Widal 반응에 양성을 보인 Citrobacter freundii에 의한 흉농양 1예

황규열,장인호,어영,윤갑준,이경원 대한임상검사정도관리학회 1988 臨床檢査와 精度管理 Vol.10 No.1

β-용혈성 연쇄상구균 C, G 및 F 혈청군의 균종별 분리 빈도

황규열 ( Gyu Yul Hwang ),어영 ( Young Uh ),장인호 ( In Ho Jang ),이관수 ( Kan Su Lee ) 대한임상검사과학회 2006 대한임상검사과학회지(KJCLS) Vol.38 No.1

Beta-hemolytic streptococci (BHS) are frequently isolated pathogens in clinical microbiology laboratories. Among them, Group C, G and F streptococci infrequently cause respiratory infections, but they often invade other sites. Patients with underlying diseases are prone to be infected by the organisms and some of them can be fatal. Therefore, combination tests of serological and biochemical tests are needed to correct the identification of non-A, B streptococci because to various species belong to this species. The aim of this study was to investigate the isolation rates of strains and distribution of serogroup C, G and F streptococci at Wonju Hospital during the period of 2003-2004. 133 clinical isolates of group C, G and F streptococci were examined. Of them, 13 (9.8%) were group C, 41 (31.8%) were group F, 79 (59.4%) were group G. The prevalent isolation of the strains by serogroup were: group C, Streptococcus constellatus (38.5%); group F, Streptococcus anginosus (56.1%), Streptococcus constellatus (26.9%); group G, Streptococcus anginosus (54.4%), Streptococcus dysgalatiae subsp. equisimilis (26.5%). Overall, the most frequently isolated BHS was Streptococcus anginosus (51.2%).

Microplate를 이용한 장구균 동정법

어영,황규열,장인호,윤갑준,이경원,이형환 대한임상검사정도관리협회 2003 臨床檢査와 精度管理 Vol.25 No.2

Macrolide Resistance Trends in β-Hemolytic Streptococci in a Tertiary Korean Hospital

어영,황규열,장인호,조현미,노송미,김효열,권오건,윤갑준 연세대학교의과대학 2007 Yonsei medical journal Vol.48 No.5

Purpose: Erythromycin-resistant β-hemolytic streptococci (BHS) has recently emerged and quickly spread between and within countries throughout the world. In this study, we evaluate the antimicrobial susceptibility patterns and erythromycin resistance mechanisms of BHS during 2003-2004. Materials and Methods: The MICs of seven antimicrobials were determined for 204 clinical isolates of BHS from 2003 to 2004. Resistance mechanisms of erythromycin-resistant BHS were studied by the double disk test as well as by polymerase chain reaction (PCR). Results: Compared with our previous study, resistance among Streptococcus pyogenes isolates to a variety of drugs decreased strikingly: from 25.7% to 4.8% in erythromycin; 15.8% to 0% in clindamycin; and 47.1% to 19.0% in tetracycline. The prevalent phenotypes and genotypes of macrolide-lincosamide- streptograminB (MLSB) resistance in Streptococcus pyogenes isolates have been changed from the constitutive MLSB phenotype carrying erm(B) to the M phenotype with mef(A) gene. In contrast with Streptococcus pyogenes, resistance rates to erythromycin (36.7%), clindamycin (43.1%), and tetracycline (95.4%) in Streptococcus agalactiae isolates did not show decreasing trends. Among the Streptococcus dysgalactiae subsp. equisimilis isolates (Lancefield group C, G), resistance rates to erythromycin, clindamycin, tetracycline and chloramphenicol were observed to be 9.4%, 3.1%, 68.8%, and 9.4%, respectively. Conclusion: Continual monitoring of antimicrobial resistance among large-colony-forming BHS is needed to provide the medical community with current data regarding the resistance mechanisms that are most common to their local or regional environments.

임상분리균주에 대한 은이온(Ag+) 거즈의 생체외 항균력 시험

어영,황규열,윤갑준,김효열,어홍선,권오갑 대한임상미생물학회 2007 Annals of clinical microbiology Vol.10 No.1

배경: 은이온(Ag+)과 은화합물은 그람양성과 그람음성 세균 및 효모균에 효력이 있는 광범위 항균제로 잘 알려져 있으며, 은이온은 항균제 용도로 의료기구나 의료용품의 코팅제로 사용되고 있다. 최근에는 나노기술의 발달로 더 안전하며 항균력이 증가된 은나노 입자를 생산할 수 있게 되었다. 이에 본 연구에서는 임상분리주를 대상으로 은나노를 코팅한 은이온(Ag+) 거즈의 항균력을 평가하였다. 방법: 임상검체에서 분리된 143주의 포도당비발효그람음성간균, 18 주의 통성 혐기성 그람음성세균 , 397주의 통성 혐기성 그람양성세균, 46주의 혐기성세균과 161주의 효모균 및 3주의 정도관리 균주를 대상으로 세 종류의 은이온 (Ag+) 거즈(10, 800, 1,500)의 항균력을 디스크확산법으로 시험하였다. 결과: 포도당비발효그람음성간균, 통성 혐기성 그람음성세균과 통성 혐기성 그람양성세균의 은이온 (Ag+) 거즈의 감수성률은 각각 87%, 87%, 78% 였으며, imipenem 내성 포도당비발효그람음성간균, extended spectrum β-lactamase (ESBL) 생성 장내세균, methicillin 내성 포도알균에 대한 은이온 (Ag+) 거즈의 항균력은 imipenem 감수성 포도당비발효그람음성간균, ESBL을 생성하지 않는 장내세균, methicillin 감수성 포도알균과 유사하였다. 결론: 은이온(Ag+) 거즈는 imipenem 내성 포도당비발효그람음성간균, ESBL 생성 그람음성간균, methicillin 내성 포도알균을 포함한 다수의 통성 혐기성 그람양성과 그람음성 세균에 광범위 항균력을 보였다.

Distributions of Macrolide-Lincosamide-Streptogramin B Resistance Phenotypes in Clinical Isolates of Staphylococi

어영,황규열,장인호,권오건,윤갑준,김효열 대한임상미생물학회 2008 Annals of clinical microbiology Vol.11 No.2

Background: Increased resistance rates to macrolide- lincosamide-streptogramin B (MLSB) antibiotics among clinical isolates of staphylococci are considered as a consequence of an expanded use of these antibiotics in the treatment of Gram-positive infections. The proportion of MLSB resistance phenotypes of staphylococci is quite different by geographical variations and study periods. The aim of the present study was to determine the distribution of MLSB resistance phenotypes among clinical isolates of staphylococci in a university hospital. Methods: The MLSB resistance phenotypes of clinical isolates of staphylococci were investigated by the double-disk diffusion test using erythromycin and clindamycin disks. Results: Of 7,916 isolates, 55.7% exhibited a constitutive resistance phenotype (cMLSB) whereas 8.1% expressed an inducible resistance phenotype (iMLSB). Among 3,419 coagulase-negative staphylococci (CNS), 32.6% and 10.0% exhibited cMLSB and iMLSB resistance phenotypes, respectively. Of 4,497 Staphylococcus aureus isolates, 73.1% and 6.8% were cMLSB and iMLSB resistance phenotypes, respectively. cMLSB was detected among 90.2% of methicillin-resistant S. aureus (MRSA), 46.5% of methicillin-resistant CNS (MRCNS), 3.2% of methicillin-susceptible CNS (MSCNS), and 2.2% of methicillin-susceptible S. aureus (MSSA). iMLSB was detected among 16.5% of MSSA, 11.5% of MRCNS, 6.7% of MSCNS, and 4.4% of MRSA. Conclusion: MLSB resistance was more prevalent among S. aureus isolates than CNS strains. Although cMLSB was the most frequently detected resistance phenotype among the total staphylococcal isolates, methicillin-susceptible strains exhibited somewhat higher iMLSB resistance rates compared with methicillin- resistant strains.

흉막액 배양에서 누출액과 삼출액에 따른 세균학적 특성

이현교,황규열,박순덕,어영,김주원,윤갑준,리원연 대한임상미생물학회 2015 Annals of clinical microbiology Vol.18 No.2

A total of 1,132 pleural fluid culture results obtained from October 2012 to July 2014 were analyzed to elucidate the microbiological characteristics according to transudative and exudative pleural fluid. The pleural fluid cultures were performed using aerobic and anaerobic blood culture bottles. The blood and pleural fluid for total protein, lactate dehydrogenase, and glucose measurement were submitted to laboratory at the same time with pleural fluid cultures. The rates for culture positivity, anaerobes isolation, and polymicrobials between transudative and exudative pleural fluid were 5.2% vs. 10.4%, 14.8% vs. 7.8%, and 14.8% vs. 10.9%. (Ann Clin Microbiol 2015;18:-55)

Extended Spectrum β-Lactamase를 생성하는 Escherichia coli,Klebsiella species 및 Proteus mirabilis 의 분리빈도

어영,황규열,권오건,윤갑준,김효열 대한임상미생물학회 2007 Annals of clinical microbiology Vol.10 No.2

Background: Accurate detection of extended spectrum β-lactamase (ESBL) is important because ESBLproducing organisms may appear susceptible to oxyimino- β-lactams in standard susceptibility tests, but are considered to be clinically resistant to these drugs. And continued monitoring of isolation trend of ESBL-producing organisms is essential for the guideline settlement of antibiotic usage and infection control program. Methods: Disk diffusion test using the Clinical and Laboratory Standards Institute's ESBL phenotypic confirmatory test were performed on 5,511 clinical isolates of Escherichia coli, Klebsiella pneumoniae, Klebsiella oxytoca, and Proteus mirabilis during the recent six years (April 2001-March 2007). The ESBL producer was defined as an organism showing an increase in the zone diameter of ≥5 mm for either cefotaxime or ceftazidime with clavulanic acid versus that without clavulanic acid (CTC confirmatory test, CZC confirmatory test, respectively). Results: The ESBL-positive rates were 34.8% in K. pneumoniae, 9.3% in K. oxytoca, 8.4% in E. coli, and 6.5% in P. mirabilis. Among the ESBL-positive organisms, the detection rates of ESBL CTC and CZC confirmatory tests were as follows: 91.3% vs 68.7% in K. pneumoniae, 96.3% vs 44.4% in K. oxytoca, 94.8% vs 45.4% in E. coli, and 100% vs 20% in P. mirabilis. ESBL-producing K. pneumoniae had shown a continuously increasing trend from 24.3% in 2001 to 46.4% in 2006. Conclusion: Both of the ESBL confirmatory tests should be simultaneously tested for the accurate detection of ESBL-producing K. pneumoniae, K. oxytoca, E. coli, and P. mirabilis. In addition, an active infection control approach is needed for ESBL-producing K. pneumoniae.

Nosocomial Outbreak Caused by NDM-5 and OXA-181 Carbapenemase Co-producing Escherichia coli

안광진,황규열,김영근,김효열,정혜란,홍준성,어영 대한감염학회 2019 Infection and Chemotherapy Vol.51 No.2

Carbapenemase-producing Enterobacteriaceae (CPE) is an important and increasing threat to global health. From July to September 2017, 20 inpatients at a tertiary care hospital in Korea were either colonized or infected with carbapenem-resistant Escherichia coli strains. All of E. coli isolates co-produced blaNDM-5 and blaOXA-181 carbapenemase genes and shared ≥88% clonal relatedness on the basis of a cladistic calculation of the distribution of pulsed-field gel electrophoresis patterns. Rapid detection of CPE is one of the most important factors to prevent CPE dissemination because it takes long time for CPE to become negative.

최근 20년 동안 단일 3차 의료기관의 칸디다혈증 환자에서 분리된 Candida 균종별 분리 빈도와 항진균제 내성률의 변화 추이

김동균,황규열,유길성,김주원,어영 대한임상미생물학회 2017 Annals of clinical microbiology Vol.20 No.3

Background: Candidemia has increased with an increasing number of people in the high risk group and so has become more important. This study was conducted to investigate the isolation rate of Candida species from candidemia patients and the change in rate of antifungal resistance. Methods: At a single tertiary care hospital, 1,120 blood cultures positive for Candida species from 1997 to 2016 were investigated according to date of culture, gender, age, and hospital department. Results: During the investigation period, the number of candidemia patients increased from 14 in 1997 to 84 in 2016. The most common organism identified during the two decades was Candida albicans (40.8%), followed by Candida parapsilosis (24.1%), Candida tropicalis (13.2%), and Candida glabrata (12.8%). C. glabrata was relatively common in females (45.5%) compared to males. The age group 40-89 years was more frequently infected than other age groups, and the most frequent isolates according to age group were C. albicans in neonate (66.7%), C. parapsilosis in 1-9-year-olds (41.7%), and C. glabrata in those aged ≥60 years (range; 13.3%-20.0%). According to the visited departments, C. albicans, C. glabrata, and Candida haemulonii were more common in medical departments, while C. parapsilosis was more common in surgical departments. In the antifungal susceptibility test, a rising trend of azole resistance among C. albicans and C. glabrata was observed in recent years. Conclusion: In this study, it was confirmed that the isolation rate of Candida species in blood is different by age, gender, and hospital department, and the distribution of isolated Candida species changed over time. The resistance patterns of antifungal agents are also changing, and continuous monitoring and proper selection of antifungal agents are necessary. (Ann Clin Microbiol 2017;20:-62)