Treatment of Methicillin-Resistant Staphylococcus aureus Bacteremia

추은주,Henry F. Chambers 대한감염학회 2016 Infection and Chemotherapy Vol.48 No.4

Methicillin-resistant Staphylococcus aureus (MRSA) is a significant cause of health care-associated infections. Vancomycin remains an acceptable treatment option. There has been a welcome increase in the number of agents available for the treatment of MRSA infection. These drugs have certain differentiating attributes and may offer some advantages over vancomycin, but they also have significant limitations. These agents provide some alternative when no other options are available.

메티실린 내성 황색포도알균 감염의 항생제 치료

추은주 대한의사협회 2018 대한의사협회지 Vol.61 No.3

Methicillin-resistant Staphylococcus aureus (MRSA) is a common cause of healthcare-associated infections. Recently, community-associated MRSA has emerged, manifesting as skin and soft tissue infections in patients without any prior healthcare contact. Vancomycin, a glycopeptide in clinical use for more than 50 years, still remains an acceptable treatment option. However, significant concerns have been raised regarding the decreasing susceptibility of S. aureus to this agent. The growing awareness of the limitations of vancomycin has served as an impetus for development of newer agents. There has been an increase in the number of agents available to treat MRSA infections. Linezolid, daptomycin, telavancin, and ceftaroline have received regulatory approval in the last decade for the treatment of MRSA. Although these drugs do have certain differentiating attributes and may offer some advantages over vancomycin, they also have significant limitations.

Community-Associated Methicillin-Resistant Staphylococcus aureus in Nosocomial Infections

추은주 대한감염학회 2017 Infection and Chemotherapy Vol.49 No.2

구연 : 감염 ; HIV 비감염환자에서의 크립토코쿠스 수막염의 임상 양상과 예후인자에 관한 연구

추은주,류지소,우준희,김양수,김남중 대한내과학회 2002 대한내과학회 추계학술대회 Vol.63 No.-

임상 검체에서 분리된 세균에 대한 Cefcapene의 시험관내 항균력

추은주,곽이경,이미숙,정진용,최상호,김남중,김양수,우준희,류지소 대한감염학회 2005 Infection and Chemotherapy Vol.37 No.3

Background : Cefcapene pivoxil hydrochloride is a new oral cephem which has a broad-spectrum activity with expanded potency against Gram-positive bacteria, including Staphylococcus aureus and Streptococcus, as well as Gram-negative bacteria. In this study, we examined the in vitro activity of cefcapene against recently isolated clinical specimens from patients in a tertiary hospital. Materials and Methods : We tested the in vitro antimicrobial activities of cefcapene and other cephalosporins against 450 clinical isolates from of patients in Asan Medical Center. Minimal inhibitory concentrations (MICs) were determined by agar dilution method according to the recommendations of National Committee for Clinical Laboratory Standards. Results : Compared with other cephalosporins (cefaclor, cefpodoxime, and cefixime), cefcapene had lower MIC distributions for Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, and methicillin-susceptible S. aureus. Cefcapene had variable activity against Enterobateriaceae. Conclusion : Cefcapene had excellent in vitro antimicrobial activities against common typical bacterial respiratory tract pathogens and methicillin-susceptible S. aureus. Cefcapene appears to be a promising agent for treatment of community-acquired respiratory tract infections and infections caused by methicillin-susceptible S. aureus. 목 적 : Cefcapene은 새로운 경구 cephem계 광범위항생제로 Staphylococcus aureus와 Streptococi를 포함한 그람양성균, 그람음성균에 광범위한 항균력을 나타낸다고 보고되고 있다. 본 연구에서는 임상에서 분리된 균주에 대하여 cefcapene과 다른 cephalosporin항생제의 시험관내 항균력을 조사하였다.재료 및 방법 : 2000년부터 2003년까지 서울아산병원에서 분리된 450균주를 대상으로 하여 cefcapene과 다른 cephalosporin 항생제의 시험관내 항균력을 검사하였다. 항생제 최소억제농도는 NCCLS기준을 따랐다.결 과 : 다른 cephalosporin항생제(cefaclor, cefpodoxime, cefixime)들과 비교하여 cefcapene은 Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, methicillin감수성 Staphylococcus aureus에서 낮은 MIC분포를 나타내었다. Cefcapene은 Enterobacteriaceae에 대해서는 다양한 항균력을 보여주었다.결 론:Cefcapene은 지역사회 호흡기감염의 흔한 원인균과 methicillin 감수성 S. aureus에 탁월한 시험관내 감수성을 보였다. 따라서 cefcapene은 지역사회 폐렴과 methicillin 감수성 S. aureus감염증의 치료를 위한 경구항생제로 유용할 것으로 생각된다.

반코마이신 내성 장구균 감염에 대한 quinupristin-dalfopristin 치료 경험

추은주,최상호,조영환,정선미,김백남,김남중,김미나,김양수,우준희,류지소 대한화학요법학회 2002 대한화학요법학회지 Vol.20 No.1

VRE 감염이 중환자에서 급속히 증가하고 있으나 이에 대한 확실한 치료제가 없어 새로운 항생제에 대한 활발한 연구가 있는데 그 중 하나가 quinupristin/dalfopristin이고, 저자들은 중증 환자들의 VRE 감염에 대해 quinupristin/dalfopristin를 투여하여 치료한 임상적 경험을 하였기에 문헌고찰과 함께 보고하는 바이다. Vancomycin-resistant enterococci (VRE) was first recognized in 1992 in Korea. VRE infection have been increasingly reported in immunosuppressed patients over the past decade and have become one of major nosocomial pathogens. Clinicians carings for patients with VRE infections face severe constraints in the selection of treatment. Quinupristin/dalfopristin is active in vitro againt vancomycin-resistant E. faecium (VREF), with a MIC_(90) of 1.0㎍/mL. We studied the clinical efficacy and safety of this agent in the treatment of VREF infection. Patients were included if they had signs and symptoms of active infection including bacteremia, intra-abdominal infection, and wound infection. A total of 13 patients with VREF infection were enrolled. A favorable clinical response (cure or improvement) occured in 10 of 11 evaluable patients. The only adverse events related to quinupristin/dalfopristin were arthralgia and myalgia, which occurred in 2 of 13 patients. These results suggest that quinupristin/dalfopristin is effective and safe as treatment for VREF infections in critically ill patients with serious underlying conditions.

사람면역결핍바이러스 감염인의 신경매독

전원선,이은정,김태형,유쾌한,왕동현,오태연,위지완,윤서영,서미선,조아라,박진성,전민혁,추은주,추은주 순천향대학교 순천향의학연구소 2009 Journal of Soonchunhyang Medical Science Vol.15 No.1

The synergistic infection of syphilis and HIV (Human immunodeficiency virus) infection is a re-emerging problem of global health after AIDS (Acquired immunodeficiency syndrome) era. Neglected treatment of syphilis in HIV-positive patients may lead to increased chance of HIV transmission in community and neglected screening of HIV in syphilis patients may delay diagnosis of HIV which now become a controllable chronic diseases. HIV-positive persons with syphilis co-infection are more likely to have neurologic complications and a higher rate of treatment failure with currently recommended regimens. And the neurologic manifestations of syphilis in HIV patients tend to occur earlier periods of HIV infection. But neuropsyphilis in HIV patients is still poorly understood, despite > 2 decades of clinical experiences.

항문주위 괴사근막염 수술 후 발생한 두덩결합 골수염의 경험

김지연,추은주,김종화,이재철,진소영,김태형,전민혁,이은정,박의주 대한감염학회 2009 Infection and Chemotherapy Vol.41 No.3

Osteomyelitis of the pubic symphysis is not common and has often been reported to occur after urological or gynecological procedures. It can be spontaneous in origin but it also is associated with trauma, athletic exertion, pregnancy, and parturition. The early symptoms of osteomyelitis of the pubic symphysis mimic those of osteitis pubis, and therefore, the differential diagnosis between these two entities is of clinical importance. A fifty nine-year-old man who had previously received debridement and wide excision of perianal necrotizing fasciitis visited our hospital with pain on both inguinal areas. The core biopsy of the pubic symphysis and aspiration culture were performed, from which Pseudomonas aeruginosa was recovered. He was treated with parenteral ceftazidime for 5 days followed by cefepime for 7 weeks and showed favorable clinical response. To our knowledge, this is the first report on osteomyelitis of pubic symphysis resulting from debridement and wide excision of perianal necrotizing fasciitis in Korea.

일개 대학 병원에서 경험한 뎅기열-뎅기출혈열 4예와 국내 문헌 고찰

최문한,추은주,김태형,전민혁,박의주,신동원,이설희,최종효 대한감염학회 2008 감염과 화학요법 Vol.40 No.6

Dengue virus infection is an emerging imported disease in Korea. A total of 4 cases of dengue fever or dengue hemorrhagic fever diagnosed at Soonchunhyang University Hospital in Bucheon between January 2001 and December 2007 were retrospectively reviewed, In addition, relevant domestic literatures from Korean bibliographic databases, which matched 'dengue fever', 'dengue hemorrhagic fever' or 'dengue shock syndrome' as key words, have been reviewed. Ten articles (13 patients) met the inclusion criteria and were included in this review. All the patients except for one who was infected in Africa, were infected in Asian countries: Philippines (4), Indonesia (3), India (2), Cambodia (2), Sri Lanka (1), Thailand (1), Bangladesh (1), Myanmar (1), and Malaysia (1). Clinical manifestations after returning from abroad were as follows: fever (100%), chills (82%), headache (65%), myalgia (53%), nausea (41%), neutropenia (82%), thrombocytopenia (82%) and elevation of AST (82%) and ALT (53%). Most of the patients improved with conservative care except for one who died of dengue shock syndrome.

Mortality of Community-Acquired Pneumonia in Korea: Assessed with the Pneumonia Severity Index and the CURB-65 Score

김혜인,추은주,김효열,김영근,김신우,장현하,차승익,이재희,기현균,정혜숙,유광하,류성열,권기태,이병기,김도진,강철인,정두련,백경란,송재훈,서지영,심태선,문치숙,이현경,박성연,오진영,정숙인,박경화,윤나라,윤성호,손경목,김연숙,정기석 대한의학회 2013 Journal of Korean medical science Vol.28 No.9

The pneumonia severity index (PSI) and CURB-65 are widely used tools for the prediction of community-acquired pneumonia (CAP). This study was conducted to evaluate validation of severity scoring system including the PSI and CURB-65 scores of Korean CAP patients. In the prospective CAP cohort (participated in by 14 hospitals in Korea from January 2009 to September 2011), 883 patients aged over 18 yr were studied. The 30-day mortalities of all patients were calculated with their PSI index classes and CURB scores. The overall mortality rate was 4.5% (40/883). The mortality rates per CURB-65 score were as follows: score 0,2.3% (6/260); score 1, 4.0% (12/300); score 2, 6.0% (13/216); score 3, 5.7% (5/88); score 4, 23.5% (4/17); and score 5, 0% (0/2). Mortality rate with PSI risk class were as follows: I,2.3% (4/174); II, 2.7% (5/182); III, 2.3% (5/213); IV, 4.5% (11/245); and V, 21.7%(15/69). The subgroup mortality rate of Korean CAP patients varies based on the severity scores and CURB-65 is more valid for the lower scores, and PSI, for the higher scores. Thus, these variations must be considered when using PSI and CURB-65 for CAP in Korean patients.