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Yoon, Eun-Jeong,Kwon, Ae-Ran,Min, Yu-Hong,Choi, Eung-Chil Academic Press ; Oxford University Press 2008 The Journal of antimicrobial chemotherapy Vol.61 No.3
<P>OBJECTIVES: We identified Staphylococcus aureus strains having blunt inhibitory zones around the clindamycin or josamycin discs proximal to the erythromycin disc filled with slight bacterial growth. This ambiguous phenotype was termed as 'macrolide-lincosamide-streptogramin B antimicrobial (MLS(B)) resistance having a foggy D-shaped inhibitory zone' (fMLS(B)), and we tried to analyse its molecular mechanisms. METHODS: Forty-one clinically isolated strains of fMLS(B) S. aureus were studied. The regulatory region of the erm(A) gene, which was found to be the only molecular mechanism of fMLS(B), was sequenced. Then, beta-galactosidase assays were performed to observe their expression patterns through the nucleotide sequential alteration. RESULTS: According to the sequencing electropherogram, a grouping was made of a homogeneous nucleotide sequence group (73.2%) and a heterogeneous nucleotide sequence group (26.8%). The former group was composed of a 25 bp tandem duplication type and a 25 bp tandem triplication type. Their beta-galactosidase activity was similar to that of constitutive MLS(B) resistance due to its high basal level. Nevertheless, the predicted mRNA secondary structure of the regulatory region maintains the stem-loops of inducible wild-type erm(A), and thereby its inducible character might be expected in vivo. Strains in the latter group were proven to have two different erm(A) genes, and then dual effect of expression was observed. CONCLUSIONS: The ambiguous phenotype of fMLS(B) is due to its possessing the dual character of inducible and constitutive expression of erm(A). The dual character is due to having one erm(A) gene of dual character or coexistence of two characterized erm(A) genes simultaneously.</P>
Park, Ki-Ho,Kim, Eun Sil,Kim, Hee Seung,Park, Su-Jin,Bang, Kyung Mi,Park, Hyun Jung,Park, So-Youn,Moon, Song Mi,Chong, Yong Pil,Kim, Sung-Han,Lee, Sang-Oh,Choi, Sang-Ho,Jeong, Jin-Yong,Kim, Mi-Na,Woo, Academic Press ; Oxford University Press 2012 The Journal of antimicrobial chemotherapy Vol.67 No.8
<P>We compared the clinical characteristics and outcomes of, and the bacterial genotypes in, patients with bacteraemia due to heteroresistant vancomycin-intermediate Staphylococcus aureus (hVISA) and vancomycin-susceptible S. aureus (VSSA).</P>
Koh, Won-Jung,Kwon, O Jung,Gwak, Hyesun,Chung, Joo Won,Cho, Sang-Nae,Kim, Woo Sung,Shim, Tae Sun Academic Press ; Oxford University Press 2009 The Journal of antimicrobial chemotherapy Vol.64 No.2
<P>BACKGROUND: Although previous studies have suggested that linezolid may be effective for treating multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis (TB), the optimal dose of linezolid for intractable MDR/XDR-TB is not clear. METHODS: Twenty-four patients with intractable MDR/XDR-TB were treated with a daily 300 mg dose of linezolid as part of their anti-TB drug regimen. RESULTS: The patients were treated with linezolid for a median duration of 359 days [interquartile range (IQR) 268-443 days]. Seventeen (71%) patients received 300 mg of linezolid once daily from the beginning of treatment for a median duration of 289 days (IQR 233-405 days). Of these patients, four developed peripheral neuropathy, one of whom discontinued linezolid. In seven (29%) patients, 600 mg/day linezolid was administered initially for a median duration of 104 days (IQR 26-145 days) followed by 300 mg/day linezolid for a median duration of 348 days (IQR 298-427 days). In five of these seven patients, the reason for changing from 600 to 300 mg/day was due to side effects of 600 mg/day linezolid (peripheral neuropathy in four patients and leucopenia in one patient). After reducing the dose to 300 mg/day, linezolid could be continued in six of the seven patients. Negative sputum conversion was achieved in 22 (92%) patients after a median of 89 days from the start of linezolid treatment (IQR 48-160 days). CONCLUSIONS: A daily 300 mg dose of linezolid may be useful for increasing the chances of culture conversion in the treatment of patients with intractable MDR/XDR-TB and might have fewer side effects, especially neurotoxicity, compared with a daily 600 mg dose of linezolid therapy. The present results encourage further research into the use of a 300 mg dose of linezolid for MDR/XDR-TB patients.</P>
Kim, Jaeeun,Hahn, Ji-Sook,Franklin, Michael J,Stewart, Philip S,Yoon, Jeyong Academic Press ; Oxford University Press 2009 The Journal of antimicrobial chemotherapy Vol.63 No.1
<P>OBJECTIVES: The aim of the study was to determine the susceptibility of active and dormant cell populations from Pseudomonas aeruginosa biofilms to non-antibiotic antimicrobial agents such as chlorine, hydrogen peroxide and silver ions in comparison with antibiotics. METHODS: Active cells in colony biofilm were differentially labelled by induction of a green fluorescent protein (GFP). Active and dormant cells were sorted in phosphate buffered solution by flow cytometry. Reductions in viability were determined with plate counts. RESULTS: The spatial pattern of metabolic activity in colony biofilm was verified, and the active and dormant cells were successfully sorted according to the GFP intensity. Active cells had bigger cell size and higher intracellular density than dormant cells. While dormant cells were more tolerant to tobramycin and silver ions, active cells were more tolerant to chlorine. Metabolically active cells contain denser intracellular components that can react with highly reactive oxidants such as chlorine, thereby reducing the available concentrations of chlorine. In contrast, the concentrations of silver ions and hydrogen peroxide were constant during treatment. Aerobically grown stationary cells were significantly more tolerant to chlorine unlike other antimicrobial agents. CONCLUSIONS: Chlorine was more effective in inactivation of metabolically inactive dormant cells and also more effective under anaerobic conditions. The high oxidative reactivity and rapid decay of chlorine might influence the different antimicrobial actions of chlorine compared with antibiotics. This study contributes to understanding the effects of dormancy and the presence of oxygen on the susceptibility of P. aeruginosa biofilm to a wide range of antimicrobial agents.</P>
Yoon, Young Kyung,Kim, Hyeon Jeong,Lee, Won Jin,Lee, Sung Eun,Yang, Kyung Sook,Park, Dae Won,Sohn, Jang Wook,Kim, Min Ja Academic Press ; Oxford University Press 2012 The Journal of antimicrobial chemotherapy Vol.67 No.12
<P>The purpose of this study was to develop and validate a clinical prediction rule to screen patients at risk of vancomycin-resistant enterococci (VRE) carriage at intensive care unit (ICU) admission in a hospital setting with low VRE prevalence.</P>