• Journal of Chest Surgery
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• 제42권1호
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• pp.1-8
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• 2009

배경: 패혈증에 동반된 급성호흡곤란증후군의 병태생리는 내독소에 의해 유발된 급성폐손상이다. 이 연구에서 우리는 내독소로 인해 유발된 급성 폐손상에서 moxifloxacin의 영향을 알아보고자 하였다. 대상 및 방법: 백서를 대조군(C), 내독소처리군(L), 내독소-moxifloxacin처리군(L-M)으로 나누었다. 대장균의 내독소를 기관 내 분무하여 급성폐손상을 유발하였고 L-M군에서는 내독소 분무 30분 후 moxifloxacin을 투여하였다. 내독소 투여 5시간 후 폐질량/체중비, 폐세척액 내의 단백함량, 폐세척액 내의 호중구 수, 폐장 내 myeloperoxidase (MPO) 활성도, 폐장 내 malondialdehyde (MDA) 함량을 측정하였고, 폐장 내 세포질형 $phospholipaseA_2$ ($cPLA_2$)와 분비형 $phospholipaseA_2$ ($sPLA_2$)의 발현을 관찰하고 광학현미경을 이용하여 형태학적인 분석을 시행하였다. 결과: 폐질량/체중비, 폐세척액 내의 단백함량, 폐세척액 내의 호중구 수, 폐장 내 myeloperoxidase (MPO) 활성도, 폐장 내 malondialdehyde (MDA) 함량은 L군에서 대조군 보다 유의하게 증가되어 있었고, L-M군은 L군보다 의미있게 낮은 것으로 나타났다. L군에서 $cPLA_2$와 $sPLA_2$의 발현은 증가되어 있었고 L-M군에서는 $cPLA_2$의 발현이 감소되어 있었다. 그러나 L-M군에서 $sPLA_2$의 발현은 L군과 차이가 없었다. 형태학적 분석으로 L군에서 많은 염증성 소견들을 관찰할 수 있었으나 L-M군에서는 관찰할 수 없었다. 결론: 내독소에 의해 유발된 급성폐손상의 많은 염증성 변화들이 moxifloxacin처리에 의해 소멸됨을 관찰할 수 있었다.

• 약학회지
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• 제55권1호
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• pp.22-31
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• 2011

This systematic review was conducted to assess the clinical effect of ocular fluoroquinolones used for the treatment of bacterial conjunctivitis. A literature search for randomized controlled clinical trials registered up to January 2010 based on PubMed database, using the following search terms: conjunctivitis and fluoroquinolones (besifloxacin, moxifloxacin, gatifloxacin, levofloxacin, lomefloxacin, ciprofloxacin and ofloxacin) were performed. Pooled data on the clinical resolution and bacterial eradication rates derived from selected 16 studies were reported as the relative risk (RR) and 95% confidence interval (95% CI) compared with placebo. Early clinical resolution and microbiological eradication rates in placebo were 28% and 62% respectively. Fluoroquinolones were significantly effective comparing to placebo: early RR 1.94 (95% CI 1.60~2.34) and late RR 1.30 (1.19~1.43) in clinical resolution rates, and early RR 1.75 (1.58~1.94) and late RR 1.28 (1.18~1.39) in microbiological eradication rates. Besifloxacin, ciprofloaxain and moxifloxacin in clinical resolution, and besifloxacin and levofloxacin in microbiological eradication showed higher RRs than pooled overall fluoroquinolones' RRs. New quinolones had higher antibacterial potencies for all pathogens isolated from bacterial conjunctivitis and resistant isolates than old generation quinolones. In conclusion, ocular 7 fluoroquinolones were all effective than placebo for bacterial conjunctivitis and there were differences between quinolones in early and late clinical resolutions and microbiological eradications, and no differences in safety comparing to placebo.

• 생명과학회지
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• 제20권10호
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• pp.1544-1548
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• 2010

본 연구에서는 QRDRs의 유전자 돌연변이와 목시플로사신의 농도와의 관계를 알아보기 위하여 목시플로사신의 농도를 단계적으로 높여가며 Mycoplasma hominis (M. hominis)에 작용시켜 목시플로사신에 내성을 갖는 균주 6주(M1, M4, M8, M16, M32, M64)를 만들었고, 이 돌연변이주들의 MIC는 각각 0.5, 4, 8, 16, 32, 64 ${\mu}g$/ml이었다. 이 균들의 염기서열을 분석하였더니 모든 돌연변이주들에서 Arg163Thr (GyrA), Pro445Gln (ParE) 아미노산 치환이 관찰 되었고, 목시플로사신의 농도가 높아질수록 Ser153Lys (GyrA, ${\geq}4{\mu}g$/ml), Ser91Ile (ParC, ${\geq}16{\mu}g/ml$), Val450Phe (GyrB, ${\geq}64{\mu}g/ml$) 등과 같은 아미노산의 치환이 추가로 관찰되었다. 이러한 아미노산의 치환이 목시플로사신의 내성과 연관이 있는 것으로 생각되며, 특히 GyrB 단백질의 아미노산 치환은 목시플로사신의 고도 내성과 연관이 있는 것으로 생각된다.

• 생명과학회지
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• 제16권5호
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• pp.799-805
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• 2006

호흡기 질환 환자로부터 분리된 M. pneumoniae 123 균주를 tetracycline에 저항성인 tetM 유전자만을 가진 36균주, erythromycin에만 저항성 변이를 일으킨 39균주, tetracycline과erythromycin에 저항성인 21균주, erythromycin과 tetracycline에 감수성인 27균주로 나누어 quinolone 제제와 macrolides계 항생제에 대한 감수성 검사를 시험관 희석법으로 실시하여 다음과 같은 결론을 얻었다. Tetracycline에만 저항성인 M. pneumoniae 36균주의 moxifloxacin, levofloxacin, sparfloxacin, ofloxacin, ciprofloxacin, amikacin, clarithromycin에 대한 $MIC_{90}$은 각각 0.125, 0.39, 0.125, 1.0, 1.0, 15.6과 $1.56\;{\mu}g/ml$ 이었다. Erythromycin에만 저항성인 39균주의 $MIC_{90}$은 각각 0.06, 0.39, 0.125, 1.0, 1.0, 15.6과 $25.0\;{\mu}g/ml$ 이었다. Tetracycline과 erythromycin에 모두 저항성인 21 균주의 $MIC_{90}$은 각각 0.125, 0.39, 0.125, 1.0, 1.0, 3.9,과 $1.56\;{\mu}g/ml$ 이었다. Tetracycline과 erythromycin에 모두 감수성인 27 균주의 $MIC_{90}$은 각각 0.125, 0.39, 0.125, 1.0, 1.0, 7.8과 $0.09\;{\mu}g/ml$ 이었다. 이상의 결과로 moxifloxacin, levofloxacin, sparfloxacin 과 같은 quinolone 계 항생물질은 tetracycline이나 erythromycin에 단독 혹은 모두에 저항성인 M. pneumoniae 균주에도 감수성이었으므로 이들 균에 의한 감염증의 치료에 이용할 수 있는 약제이었으나, ofloxacin, ciprofloxacin, clarithromycin 등의 약제 선택에는 항생물질에 대한 감수성검사를 실시하여 적절한 항생제를 선택하는 등의 각별한 주의가 요망된다.

• 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.

• 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.

• 대한임상검사과학회지
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• 제56권2호
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• pp.115-124
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• 2024

플루오로퀴놀론(fluoroquinolone, FQ) 항균제 내성을 갖는 황색포도알균(Staphylococcus aureus)의 출현 및 확산으로 감염증 치료에 어려움을 겪고 있다. 이 퀴놀론 내성 황색포도알균(quinolone resistant S. aureus, QRSA) 에 대한 분자역학적 특성을 조사하여 치료에 도움을 주는 자료를 만들고자하였다. 대전광역시 소재 1개 종합병원에서 혈액배양 검체에서 분리된 QRSA 균주를 대상으로 mecA와 SCCmec 유전자형 분석에 따른, gyrA, gyrB 유전자의 돌연변이를 조사하였다. Ciprofloxacin 내성균주는 SCCmec typing에서 II형이 44개로 73%, IVa형이 5개로 8%, III와 V형이 1개로 2%, nontypeable 균주가 11개로 18%, levofloxacin, moxifloxacin은 II형이 44개로 73%, IVa형이 5개로 8%, III와 V형이 1개로 2%, non typeable 균주가 10개로 17%의 결과를 보였다. gyrA와 gyrB 영역 모두에서 58개로 96.7%, levofloxacin은 56개로 93.3%, moxifloxacin에는 57개로 95%를 나타냈다. QRSA 균주에 대한 gyrA와 gyrB의 돌연변이는 각각 6개씩 12개의 돌연변이가 확인되었다. 연구 대상 QRSA의 FQ 항균제의 내성률은 약 98%를 나타냈고, QRSA 균주에 대한 gyrA와 gyrB의 돌연변이는 각각 6개씩 12개의 돌연변이가 확인되었다.

• Archives of Plastic Surgery
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• 제41권6호
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• pp.759-767
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• 2014

Background Infection caused by nontuberculous mycobacteria (NTM) has been increasing. Awareness of this infection is crucial yet problematic. Delayed management may lead to destructive results. We empirically treated a series of patients with clinical suspicion of NTM infection prior to the identification of the pathogen. Methods A total of 12 patients who developed surgical site infections between January 2011 and February 2014 were reviewed. Patients with a skin and subcutaneous infection resistant to standard management over two weeks, and previous history of aesthetic procedures within three months were regarded as highly suspected of having an NTM infection. A variety of diagnostic modalities were examined simultaneously, along with starting empirical treatment including a combination of clarithromycin and moxifloxacin, and surgical debridement. Results All wounds healed completely within 4 weeks. The mean follow-up duration was 7.2 months, and none of the patients developed relapse. Specific NTM pathogens were identified in six patients. Eight patients showed caseating granuloma implying an NTM infection. One patient showed an uncommon Stenotrophomonas infection, which was successfully treated. Three patients had no evidence of a pathogen despite repeated microbial tests. Complications such as scarring, pigmentation, and disfigurement were common in all the patients. Conclusions NTM should be considered in the differential diagnosis of an unusual skin and soft-tissue infection. We propose an empirical regimen of clarithromycin and moxifloxacin as an efficient treatment option for an NTM infection.

• Tuberculosis and Respiratory Diseases
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• 제78권2호
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• pp.78-84
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• 2015

Background: Reports of therapeutic drug monitoring (TDM) for second-line medications to treat multidrug-resistant tuberculosis (MDR-TB) remain limited. Methods: A retrospective cohort from the Virginia state tuberculosis (TB) registry, 2009-2014, was analyzed for TDM usage in MDR-TB. Drug concentrations, measured at time of estimated peak ($C_{max}$), were compared to expected ranges. Results: Of 10 patients with MDR-TB, 8 (80%) had TDM for at least one drug (maximum 6 drugs). Second-line drugs tested were cycloserine in seven patients (mean $C_{2hr}$, $16.6{\pm}10.2{\mu}g/mL$; 4 [57%] below expected range); moxifloxacin in five (mean $C_{2hr}$, $3.2{\pm}1.5{\mu}g/mL$; 1 [20%] below); capreomycin in five (mean $C_{2hr}$, $21.5{\pm}14.0{\mu}g/mL$; 3 [60%] below); para-aminosalicylic acid in five (mean $C_{6hr}$, $65.0{\pm}29.1{\mu}g/mL$; all within or above); linezolid in three (mean $C_{2hr}$, $11.4{\pm}4.1{\mu}g/mL$, 1 [33%] below); amikacin in two (mean $C_{2hr}$, $35.3{\pm}3.7{\mu}g/mL$; 1 [50%] below); ethionamide in one ($C_{2hr}$, $1.49{\mu}g/mL$, within expected). Two patients died: a 38-year-old woman with human immunodeficiency virus/acquired immune deficiency syndrome and TB meningitis without TDM, and a 76-year-old man with fluoroquinolone-resistant (pre-extensively drug-resistant) pulmonary TB and low linezolid and capreomycin concentrations. Conclusion: Individual pharmacokinetic variability was common. A more standardized approach to TDM for MDR-TB may limit over-testing and maximize therapeutic gain.

• 한국축산식품학회지
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• 제38권4호
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• pp.759-767
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• 2018

The concern about the possibility of food can be a vehicle for the transmission of Clostridium difficile to humans has been raised recently due to the similarities among the strains isolated from patients, foods and food animals. In this study, therefore, the prevalence of C. difficile was investigated in beef and chicken meat products collected from 57 different butcher shops, markets and fast food restaurants in Sakarya province of Turkey. Two out of 101 samples (1.98%) was positive for C. difficile indicating a very low prevalence. The pathogen was isolated from an uncooked meatball sample and a cooked meat $d{\ddot{o}}ner$ sample, whereas not detected in chicken meat samples. The meatball isolate was resistant to vancomycin and tetracycline, while the cooked meat $d{\ddot{o}}ner$ isolate was resistant to vancomycin and metronidazole. Both isolates were sensitive to moxifloxacin and clindamycin. Toxins A and B were not detected. This study reveals the presence of C. difficile in further processed beef products in Turkey.