• Advances in Traditional Medicine
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• v.3 no.3
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• pp.157-162
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• 2003

Various extracts of higher plants have been used in traditional medicine systems for centuries. While tropical and sub-tropical plants have received considerable attention from the researchers for evaluation of their bioactivity, temeperate plants have always been neglected somewhat. Similarly, seeds of the plants have not been considered seriously compared to other plant parts, e.g. leaves, stems, roots, flowers, etc. as a potential source for biologically active compounds. As part of our on-going evaluation of the extracts of the seeds of temperate plants, especially from Scotland, for biological activity, Achillea millefolium, Angelica sylvestris and Phleum pratense have been chosen for the present study. Both A. millefolium and A. sylvestris are well known for their traditional medicinal uses in Europe and also in the orient, but there is no report on any medicinal properties of P. pratense available to date. Extracts of the seeds of these plants have been assessed for their antioxidant and antibacterial potential and also for general toxicity. Both DCM and MeOH extracts of A. millefolium showed the most significant broad spectrum antibacterial activity among the three plants and inhibited the growth of almost all test strains of bacteria. The DCM extracts of all three species were active against methicillin resistant Staphylococcus aureus (MRSA) and Citrobacter freundii $(MIC=6.25{\times}10^{-1}\;mg/mL)$. While the MeOH extracts of A. millefolium and P. pratense were active against C. freundii, that of P. pratense was also active against MRSA. The MeOH extract of A. sylvestris did not show any antibacterial activity against any of the eight bacterial strains at test concentrations. The MeOH extract of P. pratense showed the most prominent antioxidant activity $(IC_{50}=145\;{\mu}g/ml)$ and there was no antioxidant activity observed with the DCM extract of A. millefolium. The DCM extract of P. pratense was the most toxic $(LC_{50}=20\;{\mu}g/ml)$ among the extracts.

• Korean Journal of Microbiology
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• v.47 no.4
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• pp.308-315
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• 2011

The purpose of this work was to examine the antimicrobial activity derived from the lactic acid bacterium, UK-3 isolated from the vaginas of women of childbearing age. Various physiological and biochemical properties of this strain were characterized. Both the BIOLOG system and phylogenetic analysis using 16S rRNA sequencing were utilized for identification, and the strain was designated as Lactobacillus plantarum UK-3, and registered in GenBank as [JK266589]. Growth rate, production of organic acids (e.g., lactic acid and acetic acid), and pH during growth were monitored. The maximum concentrations of lactic acid and acetic acid were approximately 684.11 mM and 174.26 mM, respectively, and pH changed from 7.0 to 3.7 after 72 h of incubation. High performance liquid chromatography was used to confirm lactic acid and acetic acid production. Significant antimicrobial activity of the concentrated supernatant was demonstrated against various Gram-positive (e.g., Staphylococcus aureus, Staphylococcus epidermidis, Methicillin-resistant Staphylococcus aureus, Enterococcus faecalis, Neisseria species., Listeria monocytogenes), Gram-negative bacteria (e.g., Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis), and yeast (e.g., Candida albicans) by the plate diffusion method. As a result, the concentrated L. plantarum UK-3 cultures had lower acidity and inhibited the growth of all microorganisms tested, whereas the growth of L. acidophilus was not affected.

• Journal of Korean Foot and Ankle Society
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• v.23 no.2
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• pp.58-66
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• 2019

Purpose: To evaluate the efficacy of antibiotic-loaded cement spacers (ALCSs) for the treatment of diabetic foot infections with osteomyelitis as a salvage procedure and to analyze the risk factors of treatment failure. Materials and Methods: This study reviewed retrospectively 39 cases of diabetic foot infections with osteomyelitis who underwent surgical treatment from 2009 to 2017. The mean age and follow-up period were $62{\pm}13years$ and $19.2{\pm}23.3months$, respectively. Wounds were graded using the Wagner and Strauss classification. X-ray, magnetic resonance imaging (or bone scan) and deep tissue cultures were taken preoperatively to diagnose osteomyelitis. The ankle-brachial index, toe-brachial index (TBI), and current perception threshold were checked. Lower extremity angiography was performed and if necessary, percutaneous transluminal angioplasty was conducted preoperatively. As a surgical treatment, meticulous debridement, bone curettage, and ALCS placement were employed in all cases. Between six and eight weeks after surgery, ALCS removal and autogenous iliac bone graft were performed. The treatment was considered successful if the wounds had healed completely within three months without signs of infection and no additional amputation within six months. Results: The treatment success rate was 82.1% (n=32); 12.8% (n=5) required additional amputation and 5.1% (n=2) showed delayed wound healing. Bacterial growth was confirmed in 82.1% (n=32) with methicillin-resistant Staphylococcus aureus being the most commonly identified strain (23.1%, n=9). The lesions were divided anatomically into four groups; the largest number was the toes: (1) toes (41.0%, n=16), (2) metatarsals (35.9%, n=14), (3) midfoot (5.1%, n=2), and (4) hindfoot (17.9%, n=7). A significant difference in the Strauss wound score and TBI was observed between the treatment success group and failure group. Conclusion: The insertion of ALCSs can be a useful treatment option in diabetic foot infections with osteomyelitis. Low scores in the Strauss classification and low TBI are risk factors of treatment failure.

• Journal of Life Science
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• v.29 no.2
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• pp.223-230
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• 2019

Ozone is a gaseous molecule able to kill microorganisms, such as yeast, fungi, bacteria, and protozoa. However, ozone gas is unstable and cannot be used easily. In order to utilize ozone properly and efficiently, plant oil can be employed. Ozone reacts with C-C double bonds of fatty acids, converting to ozonized oil. In this reaction, ozonide is produced within fatty acids and the resulting ozonized oil has various biological functions. In this study, we showed that ozonized oil has antimicrobial activity against fungi and bacteria. To test the antimicrobial activity of ozonized oil, we produced ozonized olive oil. Ozonized olive oil was applied to Staphylococcus aureus, methicillin-resistant Staphylococcus aureus (MRSA), Staphylococcus epidermidis, Pseudomonas aeruginosa, Escherichia coli, and Candida albicans. Antimicrobial activity was assayed using the disk diffusion method following the National Committee for Clinical Laboratory Standards. Minimal inhibitory concentrations (MIC) were 0.25 mg for S. aureus, 0.5 mg for S. epidermidis, 3.0 mg for P. aeruginosa, and 1.0 mg for E. coli. Gram positive bacteria were more susceptible than Gram negative bacteria. We compared growth inhibition zones against S. aureus and MRSA, showing that the ozonized olive oil was more effective on MRSA than S. aureus. Furthermore, the ozonized olive oil killed C. albicans within an hour. These data suggested that ozonized olive oil could be an alternative drug for MRSA infection and could be utilized as a potent antimicrobial and antifungal substance.

• Pediatric Infection and Vaccine
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• v.26 no.1
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• pp.42-50
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• 2019

Purpose: We investigated the clinical features and epidemiology of staphylococcal scalded skin syndrome (SSSS) from year 2006 to 2015 in Changwon city, Korea. Methods: We reviewed medical records of 69 patients diagnosed with SSSS from year 2006 to 2015. Antibiotic susceptibility testing was performed by agar dilution method. Methicillinresistant Staphylococcus aureus (MRSA) was phenotypically identified by oxacillin susceptibility testing and genotypically confirmed by the existence of the mecA gene. Results: The median age of patients was 2.0 years (range 0.2-6 years). Three (4.3%), 53 (76.8%), and 13 (18.9%) patients showed the generalized type, the intermediate type, and the abortive type, respectively. Patients occurred throughout the year, but most patients occurred between July and October. MRSA was isolated from 54 of the 60 patients regardless of the clinical types. All patients recovered without any complications. Conclusions: There was a constant occurrence of SSSS patients caused by MRSA in Changwon area during 2006 and 2015. It is needed to constantly monitor the occurrence of patients with SSSS.

• Pediatric Infection and Vaccine
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• v.31 no.1
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• pp.46-54
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• 2024

Purpose: This study aimed to identify the pathogens of bloodstream infection in children with underlying hemato-oncologic diseases, analyze susceptibility patterns, compare temporal trends with those of previous studies, and assess empirical antimicrobial therapy. Methods: Retrospective review study of children bacteremia in hemato-oncologic diseases was conducted at Seoul National University Bundang Hospital from January 2013 to July 2023. Results: Overall, 98 episodes of bacteremia were observed in 74 patients. Among pathogens isolated, 57.1% (n=56) were Gram-positive bacteria, 38.8% (n=38) were Gram-negative bacteria, and 4.1% (n=4) were Candida spp. The most common Gram-positive bacteria were coagulase-negative staphylococci (n=21, 21.4%) and Staphylococcus aureus, (n=14, 14.3%) whereas the most common Gram-negative bacteria were Klebsiella pneumoniae (n=16, 16.3%) and Escherichia coli (n=10, 10.2%). The susceptibility of Gram-positive bacteria to penicillin, oxacillin, and vancomycin was 11.5%, 32.7%, and 94.2%, respectively and the susceptibility of Gram-negative bacteria to cefotaxime, piperacillin/tazobactam, imipenem, gentamicin, and amikacin was 68.6%, 80%, 97.1%, 82.9%, and 91.4%, respectively. Methicillin-resistant S. aureus was detected in 1 strain and among Gram-negative strains, extended spectrum β-lactamase accounted for 28.9% (12/38). When analyzing the antibiotic susceptibility and empirical antibiotics, the mismatch rate was 25.5% (n=25). The mortality rate of children within 30 days of bacteremia was 7.1% (n=7). Conclusions: Empirical antibiotic therapy for bacteremia in children with hemato-oncologic diseases should be based on the local antibiogram in each institution and continuous monitoring is necessary.

• Tuberculosis and Respiratory Diseases
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• v.55 no.1
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• pp.59-68
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• 2003

Background : In intubated patients, cultures of endotracheal aspirates (EA) are apt to contamination throughout the endotracheal tube. Therefore, the identification of etiologic agents via conventional EA cultures is not always reliable. In order to differentiate a pulmonary infection from a non-infectious disease, and to identify the true etiologic agent of acute pulmonary infection, blinded protected specimen brushing (PSB) was used, and its efficacy evaluated. Methods : In 51 intubated patients, with suspected pneumonia, blind PSB were performed, and the results compared with blood and EA cultures. A protected specimen brush was introduced through the endotracheal tube, and settled at the affected large bronchus. A specimen brush was introduced to the expected region using the blind method. The tip of the brush was introduced with an aseptic technique after vigorously mixed for 1 minute in $1cm^3$ of Ringer's lactate solution. The specimens were submitted for quantitative culture within 15 minutes, with a culture being regarded as positive if the colony forming units were above $10^3/ml$. Results : Of the 51 patients, 15 (29.4%) had community-acquired pneumonia (CAP), 27 (52.9%) hospital-acquired pneumonia (HAP) and 9 (17.6%) non-infectious diseases. The sensitivity and specificity of the quantitative PSB culture for the diagnosis of pneumonia were 52.4 and 88.9%, respectively. The sensitivity and specificity of EA were 78.6 and 77.8%, respectively. The blind PSB was superior to the EA for the identification of true etiologic agents. Of 53 episodes of 27 HAP patients, MRSA (Methicillin-resistant staphylococcus aureus) (41.5%) was the most common causative agent followed by Pseudomonas aeruginosa (15.1%), Klebsiella sp. (7.5%) and Acinetobacter sp. (7.5%). Conclusions : As a simple, non-invasive diagnostic modality, the blind PSB is a useful method for the differentiation of a pulmonary infection from non-infectious diseases and to identify the etiologic agents in intubated patients. A blind PSB can be performed without bronchoscopy, so is safer, more convenient and cost-effectiveness for patients where bronchoscopy can not be performed.

• Clinical and Experimental Pediatrics
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• v.49 no.8
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• pp.882-888
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• 2006

Purpose : Bacteremia is one of the major concerns in the treatment of pediatric cancer patients. This study was to determine the etiologic agents and the pattern of antibiotic susceptibilities in a single tertiary medical center. Methods : We retrospectively reviewed the medical records of the cases of bacteremia in pediatric cancer patients from 1998 to 2005 in Keimyung University Dongsan Medical Center. Results : There were 62 cases of bacteremia from 44 patients. Gram-positive organisms(48.3%) were more common than gram-negative organisms(38.7%) or fungi(13%). Among gram-positive organisms, Staphylococcus epidermidis was the most common etiologic agent(63.3%), followed by Staphylococcus aureus(16.7%), ${\alpha}$-hemolytic Streptococcus(16.7%), and Streptococcus mitis(3.3%). Among gram-negative organisms, Alcaligenes xylosoxidans was the most common agent(41.7%) and the other organisms were Klebsiella pneumoniae(20.8%), Stenotrophomonas maltophilia(12.5%), Acinetobacter baumanii(8.2%), etc. In febrile neutropenic patients, however, K. pneumoniae was the most common cause of gram-negative bacteremia. All of the isolated K. pneumoniae in our center produced extended-spectrum beta-lactamase and were related with high mortality. S. aureus, S. epidermidis, and Streptococcus species were all susceptible to vancomycin and teicoplanin. Most staphylococci were resistant to penicillin and oxacillin. Most of the gram-negative organisms were susceptible to imipenem. Conclusion : Gram-positive organisms were more commonly isolated than gram-negative organisms in pediatric cancer patients like other studies. We could obtained valuable information on the choice of proper antibiotics in our institution. Further studies will be needed to explain the prevalence of A. xylosoxidans in our center.

• Tuberculosis and Respiratory Diseases
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• v.62 no.6
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• pp.506-515
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• 2007

Background: Nosocomial pneumonia in an intensive care unit (ICU) is associated with a high mortality rate. Diagnosing a respiratory tract infection in critically ill patients is still difficult but detailed information for the pathogens is needed to establish an adequate antimicrobial treatment. This study examined the causative organisms and their antimicrobial resistance using bronchoalveolar lavage (BAL) from patients suspected of having pneumonia in the ICU. Methods: From January 2004 to June 2006, ICU patients with diffuse lung infiltration were prospectively enrolled. The BAL was used to diagnose the respiratory infection, with 104 > or = organisms considered a positive result. The most common organisms and their antimicrobial resistances were analyzed from the quantitative BAL cultures in the burn ICU and non-burn ICU. Results: A total 72 patients were included, 35 (M 29, F 6) in the burn ICU and 37 (M 26, F 11) in the non-burn ICU. 27 patients (77.1%) in the burn ICU and 22 patients (59.5%) in the non-burn ICU met the criteria for a positive BAL culture. The major pathogens were Staphylococcus aureus, Acinetobacter species and Pseudomonas aeruginosa. All strains (100%) of Staphylococcus aureus isolated from BAL (9 cases) were methicillin-resistant (MRSA) in the burn ICU, but 5 strains (71.4%, 7 cases) were MRSA in the non-burn ICU. Regarding Pseudomonas aeruginosa, the rate of resistance to amikacin, ciprofloxacin, cefepime, imipenem, ceftazidime, piperacillin/tazobactam in the burn and non-burn ICU ranged from 45.5% to 90% and 25% to 50%, respectively. In addition, the rate of resistance of Acinetobacter species to the above drugs in the burn and non-burn ICU ranged from 81.8% to 100% and 62.5% to 100%, respectively. Conclusions: These results are expected to provide useful guidelines for choosing the effective empirical antimicrobial therapy in patients with lung infiltrations in the burn and non-burn ICU.

• Clinical and Experimental Pediatrics
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• v.53 no.4
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• pp.592-597
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• 2010

Hyperimmunoglobulin E syndrome (HIES) is a rare immunodeficiency disease which is characterized by high serum IgE levels, eczema, and recurrent infections. Herein we present the case of a patient with HIES associated with STAT3 gene ($stat3$) mutation. A 16 year-old girl was admitted to our hospital due to hemoptysis caused by pneumonia with bronchiectasis. She had a history of recurrent skin and respiratory tract infections, such as pneumonia caused by MRSA (methicillin-resistant $Staphylococcus$ $aureus$) and $Pseudomonas$ $aeruginosa$. On physical examination, a broad round shaped nose, oral thrush, and chronic eczematous skin rash over her whole body were found. Laboratory data showed an elevated eosinophil count ($750/{\mu}L$) and total IgE level (5,001 U/mL). The patient's National Institutes of Health (NIH) score for HIES was 44. Direct sequencing of the STAT3 gene revealed that the patient was heterozygous for a missense mutation in the DNA binding domain of the STAT3 protein (c.1144C>T, p. Arg382Trp). HIES should be suspected in patients with recurrent infections and can be confirmed by clinical scoring and genetic analysis.