국내 한 대학병원에서 수집된 Mupirocin 내성 포도알균의 내성 유전자 및 항생물질 감수성 분석

민유홍,이종서,권애란,심미자,최응칠,Min, Yu-Hong,Lee, Jong-Seo,Kwon, Ae-Ran,Shim, Mi-Ja,Choi, Eung-Chil 한국미생물학회 2012 미생물학회지 Vol.48 No.2

서울의 한 종합병원에서 포도알균 임상균주들을 2003, 2005, 2006 및 2009년에 각각 100, 195, 151 및 112주를 수집하여 mupirocin 내성율 변화 추이를 분석하였다. Staphylococcus aureus의 mupirocin에 대한 고도내성(최소억제농도 ${\geq}512{\mu}g/ml$) 빈도는 감소 추세로 2005년 이후에는 나타나지 않았다. 반면 S. aureus의 저도내성(최소억제농도 $8-256{\mu}g/ml$)은 2005년까지 나타나지 않았으나 2006년부터 나타나기 시작하여 2009년에는 6.9%에 이르렀다. Coagulase-negative staphylococci (CNS)의 전체적인 내성율은 S. aureus와 달리 상당히 높은 수준이었다. 2003년 CNS의 고도내성율은 16.0%이었으나 지속적으로 상승하여 2009년에는 31.5%에 이르렀다. CNS의 저도내성율은 2003년 8.0%이었고 이후 11% 정도의 일정 수준을 나타내었다. 모든 고도내성 균주들에서 ileS-2의 존재가 확인되었으며, 모든 저도내성 균주들에 대하여 ileS 유전자의 염기서열을 분석한 결과, 저도내성의 원인으로 알려진 V588F 변이가 공통적으로 발견되었다. 이외에도 S. aureus에서 V458G, 그리고 CNS에서 D172A, Y490H, I750V 변이들이 새로 발견되었다. Mupirocin 내성 균주들의 oxacillin 및 피부감염 치료에 사용되는 주요 외용 항생물질들에 대한 내성율을 측정한 결과, 고도내성인 S. aureus 1주는 이들 모든 항생물질에 내성이었고 저도내성인 S. aureus 10주는 fusidic acid를 제외한 모든 항생물질에 내성이었다. Mupirocin에 고도내성(61주) 및 저도내성(27주)인 CNS 균주들은 감수성인 CNS 균주들(167주)보다 이들 항생물질에 대하여 상당히 높은 내성율을 보였다. 따라서 포도알균에 의한 피부감염의 효과적인 치료를 위해선 mupirocin 내성 균주의 출현을 방지해야 한다. We analyzed mupirocin resistance rates among staphylococcal isolates collected from a Korean hospital in 2003 (100 isolates), 2005 (195 isolates), 2006 (151 isolates), and 2009 (112 isolates). In Staphylococcus aureus, rates of high-level mupirocin resistance (MIC, minimal inhibitory concentration ${\geq}512{\mu}g/ml$) decreased and did not appear since 2005. In contrast, low-level mupirocin resistance (MIC $8-256{\mu}g/ml$) was not detected in 2003 and 2005 but its rates later increased to 6.9% in 2009. Total resistance rates of coagulase-negative staphylococci (CNS) were significantly higher than those of S. aureus. The rates of high-level resistance of CNS increased from 16.0% in 2003 to 31.5% in 2009. The rate of low-level resistance of CNS was 8.0% in 2003 and around 11% later. In all high-level resistant isolates, the ileS-2 gene was detected. All low-level resistant isolates contained the known V588F mutation in ileS gene. Previously unknown mutations such as V458G in S. aureus and D172A, Y490H and I750V in CNS were identified additionally. One S. aureus isolate with high-level resistance was resistant to oxacillin and several topical antibiotics commonly used for the treatment of skin infection. Ten S. aureus isolates with low-level resistance were also resistant to all of these antibiotics except fusidic acid. CNS isolates with high-level (61 isolates) and low-level resistance (27 isolates) exhibited significantly higher resistance rates to these antibiotics than mupirocin-susceptible CNS isolates (167 isolates). In conclusion, prevention of the emergence of mupirocin resistance is necessary for the effective treatment of skin infection by staphylococci.

에센셜 오일 배합물의 Propionibacterium acnes에 대한 항균활성

민유홍 ( Yu Hong Min ) 대한미용학회 2015 대한미용학회지 Vol.11 No.3

In this study, the in vitro activity of 105 combinations of 15 essential oils against Propionibacterium acnes was assessed, with the aim of identifying essential oil blends that might exhibit synergistic or antagonistic effects. These 15 essential oils were chosen because they are used in aromatherapy for the treatment of acne. The mixtures of the essential oils at ratio of 1 : 1 were tested. In the disk diffusion test, the diameters of the inhibition zone increased for 57 combinations and decreased for 47 combinations when compared with the mean values of the inhibition zone diameters for individual oils. The diameter of the inhibition zone was not changed for the other one combination (grapefruitbergamot). The highest enhancing effect was detected for the palmarosa-rosemary combination (inhibition zone diameter increased by 105.7%). The highest levels of reduction of the inhibitory activity were seen in the peppermint-grapefruit and peppermint-lemon combinations (inhibition zone diameters decreased by 63.5% and 57.4%, respectively). In the checkerboard dilution test, the palmarosa-rosemary combination showed a partial synergistic effect, whereas the peppermint-grapefruit and peppermint-lemon combinations showed antagonisms. These data indicate variable degrees of interaction between antibacterial activities of essential oil blends against P. acnes.

과립구-단구 집락촉진인자가 급성백혈병 골수세포 장기배양에 미치는 영향 - 백혈병세포 생체외 골수정화법에의 적용가능성 검토 (1) -

민유홍 ( Min Yu Hong ),고윤웅 ( Go Yun Ung ),이선주 ( Lee Seon Ju ),한지숙 ( Han Ji Sug ) 대한내과학회 1993 대한내과학회지 Vol.44 No.3

Background : Significant changes in leukemic cell behaviour have been reported to occur during long-term cultures of bone marrow from patients with AML. Recent reports of intensive therapy and hematopoietic rescue with autologous marrow cells grown in the long-term bone marrow culture (LTBMC) system have aroused much attention. But its effectiveness ans a means to purging leukemic cells and expansion of regenerating normal hemopoietic series should be increased for better autotransplant outcomes. Granulocyte-macrophage colony-stimulating factor (GM-CSF) is crucial in the regulation of proliferation and maturation of normal hematopoietic progenitor cells. It also exerts profound stimulative effects on leukemic cells, and renders them more susceptible to purging agents. To evaluate the effects of GM-CSF on the LTBMC-mediated myelopoietic recoveries and purging of leukemic cells, we studied the effects of GM-CSF priming on long-term cultures of acute leukemic bone marrow cells. Methods : The mononuclear bone marrow cells of 22 patients with acute leukemia were incubated with 100ng/ml GM-CSF for 24 hours. After preincubation, the LTBMCs were started in 25 ㎠-culture flask in 10 ml culture medium supplemented with 12.5% fetal bovine serum and 12.5% horse serum at 37℃. Over a period of 4 weeks, the LTBMCs were demipopulated and replaced by fresh medium weekly. Adherent layers were examined in situ by inverted microscopy of flask bases during the course of the study. Nonadherent cells recovered after feeding were counted, and plated in clonogenic assays and differentail morphologic counts were performed on cytospin preparation. Adherent layer cells were obtained by detaching at the termination of cultures by incubation with collagenase. Results : We found GM-CSF predomination influenced initial increase in (a) the number of nonadherent cells, (b) the number of terminally differentiated granulocytes (band and segmented neutrophils), and (c) the number of nonadherent granulocyte-macrophage colony-forming units (CFU-GM) consisted of myeloid cells morphologically identical to normal control cultures considerably (p<0.05) in LTBMC before the establishment of a confluent adherent layer. And GM-CSF priming tended to decrease the number of nonadherent leukemic colony-forming units in 1-week-old LTBMC, which is not statistically significant. These effects were lost after 2 weeks of LTBMC. Conclusion : GM-CSF priming of leukemic cells prior to LTBMC may be more effective for purging leukemic cells and expanding myeloid recoveries than without GM-CSF, but its effects were restricted before the establishment of confluent adherent layers. Its transient effects suggest that GM-CSF may not be active on primitive hemopoietic stem cells responsible for LTBMC propagation. Alternatively, stromal cells may exert tight regulatory control over progenitor cells. Further analysis will be required to enhance recovery of normal myelopoiesis and to decrease survival of leukemic progenitor cells more effectively on the basis of combined use with different hemopoietic growth factors or with other various cytokines.

옻나무 수피부(Rhus verniciflua Stokes bark) 메탄올 추출물의 항균활성

민유홍 ( Yu Hong Min ),권애란 ( Ae Ran Kwon ),이은숙 ( Eun Sook Lee ) 한약응용학회 2013 한약응용학회지 Vol.13 No.1

Objectives:In this study, the in vitro antibacterial spectrum of methanol extract of Rhus verniciflua Stokes bark was determined. Antibacterial activities of the extract against clinical isolates of Staphylococcus aureus including methicillin-resistant S. aureus were also evaluated. Methods:Agar dilution method was used to determine minimum inhibitory concentration of the extract for standard strains of Gram-positive and Gram-negative bacteria and clinical isolates of S. aureus. Results:The extract showed activities against all standard strains tested in the minimum inhibitory concentration range 0.031-0.5 mg/ml for Gram-positive bacteria and 0.031-1 mg/ml for Gram-negative bacteria. Against methicillin-susceptible and-resistant S. aureus, the extract also showed good activity. Conclusions:Methanol extract of R. verniciflua Stokes bark had broad antibacterial spectrum and good activity against clinical isolates of methicillin-resistant S. aureus.

유전자재조합 과립구-단구 집락촉진인자(rhGM-CSF)에 의한 약물유도 무과립세포증 치험

민유홍 ( Min Yu Hong ),윤영섭 ( Yun Yeong Seob ),김철우 ( Kim Cheol U ),한지숙 ( Han Ji Sug ),이선주 ( Lee Seon Ju ),고윤웅 ( Go Yun Ung ) 대한내과학회 1993 대한내과학회지 Vol.44 No.4

A 43-year-old woman was admitted to the Department of Internal Medicine, Sevrance Hospital because of fever and sore throat, developed after receiving arylthiouracil, phenylephrine hydrochloride and chlorpheniramine maleate for rhinitis last 2 week. Physical examination revealed markedly enlarged, hyperemic tonsils with whitish exydates. The total blood leukocyte count was 800/mm³, with 100% lymphocytes. The hemoglobin was 9.5 g/dl, hematocrit 29.5% and platelet 224,000/mm³. A bone marrow examination revealed no myeloid cells, but erythroid and megakaryocytic series were normal. The cellularity was moderately decreased. Although the patient was treated with the appropriate broad-spectrum antibiotics, the patient was persistently and severly ill with granulocytes less than 50/mm³ continuously. On the fourth day of hospitalization, we decided to administer granulocyte-macrophage colony-stimulating factor (GM-CSF; Schering-Plough/Sandoz). Three days after the administration of 3 ㎍/kg GM-CSF daily subcutaneously, the leukocytes from 56/mm³ to 1,800/mm³. GM-CSF was given daily for 6 days, and it was discontinued when the leukocyte count reached 13,400/mm³ with neutrophil count of 11,390/mm³. Follow-up bone marrow examination revealed marked panmyeloid hyperplasia with left-shift and increased cellularity. After discontinuing treatment, granulocytes gradually returned to normal. The patient recorvered completely without any adverse effect during the treatment. We assume that the rapid recovery of granulocytes was attributable to GM-CSF, and we suggest that GM-CSF should be tried in patients with drug-induced agranulocytosis with depletion of myeloid precursors in the hypocellular bone marrow.

급성림프구성백혈병 환자에서 막성 콩팥병증으로 나타난 만성 이식편대 숙주병 1예

정지예 ( Ji Ye Jung ),윤설희 ( Sul Hee Yoon ),황도유 ( Doh Yu Hwang ),정준원 ( June Won Cheong ),김진석 ( Jin Seok Kim ),정현주 ( Hyun Joo Jung ),민유홍 ( Yoo Hong Min ) 대한내과학회 2008 대한내과학회지 Vol.75 No.1S

증례 : 혈액종양 ; 동종 조혈모세포이식 후 다발성 근염으로 발현된 만성 이식편대숙주반응

이혜원 ( Hye Won Lee ),최희경 ( Hee Kyung Choi ),김수정 ( Soo Jeong Kim ),황도유 ( Doh Yu Hwang ),최준용 ( Jun Yong Choi ),정준원 ( June Won Cheong ),민유홍 ( Yoo Hong Min ) 대한내과학회 2009 대한내과학회지 Vol.76 No.1

동종 조혈모세포이식 후의 합병증으로 드물게 다발성근염으로 만성 이식편대숙주반응이 생길 수 있으며, 경우에 따라 치명적일 수 있으므로 조기 진단이 중요하겠다. 그러나, 임상 양상이 비특이적일 경우 진단이 쉽지 않으며 이식 후 수년 뒤에도 유일한 이식편대숙주반응으로 발현될 수 있어 동종 조혈모세포이식을 받았던 환자를 진료할 때에는 이에 대한 주의가 필요하겠다. Chronic graft-versus-host disease (cGVHD) remains one of the major complications of allogeneic hematopoietic stem cell transplantation. Although cGVHD has various manifestations in almost all organs, cases of cGVHD involving skeletal muscle are rare. We experienced a 26-year-old man with polymyositis with no other concurrent cGVHD after HLA-matched myeloablative transplantation for acute myelogenous leukemia. He had a history of acute and chronic GVHD. The patient complained of fever and myalgia 3 years after transplantation. The serum creatine kinase (CK, 2,223 IU/L) and aldolase (87.6 sigmaU/mL) were elevated. The muscle biopsy and electromyographic findings were consistent with myositis with necrosis. His condition improved dramatically with immunosuppressive therapy. Although muscle involvement, alone, in cGVHD is very rare, early diagnosis and proper treatment are still important. (Korean J Med 76:110-113, 2009)

급성 골수성 백혈병 환자에서 병발한 소장결장염

오성진(Sung Jin Oh),김남규(Nam Kyu Kim),백승혁(Seung Hyuk Baik),이강영(Kang Young Lee),손승국(Seong Kook Sohn),맹호영(Ho Young Maeng),민유홍(Yu Hong Min) 대한외과학회 2005 Annals of Surgical Treatment and Research(ASRT) Vol.68 No.2

골수이식후 생착확인을 위한 VNTR LOCUS(pYNZ22)의 중합효소연쇄반응(PCR)과 제한효소분절길이다형성(RFLPs)

김태연,민유홍,정해원 서울大學校保健大學院 1994 國民保健硏究所硏究論叢 Vol.4 No.2

A genetic locus (Defined by DNA probe pYNZ22) that contains a VNTR has been amplified from a genomic DNA by the PCR. A normal unrelated persons and a series of bone marrow transplantation (BMT) patients with their HLA-identical siblings were analyzed. Amplification of the VNTR loci revealed the discrimination of 20 out of 26 unrelated persons and 5 out of 8 siblings. When the result of PCR was compared with RFLPs in the case of BMT candidates and their siblings, probe pYNH24 revealed the discrimination of 4 out of 8 sibling pairs and p13-1-25 revealed the discrimination of 6 out of 8 sibling pairs. Three polymorphic genetic loci detected a donor and recipient DNA at least one or more loci among all 8 of sibling pairs. Above all, the studies of genetic locus that is apparent to individual identification are of practical value such as BMT which needs essential search. Both PCR and RFLP, molecularbiol work, are coming into wide use for polymorphism research. Thus the use of DNA polymorphism between donor and recipient is very important and is easily applicable to clinical studies of BMT.

악성 임파종의 골수 침범에 관한 임상적 연구

한지숙,박중원,민유홍,고윤웅,양우익,최인준 大韓血液學會 1990 大韓血液學會誌 Vol.25 No.2