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CTX-M-12, PER-1 및 OXA-30 β-Lactamase 생성 Klebsiella pneumoniae의 출현
배일권,이유내,정석훈,이경원,용동은,이종욱,홍성근,김의종,박연준,최태열,어영,신종희,이위교,안지영,이성희,우건조,곽효선 대한임상미생물학회 2006 Annals of clinical microbiology Vol.9 No.2
Background: The aim of this study was to determine a nation-wide prevalence of Ambler class A and D extended-spectrum -lactamases (ESBL) in Klebsiella pneumoniae isolates in Korea. Methods: During the period of April to May 2005, 189 isolates of K. pneumoniae were collected from 11 Korean hospitals. Antimicrobial susceptibilities to ceftazidime and cefotaxime were tested by the disk diffusion method, and ESBL production was determined by double-disk synergy test. Determinants of ceftazidime or cefotaxime-resistance were transferred to Escherichia coli J53 (azide-resistant) by transconjugation. Genotypes of class A and D ESBL genes were determined by PCR amplification and sequencing. Results: One hundred-sixty isolates of K. pneumoniae showed positive results in double-disk synergy test. The most prevalent ESBL was SHV-12 (n=148). Also detected were genes encoding ESBLs including TEM-52 (n=1), SHV-2a (n=2), CTX-M-3 (n=15), CTX-M-9 (n=6), CTX-M-12 (n=2), CTX-M-14 (n=9), CTX-M-15 (n=1), PER-1 (n=1), GES-5 (n=3), and OXA-30 (n=2) -lactamases. Conclusion: With the emergence of CTX-M-12, PER-1, and OXA-30 -lactamases, the ESBLs in K. pneumoniae isolates are becoming more diverse in Korea.
Carbapenem 내성 Acinetobacter baumannii
배일권,정석훈,이경원 대한임상미생물학회 2012 Annals of clinical microbiology Vol.15 No.1
Clinical isolates of Acinetobacter spp. in Korea exhibit higher antimicrobial resistance rates than in foreign countries and frequently show multi-drug resistance. Approximately 67% (272/405) of Acinetobacter baumannii isolates collected from 19 hospitals in Korea in 2008 exhibited intermediate susceptibility or resistance to imipenem and/or meropenem. The most important mechanisms in acquiring carbapenem resistance in A. baumannii in Korea are production of OXA-23 and overproduction of OXA-51, while that in non-baumannii Acinetobacter is the production of metallo-β-lactamases. All the carbapenem-resistant A. baumannii isolates were identified as clonal complex 92 and belonged to worldwide clone 2.
CTX-M-12와 새로운 CTX-M형 Extended-Spectrum β-Lactamase생성 Klebsiella pneumoniae의 출현
배일권,정석훈,이경원,용동은,이종욱,홍성근,김의종,박연준,강정옥,어영,신종희,이위교,안지영,이성희,우건조,곽효선 대한진단검사의학회 2006 Annals of Laboratory Medicine Vol.26 No.1
배경 : 본 연구는 전국 12개병원에서 분리된 Klebsiella pneu-moniae를 대상으로 class A형 extended-spectrum -lactamase(ESBL)의 생성현황을조사하고자 하였다.방법 : 2004년 2-7월에 전국 12개 병원에서 분리된 ceftazidime이나 cefotaxime에 내성인K. pneumoniae 를 수집하였다. 항균제감수성을 디스크 확산법과 한천희석법으로 시험하였으며, ESBL생성은 double-disk synergy 시험으로 확인하였다. ESBL 생성균주의 내성을 접합으로 azide 내성 E. coli J53으로 전달하였다.PCR로 ESBL 유전자를 검출하였고, PCR 산물의 염기서열을 양방향으로 분석하였다.결과 : 전국 12개 병원에서 수집된 212주 중 172 (81%)주가double-disk synergy 양성이었다. 가장 흔한 ESBL은 SHV-12(104주)였으며, SHV-2(6주), SHV-2a (17주), CTX-M-3 (18주), CTX-M-9 (6주), CTX-M-12 (1주), CTX-M-14 (27주),CTX-M-15 (3주) 및 새로운 CTX-M형 유전자(1주)도 검출되었다.
Detection of Carbapenemases in Clinical Enterobacteriaceae Isolates Using the VITEK AST-N202 Card
배일권,강현경,장인호,이운형,김근한,김정옥,정석훈,이경원 대한감염학회 2015 Infection and Chemotherapy Vol.47 No.3
Background: The rapid and accurate detection of carbapenemase-producing Enterobacteriaceae (CPE) in clinical microbiology laboratories is essential for the treatment and control of infections caused by these microorganisms. This study was performed to evaluate the ability of the VITEK AST-N202 card to detect CPE isolates. Materials and Methods: A total of 43 (Klebsiella pneumoniae, n = 37; Escherichia coli, n = 3; and Enterobacter cloacae, n = 3) CPE isolates and 79 carbapenemase-non-producing Enterobacteriaceae (CNE) isolates were included in this study. The CPE isolates harbored KPC-2 (n = 11), KPC-3 (n = 20), GES-5 (n = 5), VIM-2 (n = 2), IMP-1 (n = 1), NDM-1 (n = 2), or OXA-232 (n = 2). Of the 79 CNE isolates, eight K. pneumoniae isolates were resistant to ertapenem, imipenem, and meropenem, while the remaining 71 isolates were susceptible to the carbapenems. Antimicrobial susceptibilities were tested using the VITEK AST-N202 card, and the results were interpreted as positive when the isolates showed resistant or intermediate results. Modified-Hodge tests (MHTs) were performed using ertapenem or meropenem disks for the screening of carbapenemase production. Polymerase chain reaction (PCR) and direct sequencing were used to identify β-lactamase genes. Results: Sensitivity of MHT with ertapenem and meropenem disks for the detection of carbapenemase was 81.4% (35/43) and 81.4% (35/43), respectively, and a combination with both antibiotic disks increased the sensitivity to 88.4% (38/43). Specificity of the MHT was 100% (79/79) for the CNE isolates. Sensitivity of ertapenem, imipenem, and meropenem as assessed by the VITEK AST-N202 card was 100% (43/43), 93% (40/43), and 95.3% (41/43), respectively. Specificity (89.8%, 71/79) of the test with each carbapenem was improved to 100% (71/71) when eight carbapenem-resistant CNE isolates were excluded from the testing. Conclusion: The VITEK AST-N202 card showed high sensitivity for the detection of carbapenemases in Enterobacteriaceae strains. PCR and sequencing experiments for the detection of carbapenemases are recommended when clinical Enterobacteriaceae isolates show non-susceptibility to carbapenems.
혈액검체에서 분리된 Streptococcus oralis 의 항균제 내성
배일권(Il Kwon Bae) 한국구강보건과학회 2017 한국구강보건과학회지 Vol.5 No.2
A rapid increase in antimicrobial resistant bacteria has become a serious problem in many countries including Korea. Streptococcus oralis is an early colonizer of the oral cavity that contributes to dental plaque formation. Many different genotypes can coexist in the same individual and cause opportunistic infection such as bacterial endocarditis. The aim of this study was to determine the prevalence of antimicrobial resistance among blood culture isolates of S. oralis in Korea. S. oralis had been isolated during the period from January to December in 2013. The resistance rate of 36 clinical isolates of S. oralis were 25.0% to penicillin, 22.2% to ampicillin, 19.4% to cefotaxime, 19.4% to cefepime, 2.8% to meropenem, 5.5% to clindamycin, 27.8% to chloramphenicol, 47.2% erythromycin, and 47.2% to tetracycline. None was resistant to vancomycin. Strict infection control and active surveillance program will be required to manage the antimicrobial resistance problem.
배일권(Il Kwon Bae),강두호(Doo Ho Kang),김선민(Seon Min Kim),배영민(Yeong Min Bae) 한국구강보건과학회 2017 한국구강보건과학회지 Vol.5 No.1
Indoor environments of house and family member can become contaminated with potential variety bacteria. The aim of this study is to accesses the identification and distribution of indoor environments of house contaminated bacterial strains. We sampled living room floor, bathroom floor, bathroom knob, bottom of bathtub, refrigerator, refrigerator handle, desk, table, sink, bottom of shoes rack, hand of family member, nose of family member, and toilet bowl. All samples were cultured on blood agar media (BAM) and MacConkey agar media (MAM). The colonies grown on each media were identified with matrix-assisted laser desorption/ioniazation-time of flight mass spectrometry (MALDI-TOF) using MALDI Biotyper and 16S rDNA sequencing. Fifty-five isolates on BAM and MAM were identified as Acinetobacter soli (n=8), Acinetobacter lwoffii (n=6), Acinetobacter baylyi (n=3), Acinetobacter pittii (n=3), Acinetobacter baumannii (n=3), Acinetobacter junii (n=2), Acinetobacter radioresistnes (n=1), Aeromonas hydrophila (n=3), Aeromonas jandaei (n=1), Enterobacter cloacae (n=5), Enterobacter aerogenes (n=4), Klebsiella pneumoniae (n=1), Moraxella osloensis (n=1), Massilia timonae (n=1), Pseudomonas oryzihabitans (n=5), Pseudomonas aeruginosa (n=2), Pseudomonas mosselii (n=1), Pseudomonas stutzeri (n=1), Raoultella ornithinolytica (n=2), Serratia marcescens (n=2). These results suggest that indoor environments of house and family members were contaminated with variety nomal flora and nosocomial bacteria.