Benzalconium chloride액 오염에 의한 Burkholderia cepacia 위감염

김상화,유계선,정인경,서환조 대한감염학회 1998 감염 Vol.30 No.6

목 적 : 소독제의 오염에 의한 감염의 집단 발생은 심각한 문제가 될 수 있다. 또한, 혈액 배양 검사를 위한 피부 소독시에 오명ㅁ된 소독제의 사용은 가균혈증을 야기하고 다른 검체의 미생물 검사에서도 위감염의 원인이 된다. 소독제 오염의 원인 균으로는 Burkholderia cepacia, Pseudomonas aeruginosa, Xanthomonas maltophilia, Pseudomonas fluorescens 등이 있으며, 특히 B. cepacia의 오염으로 인한 감염과 위감염은 종종 보고된다. 경희의료원 미생물 검사실에 의뢰된 미생물 배양검사 결과 중 B. cepacia의 분리건수의 급격한 증가가 있어 오염된 소독제에 의한 세균의 집단 발생 여부를 확인하고자 하였다. 방 법 : 1996년 4월부터 1997년 4월까지 경희의료원 미생물 검사실에 의뢰된 미생물 배양검사 결과 중 B. cepacia의 전체 분리건수와 부서별 특징을 후향적으로 조사하였다. 또한, B. cepacia 가 동정 된 환자의 병록지를 분석하여 임상 양상을 파악하였다. 경희의료원 산부인과 외래에서 내진 시 사용하는 speculum과 forcep 그리고 소독제로 사용중인 0.1% benzalconium액과 0.1% benzalconium 액으로 만들어진 스폰지를 대상으로 하고 미생물 배양 검사 및 항생제 감수성 검사를 실시 하였다. 결 과 : 오염된 benzalconium액을 소독제로 사용한 부서에서 의뢰된 미생물 배양 검사에서 B. cepacia의 분리건수가 현저히 증가 하였다. 또한, 동정된 B. cepacia 는 ciprofloxacin과 trimethoprim-sulfamethoxazole에는 감수성을 보였으나 gentamicin, ampicillin, cephalexin, ampicillin-sulbactam에는 높은 내성을 보였다. 결 론 : 소독제의 오염 여부에 대한 정기적 검사가 필요하며 소독제의 관리 방법을 재검토할 필요가 있다. Background : Outbreaks of infection as a result of contaminated antiseptics and disinfectants have been reported. The major contaminants reported have been Burkholderia cepacia, Pseudomonas aerugnosa, Xanthomonas maltophilia and Pseudomonas fluorescens. A marked increase in the number of B. cepacia isolates was observed in a microbiology laboratory in Kyung Hee Univeresity Hospital. We investigated an outbreak of pseudoinfection caused by benzalconium-chloride solution contaminated with B. cepacia. Methods : We reviewed microbiology laboratory records from April 1996 to April 1997 to identify B. cepacia isolates and medical records of the patients from whom B. cepacia was cultured. Samples of 0.1% benzalconium solutions, benzalconium chloride-soaked cotton balls, specula, and forceps used in the outpatient department were examinated. Results : The majority was isolated from vaginal cultures in outpatients of gynecology department. The source of this outbreak was identified as the contaminated benzalconium-chloride solution. Investigation revealed that positive cultures were due to contamination of benzalconium-chloride solution and clinically insignificant in most cases. B. cepacia isolates were susceptible to ciprofloxacin and trimethoprim-sulfamethoxazole, but the majority were resistant to gentamicin, ampicillin, cephalexin, and ampicillin-sulbactam. Conclusion : It is necessary to check for microbial contamination of antiseptics and disinfectants when an outbreak caused by B. cepacia is observed in hospital patients.

Burkholderia Cepacia Causing Nosocomial Urinary Tract Infection in Children

Ki Wuk Lee,Sang Taek Lee,조희연 대한소아신장학회 2015 Childhood kidney diseases Vol.19 No.2

Purpose: Burkholderia cepacia is an aerobic, glucose–non-fermenting, gramnegative bacillus that mainly affects immunocompromised and hospitalized patients. Burkholderia cepacia has high levels of resistance to many antimicrobial agents, and therapeutic options are limited. The authors sought to analyze the incidence, clinical manifestation, risk factors, antimicrobial sensitivity and outcomes of B. cepacia urinary tract infection (UTI) in pediatric patients. Methods: Pediatric patients with urine culture-proven B. cepacia UTI between January 2000 and December 2014 at Samsung Medical Center, a tertiary referral hospital in Seoul, Republic of Korea, were included in a retrospective analysis of medical records. Results: Over 14 years, 14 patients (male-to-female ratio of 1:1) were diagnosed with B. cepacia UTI. Of 14 patients with UTI, 11 patients were admitted to the intensive care unit, and a bladder catheter was present in 9 patients when urine culture was positive for B. cepacia. Patients had multiple predisposing factors for UTI, including double-J catheter insertion (14.2%), vesico-ureteral reflux (28. 6%), congenital heart disease (28.6%), or malignancy (21.4%). Burkholderia cepacia isolates were sensitive to piperacillin-tazobactam and sulfamethoxazoletrimethoprim, and resistant to amikacin and colistin. Treatment with parenteral or oral antimicrobial agents including piperacillin-tazobactam, ceftazidime, meropenem, and sulfamethoxazole-trimethoprim resulted in complete recovery from UTI. Conclusion: Burkholderia cepacia may be a causative pathogen for nosocomial UTI in pediatric patients with predisposing factors, and appropriate selection of antimicrobial therapy is necessary because of high levels of resistance to empirical therapy, including aminoglycosides.

Burkholderia Cepacia Causing Nosocomial Urinary Tract Infection in Children

Lee, Ki Wuk,Lee, Sang Taek,Cho, Heeyeon Korean Society of Pediatric Nephrology 2015 Childhood kidney diseases Vol.19 No.2

Purpose: Burkholderia cepacia is an aerobic, glucose-non-fermenting, gram-negative bacillus that mainly affects immunocompromised and hospitalized patients. Burkholderia cepacia has high levels of resistance to many antimicrobial agents, and therapeutic options are limited. The authors sought to analyze the incidence, clinical manifestation, risk factors, antimicrobial sensitivity and outcomes of B. cepacia urinary tract infection (UTI) in pediatric patients. Methods: Pediatric patients with urine culture-proven B. cepacia UTI between January 2000 and December 2014 at Samsung Medical Center, a tertiary referral hospital in Seoul, Republic of Korea, were included in a retrospective analysis of medical records. Results: Over 14 years, 14 patients (male-to-female ratio of 1:1) were diagnosed with B. cepacia UTI. Of 14 patients with UTI, 11 patients were admitted to the intensive care unit, and a bladder catheter was present in 9 patients when urine culture was positive for B. cepacia. Patients had multiple predisposing factors for UTI, including double-J catheter insertion (14.2%), vesico-ureteral reflux (28.6%), congenital heart disease (28.6%), or malignancy (21.4%). Burkholderia cepacia isolates were sensitive to piperacillin-tazobactam and sulfamethoxazole-trimethoprim, and resistant to amikacin and colistin. Treatment with parenteral or oral antimicrobial agents including piperacillin-tazobactam, ceftazidime, meropenem, and sulfamethoxazole-trimethoprim resulted in complete recovery from UTI. Conclusion: Burkholderia cepacia may be a causative pathogen for nosocomial UTI in pediatric patients with predisposing factors, and appropriate selection of antimicrobial therapy is necessary because of high levels of resistance to empirical therapy, including aminoglycosides.

증례 : 복막투석 환자에서 발생한 Burkholderia cepacia 복막염 1예

강형민 ( Hyung Min Kang ),박재은 ( Jae Eun Park ),이형돈 ( Hyoung Don Lee ),한봉준 ( Bong Jun Han ),김수현 ( Su Hyun Kim ),신석호 ( Suk Ho Shin ),윤수진 ( Su Jin Yoon ) 대한내과학회 2006 대한내과학회지 Vol.71 No.2

B. cepacia는 환경에 널리 분포되어 있으며 낭성 섬유종 환자, 면역기능 저하자, 입원 기간 동안 오염된 장비와 접촉한 환자에서 감염을 일으킬 수 있는 원인균으로 알려져 있으나, 국내에서는 이에 대한 보고가 매우 드문 실정이다. B. cepacia는 소독제의 오염도 일으킬 수 있어 투석시마다 소독제를 사용하는 복막투석 환자에게는 유의해야 할 감염원으로 사료된다. 이에, 저자들은 지속성외래 복막투석을 시행 중인 환자에서 발생한 B. cepacia 복막염 1예를 경험한 바 문헌고찰과 함께 보고하는 바이다. Burkholderia cepacia is an important opportunistic pathogen in immunocompromised and nosocomial patients, but this bacterial infection is rare in Korea. We report a case of Burkholderia cepacia peritonitis in a patient on CAPD. A 69-year-old male on CAPD for 5 years was presented with turbid peritoneal dialysate, diffuse abdominal pain and diarrhea. He was treated initially with intraperitoneal cefazolin and ceftazidime, and then intraperitoneal meropenem and oral TMP/SMX. His symptoms had improved with antibiotic treatment, but white blood cell counts of dialysate increased, instead. Burkholderia cepacia was isoloated from peritoneal fluid culture. The patient refused catheter removal in spite of our recommendation. He died of suddenly developed acute myocardial infarction and upper gastrointestinal bleeding. Catether tip culture also revealed Burkholderia cepacia.(Korean J Med 71:219-223, 2006)

건강한 노인에서 침술 치료 후 발생한 Burkholderia cepacia에 의한 척추 골수염

김기대,손경목,김연숙,천신혜,송창헌,염진영,구선회3 대한노인병학회 2014 Annals of geriatric medicine and research Vol.18 No.3

Burkholderia cepacia is an important nosocomial pathogen in hospitalized patients, particularly those with prior antimicrobial therapy. B. cepacia causes various clinically significant infections such as bacteremia, pneumonia, and urinary tract and surgical site infections. However, osteomyelitis caused by B. cepacia is very rare. We present a case of B. cepacia vertebral osteomyelitis with review of the literature.

A case of lung abscess caused by Burkholderia cepacia in healthy child

이정화,이소희,홍성진,최영철,황은구,Lee, Jung Hwa,Lee, So Hee,Hong, Seong Jin,Choi, Young Chil,Hwang, Eun Gu The Korean Pediatric Society 2007 Clinical and Experimental Pediatrics (CEP) Vol.50 No.1

B. cepacia는 그람 음성 호기성 세균으로서 주로 면역 기능 저하 환자들에서 기회 감염의 중요한 원인균으로 알려져 있다. 이 세균은 매우 병원성이 강하여 침습적인 괴사성 감염을 일으키며 사망에까지 이르게 할 수 있다. B. cepacia는 여러 항생제에 높은 저항성을 보이므로 한 가지 항생제의 단독 요법보다는 여러 항생제의 병용용법을 사용해야 한다. 저자들은 건강한 소아에서 자연 발생한 B. cepacia에 의한 폐농양을 경험하였고 meropenem과 trimethoprim/sulfamethoxazole 병용 요법과 수술적 치료를 통해 성공적으로 치유한 1례를 보고하고자 한다. Burkholderia cepacia is a Gram-negative aerobic bacillus known to cause opportunistic infections in the immune-compromised hosts. This microorganism is strongly virulent and causes a necrotising invasive infection that may lead to death. As B. cepacia is highly resistant to various antimicrobials, combination antimicrobial therapy must be used instead of monotherapy. We report a successful treatment of lung abscess that was naturally caused by B. cepacia in a healthy child, through combination antimicrobial therapy of meropenem and trimethoprim/sulfamethoxazole and operative management.

Pyogenic Spondylitis in a Healthy Adult Caused by Burkholderia cepacia

양병혁,이미숙,이정희,이희주 대한감염학회 2008 Infection and Chemotherapy Vol.40 No.4

Burkholderia cepacia is an important pathogen of humans in both immunocompromised or hospitalized patients.This aerobic gram-negative rod causes various clinically significant infections such as pneumonia, bacteremia, urinary tract infection, peritonitis, endophthalmitis, and keratitis. This uncommon pathogen is mainly associated with cystic fibrosis, dialysis, and immunocompromised states. We observed a 73-year-old woman without any underlying diseases, who had both lower leg pain and fever. She was later found to have spondylitis with epidural abscess at L5-S1. Culture of the epidural abscess revealed the growth of B. cepacia. To the best of our knowledge, this is the first case of pyogenic spondylitis caused by a rare infection of B. cepacia to be reported in Korea

Burkholderia cepacia를 이용한 축산폐수의 처리

정팔진,조선영,현미희,김민정,이은주,전민식 한국물환경학회 2004 한국물환경학회지 Vol.20 No.6

We found that the Bacterium Burkholderia cepacia in livestock wastewater treatment plant was predominant species. We investigated the growth rate of this and treatment characteristics for organic matter and nitrogen removal in livestock wastewater using this microorganism. First, we cultured B. cepacia. And then, to conducted treatment for livestock wastewater by using B. cepacia., we changed C/N from 0.2~4.4. When we operated A and B process, changing F/M ratio from 1.2 to 4.4. In experiment of C/N variations, when C/N was 1.8, we found that the optimal condition for organic matter and nutrient removal effect was higher and the removal efficiency of SCOD_(cr), SBOD_5, NH₄-N was 78.4%, 95% and 74.8%. So, It is possible to treat the wastewater having the lower C/N contents such as livestock wastewater using this microorganism. In experiment of A and B process for livestock wastewater, we found that the removal efficiency of organic matter and nitrogen in operating mode of A process was higher than that of B process. Also, the optimal F/M operating A process was 0.013 and the removal efficiency of SBOD_5, SCOD_(cr), TN and TP were 97%, 60%, 95% and 91%.

Pyogenic Spondylitis in a Healthy Adult Caused by Burkholderia cepacia

Yang, Byung Hyuk,Lee, Mi Suk,Lee, Jung-Hee,Lee, Hee-Joo 대한감염학회 2008 감염과 화학요법 Vol.40 No.4

Burkholderia cepacia is an important pathogen of humans in both immunocompromised or hospitalized patients. This aerobic gram-negative rod causes various clinically significant infections such as pneumonia, bacteremia, urinary tract infection, peritonitis, endophthalmitis, and keratitis. This uncommon pathogen is mainly associated with cystic fibrosis, dialysis, and immunocompromised states. We observed a 73-year-o1d woman without any underlying diseases, who had both lower leg pain and fever. She was later found to have spondylitis with epidural abscess at L5-S1. Culture of the epidural abscess revealed the growth of B. cepacia. To the best of our knowledge, this is the first case of pyogenic spondylitis caused by a rare infection of B. cepacia to be reported in Korea

Burkholderia Cepacia (ATCC 25416)에 대한 식물병원균5종의 길항능력 평가

이영돈 ( Young Don Lee ),이찬규 ( Chan Kyu Lee ),주진호 ( Jin Ho Joo ) 한국환경농학회 2016 한국환경농학회 학술대회집 Vol.2016 No.-

현재 우리나라뿐만 아니라 세계적으로 식물병원균의 피해로 인해 작물수량감소 및 품질저하라는 결과를 초래하고 있다. 강원도 지역은 최근 인삼재배지가 늘고 있으며, 인삼의 경우 연작작물로 4~6년정도 재배를 하게 되는데 이러한 연작으로 인해 식물병원균 발병확률이 높으며 쉽게 방제하기도 어렵다. 본 연구는 이러한 식물병원균의 방제가 어려운 작물을 토대로 식물병원균을 억제할 수 있는 유용미생물을 분리 및 동정함에 있다. 토양시료는 강원도 인삼약초연구소 인삼재배지에서 각각 1 kg 씩 채취하였으며 토양으로부터 세균을 분리하였다. 실험에 이용된 병원균 5종은 Sclerotinia Sclerotiorum, Fusarium Solani, Collectotricum Gloeosporioides, Fusarium Oxysporum, Botrytis Cinerea 총 5가지로 농촌진흥청 농업유전자원정보센터(KACC)로부터 입양하였다. 이 병원균들 은 인삼재배지에서 농민들이 가장 대표적으로 겪는 병원균을 대상으로 하였다. 이 후 토양에서 분리한 세균과 입양해온 식물병원균과 대치배양을 진행하였고, 사용된 배지는 PDA배지를 사용하였다. 곰팡이의 경우 세균보다 자라는 속도가 느리기 때문에 먼저 배양 후 세균을 도말하였다. 그 결과 토양에서 분리한 균주인 Burkholderia는 5종의 식물병원균에게 길항효과를 보였다. 그 후 균주에 대한 정보를 파악하기 위해 16S rRNA염기서열을 조사하였고, 조사된 염기서열을 NCBI BLAST 프로그램을 이용하여 균주를 동정하였다. 이 균주는 Burkholderia Cepacia ATCC25416으로 99% 일치하였다. 이 균주는 이미 문헌에 의하면 유용미생물 알려져 있으며, 이 균주가 어떠한 항균물질을 생성하는지 파악하여 미생물제제로써의 활용 및 농업인들이 안정적으로 재배 및 생산에 대해 안전 체계를 구축을 할 것이다.