• Pediatric Infection and Vaccine
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• v.16 no.1
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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.

• Kosin Medical Journal
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• v.33 no.3
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• pp.422-430
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• 2018

Leuconostoc species are Gram-positive coccobacilli and are used in dairy products and are intrinsically resistant to vancomycin. Leuconostoc infections are rare in humans, usually occurring in immune-compromised patients. We describe 6 patients with Leuconostoc bacteremia at Dong-A university hospital between 1990 and 2015. One isolate (L. lactis) was identified to species level using 16S rRNA gene sequencing analysis. All patients had underlying diseases and 5 patients underwent procedures that interrupted the normal integumentary defense. Four patients died within 30 days after being identified as carrying Leuconostoc species.

• Restorative Dentistry and Endodontics
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• v.32 no.2
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• pp.102-110
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• 2007

The purpose of this study was to obtain the basic information for the improvement of dental environment by investigating the presence of methicillin- or vancomycin-resistant Staphylococcus aureus (MRSA or VRSA) isolated from dental health care workers (DHCWs) and environment of the Chosun University Dental Hospital (CUDH) and a private dental clinic (control group). Staphylococcus aureus (S. aureus) was isolated from anterior nares of 42 DHCWS and 38 sites, unit chairss, x-ray devices, computers, etc., at 10 departments of the CUDH and 20 DHCWs and 11 sites at the private dental clinic. S. aureus was isolated on mannitol salt agar plate and confirmed by PCR with S. aureus species-specific primer. Antimicrobial susceptibility test of clinical isolates of S. aureus against several antibiotics including methicillin (oxacillin) was performed by investigating minimum inhibitory concentration (MIC) using broth microdilution assay. In addition, PCR was performed to detect the methicillin- or vancomycin-resistant gene. The data showed that one strain of S. aureus was isolated from DHCWs of the CUDH and three strains of S. aureus was isolated from 3 samples of the private dental clinic, respectively. All of the isolates from the CUDH and the private dental clinic had resistance to penicillin G, amoxicillin and vancomycin and susceptibility to oxacillin and ciprofloxacin. The S. aureus strains were already obtained the resistance to penicillin G and amoxicillin. These results suggest that two dental clinics were under relatively safe environment.

• Pediatric Infection and Vaccine
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• v.8 no.2
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• pp.199-205
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• 2001

Purpose : Since the first report of vancomycin-resistant enterococci(VRE) in 1986, the resistance to vancomycin in enterococci has been increasingly rapidly. In this study, we investigated the clinical manifestations of pediatric patients with VRE and the pattern of the antibiotic use with increasing the rate of VRE in pediatrics Methods : We studied retrospectively 36 pediatric patients who were isolated VRE from January 1998 to December 2000. We classified patients into ICU and non ICU groups and reviewed species of VRE, specimens in which VRE were first detected and procedures performed before VRE detected. Results : We have found that the number of pediatric patients isolated VRE is increasingly annually in this study. In addition, the number of VRE-isolation in the ICU group and in patients who were operated or who underwent active procedures is much higher than that of in the non ICU group and in patients who were taken medication only. Enterococcus faecium is the main species of VRE. VRE showed high resistance to almost all antibiotics except tetracycline, and resistance was closely related to the duration of hospitalization and history of the antibiotic use. The proportion of the cephalosporin use was higher than any other antibiotic before VRE detection. In contrast, that of teicoplanin was higher than any other antibiotic after VRE detection(P<0.05). The cases of superinfection is higher in the ICU group than in non ICU group. Conclusion : In the hospital level, prevention of nosocomial infection through proper administrative policies, through surveillance of high risk VRE regions and prudent antibiotic use can prevent VRE outbreaks and corresponding side effects.

• Journal of fish pathology
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• v.26 no.3
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• pp.289-294
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• 2013

Enterococcus faecium was isolated from the internal organs of the rough-toothed dolphine, Steno bredanensis which was stranded at Jeju island. E. faecium were isolated from the liver, spleen, kidney, heart and lung up to $1.54{\times}10^6$ cfu/g. No significant differences of bacterial enzyme activities between E. faecium KCCM 12118 and the isolates were found. Biochemical constellation was the same or similar to that of E. faecium KCCM 12118 according to API20 strep. All isolates had the multi-drug resistance to 6 antibiotics by an agar disk diffusion method but these isolates didn't have resistance to chloramphenicol and vancomycin.

• The Korean Journal of Pain
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• v.36 no.1
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• pp.11-50
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• 2023

As the field of interventional pain management (IPM) grows, the risk of surgical site infections (SSIs) is increasing. SSI is defined as an infection of the incision or organ/space that occurs within one month after operation or three months after implantation. It is also common to find patients with suspected infection in an outpatient clinic. The most frequent IPM procedures are performed in the spine. Even though primary pyogenic spondylodiscitis via hematogenous spread is the most common type among spinal infections, secondary spinal infections from direct inoculation should be monitored after IPM procedures. Various preventive guidelines for SSI have been published. Cefazolin, followed by vancomycin, is the most commonly used surgical antibiotic prophylaxis in IPM. Diagnosis of SSI is confirmed by purulent discharge, isolation of causative organisms, pain/tenderness, swelling, redness, or heat, or diagnosis by a surgeon or attending physician. Inflammatory markers include traditional (C-reactive protein, erythrocyte sedimentation rate, and white blood cell count) and novel (procalcitonin, serum amyloid A, and presepsin) markers. Empirical antibiotic therapy is defined as the initial administration of antibiotics within at least 24 hours prior to the results of blood culture and antibiotic susceptibility testing. Definitive antibiotic therapy is initiated based on the above culture and testing. Combination antibiotic therapy for multidrug-resistant Gram-negative bacteria infections appears to be superior to monotherapy in mortality with the risk of increasing antibiotic resistance rates. The never-ending war between bacterial resistance and new antibiotics is continuing. This article reviews prevention, diagnosis, and treatment of infection in pain medicine.

• Pediatric Infection and Vaccine
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• v.7 no.2
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• pp.233-239
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• 2000

Purpose : A great deal of youngsters suffer from otitis media, for which antimicrobials are frequently prescribed. Increased antimicrobial resistance forces physicians to judiciously use antimicrobial agents in treating patients with acute otitis media. There have however been few references with regard to otitis media in Korean children, and authors proceeded investigation to look for the causative agents of otitis media in Korean children and their antimicrobial susceptibility. Methods : The study included 65 patients younger than 15 years old who had been cared at the department of pediatrics and otolaryngology in Hanyang University Hospital from July 1994 to June 1999, and diagnosed of otitis media with otorrhea which contained microorganisms isolated in otorrhea culture. The medical records were reviewed for demographic data, isolated organisms and their antimicrobial susceptibility. Results : Among 65 patients, 37(57%) were boys and 28(43%) girls. Distribution of the patients was reciprocal to the age of the patients; 27 patients(41.5%) were younger than 1 year old, 24(36.9%) were 1 to 3 years old with the average of 2.9 years of age. Staphylococus aureus was isolated in 32 patients(49.2%), Streptococcus pneumoniae in 19 patients(29.2%) Haemophilus influenzae in 9 patients(13.8%), Streptococcus oralis in 3 patients(4.6%), Moraxella catarrhalis in 1 patient(1.5%). The isolated microorganisms were not different whether patients had cleft lip/palate or not. The antibiotic resistance rates of S. aureus were ${\geq}90%$ to erythromycin, imipenem, cephalothin, and clindamycin, 86.2% to oxacillin, 25% to chloramphenicol, 12.5% to trimethoprim/sulfamethoxazole(TMP/SMX), and 0% to vancomycin and teicoplanin. The antibiotic resistance rates of S. pneumoniae were 71.4% to penicillin and greater than 60% to erythromycin, tetracycline, TMP/SMX, 7.1% to chloramphenicol, and 0% to vancomycin and teicoplanin. The antibiotic resistance rates of H. influenzae were 55% to ampicillin and TMP/SMX, and 0% to chloramphenicol, ceftriaxone, aztreonam, imipenem and ciprofloxacin. Conclusion : With otorrhea culture, the causative organisms of otitis media appear to be S. aureus, S. pneumoniae and H. influenzae. The high antibiotic resistance rates of the isolated organisms should affect the choice of antibiotics in treating patients with otitis media. Prospective investigations utilizing tympanocentesis in microbiologic studies are needed.

• Korean Journal of Microbiology
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• v.49 no.2
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• pp.126-130
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• 2013

The major aim of this study was to investigate the distribution of genes that encode multidrug efflux pumps in Enterococci spp. isolates from bovine milk samples and antibiotic resistance patterns of these strains. Of the 245 isolates, 44.1% showed ampicillin resistance, 79.2% showed erythromycin resistance, 76.3% showed tetracycline resistance and 36.3% showed chloramphenicol resistance. In case of vancomycin and ciprofloxacin, all of the isolates were susceptible to these antibiotics. Of the 245 enterococcal isolates, 82.1% have MFS type eme(A) gene, 72.7% have ABC type efr(A) gene, 77.1% have ABC type efr(B) gene, and 71.8% have ABC type lsa gene. In case of Enterococcus faecalis, the original strain for these genes, 92.5% have eme(A), 87.4% have efr(A), 88.4% have efr(B), and 88.4% have lsa. Interestingly, in case of different species of Enterococci, eme(A) was also detected in four strains of E. faecium, seven strains of E. avium, four strains of E. durans and two strains of E. raffinosus. efr(A) was also detected in two strains of E. faecium and two strains of E. durans and efr(B) was also detected in four strains of E. faecium, five strains of E. avium and four strains of E. durans. This means the possibility of co-transfer of resistance genes between Enterococci species in natural environment. These results are the first report describing the presence of same multidrug efflux pumps in different species of Enterococci in Korea.

• Korean Journal of Veterinary Service
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• v.33 no.3
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• pp.241-248
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• 2010

The present study was conducted to investigate isolation and antimicrobial resistance ratio of E. coli, E. faecium and E. faecalis from feces(l50 samples) and carcasses (150 samples) on slaughtered pigs from 6 slaughterhouse of 13 cities in the Gyeongnam during the period from January 2009 to December 2009. Isolation ratio of E. coli from feces and carcasses were 98 (65.3%) and 110(73.3%), respectively, and simultaneously, E. faecalis and E. faecium from feces and carcasses were isolated 21 (14%), 52(34.7%) and 18(12%), 14 (9.3%), respectively. All E. coli isolated from feces and carcasses except cefepime (0%) and ceftiofur (0%) were exhibited 2.4~83.6% of resistance to teteracycline (83.6%), ampicillin (68.2%), streptomycin (60%), chloram-phenicol (53.8%) and cephalothin (2.4%). All E. faecalis isolated from feces and carcasses except penicillin(0%) and vancomycin (0%) were exhibited 2.7~80.8% of resistance to teteracycline (80.8%), quinupristin/dalfopristin (78%), erythromycin (56.1%), streptomycin (43.8%) and bacitracin (2.7%). All E. faecium isolated from feces and carcasses except gentamicin (0%), vancomycin (0%), florfenicol (0%), linezloid (0%) and bacitracin (0%) were exhibited 3.1~53.1% of resistance to rifampin (53.1%), erythromycin and tetracycline (25%), penicillin (15.6%), ciprofloxacin (9.3%), and streptomycin, chloramphenicol, and quinupristin/dalfopristin (3.1%). According to the heard size, resistance ratio of E. coli strains isolated from feces and carcasses in slaughtered pigs-breeding farms over 1,500 heard to tetracycline, ampicillin, streptomycin and chloramphenicol showed higher resistance ratio (1.0~16.8%) than those of farms-breeding under 1,500 heard. From the our results, we suggest that a few of antimicrobials were used in the Gyeongnam than the other cities.

• Korean Journal of Ecology and Environment
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• v.46 no.3
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• pp.360-366
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• 2013

This study was it conducted on effluent or river water close to discharge locations from a treatment plant, which were analyzed for the presence, phenotype and antibiotic resistance rates of Vancomycin Resistant Enterococci (VRE). The test results for isolation and identification of Enterococcus spp. showed that they all were VRE positive, with a total of 32 strains detected. Multiplex PCR was conducted for 32 strains, each of which were identified as E. faecium, and the results indicated that they were all confirmed as VRE, corresponding to the Van A phenotype. The results of E. faecium concentrations measured at various locations indicated that they were, on average, higher at the location of sewage treatment plants. The frequency of positive tests as well as the number of colonies was higher downstream of treatment plants. The minimum inhibitory concentration was inspected for 26 strains of discharged water samples from sewage water treatment plants, and 6 strains of river samples. Out of 19 antibiotics, 14 and 5 species showed resistance and sensitivity, respectively.