pressure and nosocomial spread of resistant bacteria. Rapid increase of VRE and emergence of fluoroquinolone-resistant gonococci and VIM-2 metallo-${\beta}$-lactamase-producing P. aeruginosa are recently observed new threats in Korea.

• 대한임상검사과학회지
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• 제53권3호
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• pp.217-224
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• 2021

전 세계적으로 fluoroquinolone (FQ) 내성 그람음성균이 출현하고 있는 가운데, 최근 우리나라에서 FQ 내성 E. coli의 증가 추세는 심각한 우려를 낳고 있다. 이에 본 연구에서는 2018년 6월부터 12월까지 대전지역의 3차 병원에서 분리된 ciprofloxacin 내성 E. coli 56균주를 대상으로, 역학관계와 FQ 내성 결정인자의 양상을 조사하였다. 역학관계를 확인하기 위해 multilocus sequence typing (MLST)을 실시하였다. PCR과 염기서열 분석은 gyrA, gyrB, parC, parE 유전자의 QRDR에서 염색체상의 돌연변이와 aac(6)-Ib-cr, qepA, qnrA, qnrB, qnrC, qnrD 및 qnrS와 같은 PMQR 유전자의 빈도를 확인하였다. MLST 분석 결과, 12개의 ST를 확인하였으며, 이 중 가장 우세한 ST는 ST131 (31/56, 55.4%)이었고, 순차적으로 ST1193 (13/56, 23.2%), ST405 (3/56, 5.4%)의 결과를 보였다. ciprofloxacin 내성 E. coli 56균주 중 gyrA 유전자에서 83번째 아미노산인 serine (S)이 leucine (L)으로, 87번째 아미노산인 aspartic acid (D)가 asparagine (N)으로 치환되고, parC 유전자에서 80번째 아미노산인 serine (S)이 isoleucine (I)으로, 84번째 아미노산인 glutamic acid (E)가 valine (V)으로 치환된 결과(29/56, 51.8%)가 가장 빈번하게 확인되었고, aac(6)-Ib-cr (19/56, 33.9%)은 가장 흔한 PMQR 유전자로 확인되었다. 이러한 FQ 내성 결정인자의 결과는 다른 클론과 비교하여 ST131에서 더 빈번하게 확인되었다. ciprofloxacin 내성 E. coli 균주에 대한 역학적 특성의 지속적인 모니터링과 FQ 내성 결정인자에 대한 추가 연구가 필요할 것으로 사료된다.

• Journal of Microbiology and Biotechnology
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• 제20권4호
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• pp.798-802
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• 2010

Recently, a total of 74 Staphylococcus pseudintermedius isolates were collected from clinical cases of canine pyoderma and otitis externa in Korea. In this study, we examined in vitro fluoroquinolone resistance among those isolates using a standard disc diffusion technique. The results demonstrated that, except for one isolate, approximately 18.9% to 27.0% of the isolates possessed bacterial resistance to both veterinary- and human-licensed fluoroquinolones including moxifloxacin (18.9% resistance), levofloxacin (20.3% resistance), ofloxacin (24.3% resistance), ciprofloxacin (25.7% resistance), and enrofloxacin (27.0% resistance). Most surprisingly, 14 out of 74 (18.9%) isolates were resistant to all the five fluoroquinolones evaluated. Moreover, a PCR detection of the methicillin resistance gene (mecA) among the 74 isolates revealed that 13 out of 25 (52.0%) mecApositive isolates, but only 7 out of 49 (14.3%) mecA-negative isolates, were resistant to one or more fluoroquinones. Taken together, our results imply that bacterial resistance to both veterinary- and human-use fluoroquinolones becomes prevalent among the S. pseudintermedius isolates from canine pyoderma and otitis externa in Korea, as well as that the high prevalence of the mecA-positive S. pseudintermedius isolates carrying multiple fluoroquinolones resistance could be a potential public health problem.

• Clinical and Experimental Pediatrics
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• 제51권10호
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• pp.1042-1046
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• 2008

The fluoroquinolones are an important group of antibiotics widely used in the treatment of various infectious diseases in adults, as a result of an excellent spectrum of activity, good tissue penetration and convenient ways of administration. In recent decades, there has been extensive development, clinical investigation, licensure and use of fluoroquinolone antibiotics. However, the use of fluoroquinolones in children has been limited because of their potential to induce arthropathy in juvenile animals. Despite class label warnings against use in children, prescriptions for quinolone antibiotics to treat infections in children have become increasingly prevalent. The main use of fluoroquinolones in pediatrics should be, understandably, in serious life-threatening infections for which other antibiotics therapies are not effective or available. While most of the published studies failed to detect an increased rate of articular adverse effects in children treated with fluoroquinolones, an increase in the use of these compounds, particularly in community-acquired lower respiratory infections, could accelerate the emergence of multidrug-resistant (including fluoroquinolone) pneumococcal strains. This review will discus the main issues related to the use of fluoroquinolones in children, the major problems of resistance developing among these compounds, with special emphasis on the potential side effects and skilled use of these alternative potent drugs in pediatric infection.

• Archives of Pharmacal Research
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• 제19권5호
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• pp.400-405
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• 1996

In vitro studies were conducted to dertermine the frequency rate of spontaneous resistance to LB20304 and to dertermine whether cross-resistance to other antimicrobial agents develops. In eight strains of bacteria, the frequency of mutation to LB20304 at the concentrations of four and eight times the minimal inhibitory concentration(MIC) ranaged from less than 4.0 ${\times}$ $10^{-10}$ to 2.2 $\{times}$ $10^{-10}$ . These results were similar to those founf for other new fluoroquinolones. THe development of stepwise resistance was determined by repeated subculture in broth in the presence of increasing concentration of the compounds. Exposure of bacteria to increasing concentrations of LB20304 resulted in the selection of organisms with higher MICs. There were 4- to 128-fold increases in the MIC of LB20304 for bacterial strains of Staphylococcus aureus, Streptococcus pneumoniae, Escherichia coli and Pseudomonas aeruginosa. However, those strains selected after repeated exposure were well within the susceptibility range for LB20304 except for Pseudomonas aeruginosa. The resistant isolates selected with LB20304 showed cross-resistance when tested against ciprofloxacin and vice versa.