배현주 교수

With increase of multi-drug resistant Escherichia coli in community-acquired urinary tractinfections (CA-UTI), other treatment option with a therapeutic efficacy and a low antibioticselective pressure is necessary. In this study, we evaluated in vitro susceptibility of E. coliisolates from CA-UTI to fosfomycin (FM), nitrofurantoin (NI), temocillin (TMO) as well astrimethoprim-sulfamethoxazole (SMX), ciprofloxacin (CIP) and cefepime (FEP). Theminimal inhibitory concentrations were determined by E

In order to investigate the incidence, clinical and microbiologic characteristics of Clostridium difficile infection (CDI) in Korea, a prospective observational study was performed. From September 2008 through January 2010, all patients whose stool was tested for toxin assay A&B and/or C. difficile culture were studied for clinical characteristics. Toxin types of the isolates from stool were tested. The mean incidence of CDI per 100,000 patient-days was 71.6 by month (range, 52.5-114.0), and the

The study was conducted to evaluate the Antibiotic Stewardship Program (ASP) in Korean hospitals compared with the previous two surveys in 2006 and 2012. The information on ASPs was collected through an online-based survey sent by e-mail to 192 infectious diseases specialists in 101 Korean hospitals in September 2015.Fifty-four hospitals (53.5%, 54/101) responded to the online survey. One infectious diseases specialist was employed in 30 (55.6%) of the 54 hospitals, and they were in charge of AS

A successful therapy of community-acquired pneumonia requires appropriate empirical antimicrobial therapy. Etiology and antimicrobial susceptibility of major pathogens of pneumonia can differ by country. Therefore, an ideal treatment guideline of community-acquired pneumonia should be based on the studies performed in each country. We developed a treatment guideline for community-acquired pneumonia in immunocompetent adults in Korea. This guideline was developed by the joint committee of the Kor

Background: Acute pyelonephritis (APN) is one of the most common community-acquired bacterial infections. Recent increases of antimicrobial resistance in urinary pathogens might have changed the other epidemiologic characteristics of APN. The objective of this study was to describe the current epidemiology of APN in Korea, using the entire population. Methods: From the claims database of the Health Insurance Review and Assessment Service in Korea, the patients with International Classification o

Previous exposure to antimicrobials is a major risk factor for Clostridioides difficile infection (CDI). Antibiotic prescription and C. difficile toxin assay records of patients admitted to a tertiary hospital in Korea from 2009 to 2013 were collected to investigate the association between antibiotic consumption and CDI incidence. A Spearman's correlation analysis between CDI incidence (positive result of toxin assay/10,000 admissions) and antibiotic consumption (defined daily dose/1,000 patient

Background: This study is to describe the changes in prescribing practices of antibiotics to treat community-acquired pneumonia (CAP) in Korea during 2010–2015. Methods: The claim database of the Health Insurance Review and Assessment Service in Korea was used to select adult patients (≥ 18 years of age) admitted between 2010 and 2015, with the International Classification of Diseases, Tenth Revision codes relevant to all-cause pneumonia for the first or second priority discharge diagnosis. The

Advances in the treatment and prevention of Pneumocystis jirovecii infection (PJI) in human immunodeficiency virus (HIV) patients decreased incidence and mortality dramatically, however, it may be associated with an increased frequency of unusual manifestation such as cystic formation, pneumothorax, focal infiltration, nodular formation, or extrapulmonary lesions. We report three cases of PJI with atypical manifestations. Each case demonstrates different clinical features: multiple nodular pulmo

Background: The purpose of this study was to determine the efficacy of infectioncontrol interventions to decrease the incidence of catheter-associated bloodstream infections (CA-BSI) and to examine the sustainability of its effect during and after the intervention in Korea. Materials and Methods: We conducted a prospective multi-strategy intervention in intensive care units (ICUs) at 3 university hospitals in Korea. The intervention consisted of education and on-site training for medical personn

With the emergence of B1/NAP1 strain of Clostridium difficile, epidemic feature of C. difficile infection (CDI) has been changing in North America. Clinical manifestation of CDI caused by B1/NAP1 strain is more severe resulting in high mortality and complications, and relapse rate is higher. In Korea, the epidemic feature of CDI is not clearly demonstrated yet. Infection by B1/NAP1 strain was reported recently,but the prevalence of the infections by those strains seems to be not high yet. For th

요로감염은 경증 질환인 반면 빈번히 발생하므로 항생제의 남용으로 인한 내성균의 증가와 보수적 항생제 사용으로 인한 치료 실패 및 의료 비용의 증가를 함께 고려해야 한다. 국내 지역사회 요로감염의 원인균은 선진국에 비하여 SXT와 fluoroquinolone 내성이 높고 최근 3세대 cephlosporin 내성도 증가하고 있어서 경험적 치료제의 선택에 어려움이 있다. 적합한 국내 지침을 위해서는 지속적으로 항생제 감수성 자료를 분석하고 내성에 따라 지침을 개정하고 이를 널리 알리는 작업이 필요할 것으로 생각된다.

Background: The objective of this study was to examine the usefulness of blood cultures and radiologic imaging studies for developingtherapeutic strategies in community-acquired acute pyelonephritis (CA-APN) patients. Materials and Methods: We prospectively collected the clinical data of CA-APN patients who visited 11 hospitals from March2010 to February 2011. Results: Positive urine and blood cultures were obtained in 69.3% (568/820) and 42.7% (277/648), respectively, of a total of 827CA-APN pa

The study investigated molecular mechanisms for prolonged nosocomial spread of multidrug-resistant Klebsiella pneumoniae co-producing plasmid-mediated AmpC β-lactamase DHA-1 and extended-spectrum β-lactamase SHV-12. Forty-eight clinical isolates of K. pneumonia, resistant to the extended-spectrum cephalosporins,were collected in a 750-bed university hospital over a year. The isolates were characterized for PCR-based β-lactamase genotypes, isoelectric focusing and pulsed-field gel electrophoresis

목 적 : 이전에 시행된 단국대학교병원의 항생제 사용 실태조사 결과, cephalosporin과 aminoglycoside이 각각 52.8%, 30.4%로 가장 많이 사용되는 항생제였고 항생제 사용 목적을 분석한 결과, 예방 목적 대 치료 목적의 항생제 사용 비율이 각각 3.9 : 1과 3.6 : 1의 비율로 대부분의 항생제가 예방 목적으로 사용되고 있었다. 따라서 임상에서 가장 많이 사용되는 cephalosporin과 aminoglycoside 항생제의 수술 전후 사용 실태를 파악하고자 하였다. 재료 및 방법 : 1997년 7월 한 달간 퇴원한 환자 중 14개 주요수술(전체 수술의 26.4%)을 대상으로 후향적 방법으로 예방적 항생제 사용의 적정성을 분석하였다. 결 과: 1) 예방적 사용이 권장된 8종류 105건의 수술 중 항생제 선택이 적절하였던 경우는 비천공성 충수절제술 2건에 불과하였다. 1세대 cephalosporin이 권장되는 7종 수술 중 37.8% (44/92건)에서만

Background: Uncomplicated acute cystitis (CA-UAC) is one of the most common infections treated with antibiotics in the community. However, few data on etiology of CA-UAC and its susceptibility to antibiotics are available, primarily because, in Korea, insurance does not allow reimbursement for microbiological evaluation of CA-UAC. However, microbiologic data on community-acquired uncomplicated acute pyelonephritis (CA-UAPN) are available. The objective of the study was to evaluate the question o