2006년부터 2010년까지 한 병원의 집중치료실에서 분리된 Imipenem 내성 Acinetobacter baumannii의 비율과 Carbapenem 계열 항균제 처방의 상관관계

홍성극,성문우,이도훈,김의종 대한진단검사의학회 2012 Laboratory Medicine Online Vol.2 No.4

Carbapenem resistance in Acinetobacter baumannii has increased rapidly worldwide. It is generally assumed that carbapenem prescription in a hospital has a significant impact on imipenem resistance in A. baumannii. However, there are few studies validating these assumptions with statistical data. We performed a surveillance study to investigate the relationship between carbapenem prescription trends and the imipenem resistance rate of A. baumannii in an ICU. Carbapenem prescription data in the WHO anatomical therapeutic chemical (ATC)/defined daily dose (DDD) format for the period from 2006 to 2010 were obtained from the hospital electronic pharmacy records. In the same period, microbiologic data for the ICU were extracted from the laboratory information system. Imipenem resistance rates of A. baumannii increased from 4.3% in 2006 to 83.8% in 2010 (P <0.05; r2=0.85). Carbapenem prescription had increased from 19.71 DDD per 1,000 inpatient-days in 2006 to 36.99 DDD per 1,000 inpatientdays in 2010 (P <0.05; r2=0.95). Carbapenem prescription rate correlated with the imipenem resistance rate in A. baumannii (P <0.05; R=0.9). The results of our study demonstrated a correlation between carbapenem prescription trends and imipenem resistance in A. baumannii. Carbapenem 내성 Acinetobacter baumannii가 전세계적으로증가하고 있다. Carbapenem 계열 항생제 사용의 증가가 imipenem 내성 A. baumannii의 증가에 영향을 미쳤을 것이라고 일반적으로 추정된다. 그러나 이에 대해서 통계적인 자료를 이용해서 밝힌연구는 거의 없다. 이에 본 연구에서는 2006년부터 2010년까지 경기도에 소재하는 한 병원에서 carbapenem 계열 항생제 처방량과집중치료실에서 동정된 imipenem 내성 A. baumannii 내성률의상관관계를 알아보았다. Carbapenem 계열 항생제 처방 자료들은병원 전산기록을 통해 2006년부터 2010년까지의 자료를 WHO ATC/DDD 단위로 얻었다. 같은 기간의 미생물검사 자료들은 미생물검사실 정보 시스템인 WHONET (WHO, Geneva, Switzerland)프로그램을 이용하여 얻었다. Imipenem 내성 A. baumannii의비율은 2006년에는 4.3%에서 2010년에는 83.8%로 증가하였다(P<0.05; r2 =0.85). 같은 기간 carbapenem 계열 항생제 처방은2006년에 19.71 DDD/1,000 inpatient-days에서 36.99 DDD/1,000inpatient-days로 증가하였다(P<0.05; r2 =0.95). Carbapenem 계열항생제 처방량의 증가와 imipenem 내성 A. baumannii의 증가는상관관계가 있었다(P<0.05; R=0.90). Carbapenem 계열 항생제처방의 증가와 imipenem 내성 A. baumannii의 증가 사이에 유의한 상관관계가 있음을 보여주었다.

다제내성세균에 대한 적극적 감염감시

홍성극,김택수,박경운,김재석,김의종 대한임상미생물학회 2013 Annals of clinical microbiology Vol.16 No.2

Infections and outbreaks of antimicrobial-resistant bacteria, such as methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococcus (VRE), have been increasing. Detection methods for antimicrobial-resistant bacteria have been changed from traditional culture methods to chromogenic media culture and molecular methods. Straintyping methods using various molecular technologies are essential tools for epidemiologic surveillance. Furthermore, outbreak detection, using syndromic surveillance as well as passive and active surveillance, has been applied. However, it is difficult to establish effective and robust guidelines and systems for using these various methods to control antimicrobial-resistant bacteria. Therefore, clinical microbiologists and policy makers must possess expertise in the control of antimicrobial resistant bacteria, discuss the issue sufficiently, and, finally, create a system to accomplish this control.

生長抑制 處理가 쉬나무의 줄기 및 뿌리 生長에 미치는 效果

洪性珏,金鍾天,金光鎬,李暻宰,辛承極 建國大學校附設農業資源開發硏究所 1987 農資源開發論集 Vol.12 No.-

The study aimed to investigate the effects of paclobutrazol (PP333), B-9, and girdling on the shoot and root growth of one to five year-old seedlings of Evodia daniellii, of which the seed oil has been developed as a potential fuel substitute for Diesel engine. PP333 was applied, 0.1 to 6ml per seedling depending on the age and the experiment, by soil applicat-ion with water or by xylem injection with methanol. 5000 ppm B-9 was sprayed to the leaves until fully wetted. The bark was girdled 2mm wide in 2 year old seedlings and 5mm wide in 5 year old seedlings, the results were discussed as follows: 1. The number and the longitudinal growth of internode were reduced by all the treat-ments among which the soil application of PP333 was most inhibitory. 2. The diameter growth of the internode was not affected greatly or inhibited, but less severely inhibited than the longitudinal growth by the treatments. The ratio of the diameter to length of the internode which is a good indication of degree of dwarfism was increased by all the treatments, especially high by the soil application of PP333. 3. The xylem growth of the internode was inhibited more greatly than the bark growth by all the treatments among which the soil application of PP333 was most inhibitory. 4. The leaf growth was not affected, or slighly reduced by the treatments. The reduction in the leaf growth, if any, was not proportional to the reduction in the longitudinal growth of the corresponding internode. 5. The prolonged effect of all the treatments was shown in the following year growth: the growth reduction in number and length of internode, xylem diameter, ratio of xylem to bark area in the cross section of internode, which was most apparent in the treatment of PP333 soil application among treatments. 6. The soil application of PP333 reduced the seedling height, the number and the length of internodes, the dry weight and the dry weight ratio of shoot to root of one year-old seedlings. It also reduced the number and the length of internodes in 1 year-old grafted seedlings onto the 3 year-old root stock. The inhibitory effects of PP333 on the growth of the grafted see-dling was presumed as related to the possible disturbance of the source-sink relationship bet-ween the scion shoot and the root stock, in which sufficient nutrients and growth hormones could be supplied to the new shoot growth, if not applied PP333. The presumption was not inconsistent with the results that PP333 decreased the shoot-root ratio, and the xylem to bark area ratio in the cross section of the internode,of which both morphological changes imply the relatively more downward movement of nutrients and growth hormones in the PP333 treated seedlings.

쉬나무 종실유의 디젤기관 대체연료 개발에 관한 연구 - Engine 성능 및 견인력을 중심으로 - ( Studies on Development of Fuel Substitute for Diesel Engine with Seed Oil of Evodia Daniellii )

최규홍,홍성각,이여하,이승기,신승극 한국산림바이오에너지학회 1987 산림바이오에너지 Vol.7 No.1

비정형 향정신병약물을 투여 중인 정신분열병 환자의 주관적 삶의 질 : 정신병리, 약물 부작용 및 약물에 대한 주관적 반응과의 관련성

김종훈,윤정희,이자영,노경희,홍성극,윤세창,강웅구,김용식 大韓神經精神醫學會 2003 신경정신의학 Vol.42 No.2

Objectives : The purpose of this study was to evaluate the characteristics of psychopathology, adverse drug effects, and Subjective response to drugs that have a significant impact on the subjective quality of life in schizophrenic patients receiving atypical antipsychotics. Methods : One hundred and one schizophrenic patients, who were receiving maintenance treatment with atypical antipsychotics, were evaluated. Subjective quality of life was assessed using the standardized Korean modification of a self-rating scale to measure subjective well-being under neuroleptics (KmSWN). Patients' psychopathology was evaluated using the Positive and Negative Syndrome Scale. Adverse effects and subjective response to drug were evaluated using the Liverpool University Neuroleptic Side Effect Rating Scale and the Drug Attitude Inventory-10, respectively. Correlation analysis and stepwise multiple regression analysis were conducted. Results : In psychopathology, the severity of depression and anxiety showed the most significant correlation with the score ofKmSWN. In adverse drug effects, the severity of psychic side effect and extrapyramidal side effect showed the most significant correlation with the score ofKmSWN. Regarding subjective response to drug, significant correlation was observed between the severity of subjective negative response and the score of KmSWN. Stepwise multiple regression analysis revealed that psychic side effect, extrapyramidal side effect, and depression contributed significantly to the total score of KmSWN. These variables accounted for 59.7% of the total variance. Conclusion : The results of the present study suggest that psychic side effect, extrapyramidal side effect and depressive symptom are the clinical characteristics that are significantly associated with the subjective quality of life. An effective management strategy for these variables should be established in developing a treatment program to enhance the quality of life of patients with schizophrenia.

비정형 항정신병약물을 투여 중인 정신분열병 환자의 주관적 삶의 질 : 정신병리, 약물 부작용 및 약물에 대한 주관적 반응과의 관련성

김종훈,윤정희,이자영,노경희,홍성극,윤세창,강웅구,김용식 대한신경정신의학회 2003 신경정신의학 Vol.42 No.2

Objectives :The purpose of this study was to evaluate the characteristics of psychopathology, adverse drug effects, and subjective response to drugs that have a significant impact on the subjective quality of life in schizophrenic patients receiving atypical antipsychotics.

비정형 항정신병약물을 투여 중인 정신분열병 환자의 주관적 삶의 질: 정신병리, 약물 부작용 및 약물에 대한 주관적 반응과의 관련성

김종훈,윤정희,이자영,노경희,홍성극,윤세창,강웅구,김용식 대한신경정신의학회 2003 신경정신의학 Vol.42 No.2

Objectives:The purpose of this study was to evaluate the characteristics of psychopathology, adverse drug effects, and subjective response to drugs that have a significant impact on the subjective quality of life in schizophrenic patients receiving atypical antipsychotics. Methods:One hundred and one schizophrenic patients, who were receiving maintenance treatment with atypical antipsychotics, were evaluated. Subjective quality of life was assessed using the standardized Korean modification of a self-rating scale to measure subjective well-being under neuroleptics (KmSWN). Patients’ psychopathology was evaluated using the Positive and Negative Syndrome Scale. Adverse effects and subjective response to drug were evaluated using the Liverpool University Neuroleptic Side Effect Rating Scale and the Drug Attitude Inventory-10, respectively. Correlation analysis and stepwise multiple regression analysis were conducted. Results:In psychopathology, the severity of depression and anxiety showed the most significant correlation with the score of KmSWN. In adverse drug effects, the severity of psychic side effect and extrapyramidal side effect showed the most significant correlation with the score of KmSWN. Regarding subjective response to drug, significant correlation was observed between the severity of subjective negative response and the score of KmSWN. Stepwise multiple regression analysis revealed that psychic side effect, extrapyramidal side effect, and depression contributed significantly to the total score of KmSWN. These variables accounted for 59.7% of the total variance. Conclusion:The results of the present study suggest that psychic side effect, extrapyramidal side effect and depressive symptom are the clinical characteristics that are significantly associated with the subjective quality of life. An effective management strategy for these variables should be established in developing a treatment program to enhance the quality of life of patients with schizophrenia.