• 대한임상검사과학회지
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• 제48권4호
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• pp.335-342
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• 2016

일반적으로 지역사회 관련 경로로 감염되기 쉬운 S. aureus는 대부분이 MSSA로 알려져 있었으나 최근 CA-MRSA가 증가하고 있다. 항생제와 glycopeptides의 지속적인 남용은 VISA, VRSA가 더욱 증가할 가능성이 있다. 본 연구는 최근 10년간 일개 대학병원의 상처에서 분리한 황색 포도상 구균의 항생제 감수성 패턴과 항생제 내성의 유병률의 변화를 조사하기 위하여 실시 하였다. 본 연구에서는 남성이 여성보다 항생제 내성이 높게 나타났다. 그리고 연령에 따라 항생제 내성률이 증가하였다. 2006년 항생제 내성률은 penicillin, oxacillin, erythromycin, gentamicin, clindamycin, tetracycline, ciprofloxacin, fusidic acid, trimethoprim/sulfamethoxazole, clindamycin, rifampicin에서 각각 97.7%, 60.5%, 57.4%, 48.8%, 41.1%, 44.2%, 44.2%, 14.7%, 13.2%, 3.9% 나타났으며, 2016년 항생제 내성률은 penicillin, oxacillin, erythromycin, gentamicin, clindamycin, tetracycline, ciprofloxacin, fusidic acid, trimethoprim/sulfamethoxazole, clindamycin, rifampicin에서 각각 95.9%, 62.6%, 55.7%, 28.6%, 50.3%, 34.7%, 38.8%, 34.0%, 2.7%, 8.2%로 나타났다. Vancomycin, linezolid, quinupristin/dalfopristin, teicoplanin 는 항생제 감수성에서 100%를 나타내었다. 특히, fusidic acid는 2006년에 비하여 2016년에 내성이 19.3% 증가하였고, 감수성이 12.4% 감소하였으며, 통계적으로 유의하였다. 따라서, 미생물 및 항생제 변화의 주기적인 검토와 이해를 통해 적절한 항생제 감수성을 지속적으로 연구해야 할 것으로 사료된다.

• Pediatric Infection and Vaccine
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• 제16권1호
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• pp.6-12
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• 2009

There are relatively few novel antimicrobial agents despite the dramatic increase in antimicrobial resistance and multiple drug resistance of clinical isolates worldwide. Vancomycin is still the most widely used antibiotic for treating resistant Gram-positive coccal infections in children, especially for methicillin-resistant Staphylococcus aureus. For children with Gram-positive coccal infections where vancomycin is not effective or older therapeutic agents cannot be tolerated, linezolid, quinupristin-dalfopristin or daptomycin may be useful in the appropriate clinical setting. For Gram-negative bacterial infections, new carbapenems await clinical application. Tebipenem pivoxil is a novel oral carbapenem undergoing clinical trials for acute otitis media in pediatric patients. Antiviral drug development is now progressing at the pace of antibiotic development 30 years ago. Newer antiviral agents used for the treatment of herpes viruses and hepatitis C virus infections in children are included in this review.

• 한국미생물·생명공학회지
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• 제51권4호
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• pp.545-547
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• 2023

Staphylococcus epidermidis is a normal flora of human skin and is occasionally associated with pathogenic infections. We report the complete genome sequence of methicillin-resistant Staphylococcus epidermidis strain Z0118SE0272 isolated from the residential environment sharing by a companion dog and dwellers. Resistance to cefoxitin was observed in the strain, whereas it was susceptible to erythromycin, clindamycin, quinupristin-dalfopristin, trimethoprim-sulfamethoxazole, mupirocin, vancomycin, teicoplanin, linezolid, and tigecycline. The strain Z0118SE0272 identified as sequence type 130 possessed the mecA gene responsible for methicillin resistance, which composed the new type of staphylococcal cassette chromosome mec elements lacking mecRI.

• 한국식품위생안전성학회지
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• 제25권2호
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• pp.122-128
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• 2010

2009년 4월부터 12월까지 서울시 보건환경연구원 미생물 관리팀에 의뢰된 냉동식품 100건을 대상으로 일반세균수, 대장균군수, 대장균과 장구균의 오염도를 조사였으며, 분리된 장구균을 대상으로 하여 항생제 감수성 검사를 실시하였다. 일반세균수는 평균 검출량이 $4.3{\times}10^4CFU/g$ 이고 대장균군수는 평균 검출량이 $4.3{\times}10^3CFU/g$ 이고 대장균은 100건 모두에서 불검출되어 0.0%의 검출률을 보였다. 100건의 검체 중 총 22건에서 장구균이 분리되었으며 이 가운데 12주는 E. faecium, 7주는 E. faecalis, 2주는 E. gallinarum, 1주는 E. hirae이었다. 분리균주의 항생제 내성률을 검사 한 결과, 내성을 나타내는 항생제들은 erythroycin, rifampin, teracycline ciprofloxacin, chlorampenicol, penicillin이며, vancomycin, ampicillin, gentamicin, strepomycin, linezolid에 대해서는 모두 감수성이었다. 또 22건의 분리 균주 중에서 2종 이상의 항생제에 다제 내성을 나타낸 균주가 15주나 되며 가장 많은 형태로는 6균주의 장구균에서 나타난 E-RA에 대한 것이었다.

• Journal of Microbiology and Biotechnology
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• 제20권3호
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• pp.637-642
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• 2010

We investigated the prevalence and the molecular characteristics of vancomycin-intermediate Staphylococcus aureus (VISA) among methicillin-resistant Staphylococcus aureus (MRSA) strains isolated from clinical samples at tertiary or general hospitals participating in a nationwide surveillance program for VISA and vancomycin-resistant Staphylococcus aureus (VRSA) in Korea during an 8-week period in each year from 2001 to 2006. Of 41,639 MRSAs isolated, 37,856 were screened and 169 grew on brain heart infusion agar supplemented with 4 ${\mu}g/ml$ vancomycin. A vancomycin MIC of 4 ${\mu}g/ml$ was confirmed for 33 VISA isolates of the 169 isolates. Eighteen of the 33 isolates were classified as hetero-VISA (hVISA) by the population analysis profile (PAP) method. All VISA isolates were susceptible to linezolid, tigecycline, and quinupristin-dalfopristin. Most VISA isolates (MIC 4 ${\mu}g/ml$) showed a PFGE C pattern with sec, seg, and sei enterotoxin genes, including ST5-SCCmec type II, or a PFGE A pattern with sea, including ST239-SCCmec type III.

• Journal of Microbiology and Biotechnology
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• 제32권12호
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• pp.1537-1546
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• 2022

Staphylococcus aureus is a cause of high mortality in humans and therefore it is necessary to prevent its transmission and reduce infections. Our goals in this research were to investigate the frequency of methicillin-resistant S. aureus (MRSA) in Taif, Saudi Arabia, and assess the relationship between the phenotypic antimicrobial sensitivity patterns and the genes responsible for resistance. In addition, we examined the antimicrobial efficiency and application of silver nanoparticles (AgNPs) against MRSA isolates. Seventy-two nasal swabs were taken from patients; MRSA was cultivated on Mannitol Salt Agar supplemented with methicillin, and 16S rRNA sequencing was conducted in addition to morphological and biochemical identification. Specific resistance genes such as ermAC, aacA-aphD, tetKM, vatABC and mecA were PCR-amplified and resistance plasmids were also investigated. The MRSA incidence was ~49 % among the 72 S. aureus isolates and all MRSA strains were resistant to oxacillin, penicillin, and cefoxitin. However, vancomycin, linezolid, teicoplanin, mupirocin, and rifampicin were effective against 100% of MRSA strains. About 61% of MRSA strains exhibited multidrug resistance and were resistant to 3-12 antimicrobial medications (MDR). Methicillin resistance gene mecA was presented in all MDR-MRSA strains. Most MDR-MRSA contained a plasmid of > 10 kb. To overcome bacterial resistance, AgNPs were applied and displayed high antimicrobial activity and synergistic effect with penicillin. Our findings may help establish programs to control bacterial spread in communities as AgNPs appeared to exert a synergistic effect with penicillin to control bacterial resistance.

• Pediatric Infection and Vaccine
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• 제16권1호
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• pp.1-5
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• 2009

Methicillin-resistant Staphylococcus aureus (MRSA), a leading cause of nosocomial infections, has been increasingly recognized in communities of the United States. This article will review the clinical spectrum and treatment of MRSA infections in children in the context of recent epidemiological changes of MRSA infections. In general, community-associated (CA) MRSA most frequently causes skin and soft tissue infections and has an increased association with invasive infections, particularly pneumonia and musculoskeletal infections. Hospital-associated (HA) MRSA strains tend to be associated with bloodstream infections, pneumonia, and surgical site infections. Different from the United States, CA-MRSA infections are not common in Korea (only 5.9%); however, there are some CA-MRSA clones that are different from HA-MRSA clones in Korea and from CA-MRSA clones in other countries. The treatment of MRSA infections should be guided by antimicrobial susceptibility testing, the site of infection, and the infection severity. Vancomycin is the treatment of choice for invasive MRSA infections. Other agents such as trimethoprim-sulfamethoxazole, clindamycin, linezolid, quinupristin-dalfopristin, and daptomycin have been used for some conditions.

• 대한의생명과학회지
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• 제30권1호
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• pp.32-35
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• 2024

In vitro antimicrobial activities of hot water extracts of Chamaecyparis obtuse, for methicillin-resistant Staphylococcus aureus (MRSA) was compared to commonly used conventional antimicrobial agents. All MRSA was susceptible to linezolid or vancomycin, but also to erythromycin. MIC range and MIC₉₀ to erythromycin, clindamycin, levofloxacin, tetracycline for MRSA were each 4 ㎍/mL, 2 ~ >128 ㎍/mL, ≤0.06 ~ >128 ㎍/mL, 0.25 ~ >128 ㎍/mL, 0.25~64 ㎍/mL and 4 ㎍/mL, .128 ㎍/mL, >128 ㎍/mL, >128 ㎍/mL, 64 ㎍/mL. The hot water extracts of leaf of C. obtuse had the lowest MIC range, MIC₅₀, and MIC₉₀ (0.125 µL/mL) for the MRSA tested, and it was possible more potent than various conventional antimicrobial agents. Screen antibacterial drug candidate with high antibacterial activity such as derivatives of C. obtuse leaf extract such as terpinen-4-ol or using combined therapy with commercialized antibacterial agents will likely be helpful in treating refractory MRSA infections.

• Journal of Yeungnam Medical Science
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• 제37권4호
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• pp.277-285
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• 2020

Tuberculosis (TB) is still a major health problem worldwide. Especially, multidrug-resistant TB (MDR-TB), which is defined as TB that shows resistance to both isoniazid and rifampicin, is a barrier in the treatment of TB. Globally, approximately 3.4% of new TB patients and 20% of the patients with a history of previous treatment for TB were diagnosed with MDR-TB. The treatment of MDR-TB requires medications for a long duration (up to 20-24 months) with less effective and toxic second-line drugs and has unfavorable outcomes. However, treatment outcomes are expected to improve due to the introduction of a new agent (bedaquiline), repurposed drugs (linezolid, clofazimine, and cycloserine), and technological advancement in rapid drug sensitivity testing. The World Health Organization (WHO) released a rapid communication in 2018, followed by consolidated guidelines for the treatment of MDR-TB in 2019 based on clinical trials and an individual patient data meta-analysis. In these guidelines, the WHO suggested reclassification of second-line anti-TB drugs and recommended oral treatment regimens that included the new and repurposed agents. The aims of this article are to review the treatment strategies of MDR-TB based on the 2019 WHO guidelines regarding the management of MDR-TB and the diagnostic techniques for detecting resistance, including phenotypic and molecular drug sensitivity tests.

• Tuberculosis and Respiratory Diseases
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• 제77권4호
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• pp.161-166
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• 2014

Since tuberculosis (TB) remains a major global health concern and the incidence of multi-drug resistant (MDR)-TB is increasing globally, new modalities for the detection of TB and drug resistant TB are needed to improve TB control. The Xpert MTB/RIF test can be a valuable new tool for early detection of TB and rifampicin resistance, with a high sensitivity and specificity. Late-generation fluoroquinolones, levofloxacin, and moxifloxacin, which are the principal drugs for the treatment of MDR-TB, show equally high efficacy and safety. Systemic steroids may reduce the overall TB mortality attributable to all forms of TB across all organ systems, although inhaled corticosteroids can increase the risk of TB development. Although fixed dose combinations were expected to reduce the risk of drug resistance and increase drug compliance, a recent meta-analysis found that they might actually increase the risk of relapse and treatment failure. Regarding treatment duration, patients with cavitation and culture positivity at 2 months of TB treatment may require more than 6 months of standard treatment. New anti-TB drugs, such as linezolid, bedaquiline, and delamanid, could improve the outcomes in drug-resistant TB. Nontuberculous mycobacterial lung disease has typical clinical and immunological phenotypes. Mycobacterial genotyping may predict disease progression, and whole genome sequencing may reveal the transmission of Mycobacterium abscessus. In refractory Mycobacterium avium complex lung disease, a moxifloxacin-containing regimen was expected to improve the treatment outcome.