Bloodstream Infections and Clinical Significance of Healthcare-associated Bacteremia: A Multicenter Surveillance Study in Korean Hospitals

Son, Jun Seong,Song, Jae-Hoon,Ko, Kwan Soo,Yeom, Joon Sup,Ki, Hyun Kyun,Kim, Shin-Woo,Chang, Hyun-Ha,Ryu, Seong Yeol,Kim, Yeon-Sook,Jung, Sook-In,Shin, Sang Yop,Oh, Hee Bok,Lee, Yeong Seon,Chung, Doo The Korean Academy of Medical Sciences 2010 JOURNAL OF KOREAN MEDICAL SCIENCE Vol.25 No.7

<P>Recent changes in healthcare systems have changed the epidemiologic paradigms in many infectious fields including bloodstream infection (BSI). We compared clinical characteristics of community-acquired (CA), hospital-acquired (HA), and healthcare-associated (HCA) BSI. We performed a prospective nationwide multicenter surveillance study from 9 university hospitals in Korea. Total 1,605 blood isolates were collected from 2006 to 2007, and 1,144 isolates were considered true pathogens. HA-BSI accounted for 48.8%, CA-BSI for 33.2%, and HCA-BSI for 18.0%. HA-BSI and HCA-BSI were more likely to have severe comorbidities. <I>Escherichia coli</I> was the most common isolate in CA-BSI (47.1%) and HCA-BSI (27.2%). In contrast, <I>Staphylococcus aureus</I> (15.2%), coagulase-negative <I>Staphylococcus</I> (15.1%) were the common isolates in HA-BSI. The rate of appropriate empiric antimicrobial therapy was the highest in CA-BSI (89.0%) followed by HCA-BSI (76.4%), and HA-BSI (75.0%). The 30-day mortality rate was the highest in HA-BSI (23.0%) followed by HCA-BSI (18.4%), and CA-BSI (10.2%). High Pitt score and inappropriate empirical antibiotic therapy were the independent risk factors for mortality by multivariate analysis. In conclusion, the present data suggest that clinical features, outcome, and microbiologic features of causative pathogens vary by origin of BSI. Especially, HCA-BSI shows unique clinical characteristics, which should be considered a distinct category for more appropriate antibiotic treatment.</P>

국내 5개 3차 병원의 β-lactam계 항생제 사용 실태 및 Klebsiella pneumoniae의 항생제 내성과의 상관 관계

정숙인,박경화,권기태,고관수,오원섭,정두련,백경란,염준섭,장현하,김신우,손준성,송재훈 대한감염학회 2007 감염과 화학요법 Vol.39 No.4

Background : This study was performed to evaluate the prescribing pattern of β-lactam antibiotics and the relationship between antimicrobial resistance and antimicrobial use in 5 tertiary care hospitals in Korea. Materials and Methods : Data on annual patient-days and annual consumption (defined daily dose (DDD) per 100 patient-days) of β-lactam antibiotics from 2003 to 2005 in 5 tertiary hospitals were analyzed. To determine the antimicrobial resistance in K. pneumoniae, broth microdilution test and double disk synergy were performed according to the CLSI performance standards. Spearman's correlation coeffient was used to determine the relationship between antibiotic consumption and resistance. Results : The prescription of β-lactam antibiotics in 5 tertiary hospitals markedly varied. In two hospitals, increase in consumption of β-lactam antibiotics was more than 30% during recent 3 years. The higher consumption of β-lactam antibiotics significantly correlated with the higher rate of antibiotic-resistant K. pneumoniae in 5 tertiary care hospitals. Conclusion : Continuous surveillance of antibiotic use is needed to encourage appropriate prescribing of antibiotics and to reduce antibiotic resistance. 목적 : 항생제의 오남용으로 인한 내성균의 발현 및 급속한 확산이 전세계적으로 문제시 되고 있다. 특히 병원은 항생제 내성의 중심점에 있는 것으로 여겨진다. 본 연구에서는 최근 3년간 국내 5개 3차 병원의 β-lactam계 항생제의 사용량을 조사하고, 각 병원별 항생제 사용량과 K. pneumoniae의 항생제 내성률과의 상관관계를 알아보고자 하였다. 재료 및 방법 : 국내 5개 3차 병원에서 2003년 1월부터 2005년 12월까지 병원 입원 환자를 대상으로 연도별 재원연인원수와 각 β-lactam계 항생제의 총사용량을 수집하여 DDD (defined daily dose) per 100 patient-days로 환산하여 비교하였다. 2005년 6월부터 8월까지 각 병원의 임상검체에서 동정된 K. pneumoniae를 수집하여 액체배지미량희석법으로 항생제 감수성 검사를 시행하였고 ESBL(extended-spectrum β-lactamase) 생성 여부는 double disk synergy test를 시행하였다. 항생제 사용량과 내성의 상관관계는 Spearman 상관관계 분석을 시행하였다. 결과 : 5개 병원 중 3개 병원에서는 연도별 β-lactam계 항생제 사용량이 비슷하게 유지되었으나, 2개 병원에서는 2003년에 비해 2005년에 항생제 사용량이 30% 이상 증가하였다. β-lactam계 항생제 중 제제별 비율은 각 병원마다 차이가 있었으나, 3세대 cephaosporin의 사용이 가장 많았고 2세대 ceaphlosporin, β-lactam/β-lactamase inhibitor, 1세대 cephalosporin 순이었다. 경구용 β-1actam계 항생제의 사용량(r=0.900, P<0.037)과 2세대 cephalosporin의 사용량(r=0.900, P<0.037)은 각각 K. pneumoniae의 ESBL 생성과 양의 상관관계가 있었다. Ceftazidime의 사용량은 K. pneumoniae의 ceftazidime 내성률과 양의 상관관계가 있었다(r=0.900, P<0.037). 반면 imipenem의 사용량은 piperacillin/tazobactam 내성과 음의 상관관계가 있었다(r=-0.900, P<0.037). 결론 : 최근 3개년간 항생제 사용량은 병원별로 차이가 있으나 일부 병원에서는 증가하였다. β-lactam계 항생제의 사용량은 K. pneumoniae의 항생제 내성과 상관관계가 있었다. 항생제 사용을 줄임으로써 항생제 내성을 감소시킬 수 있을 것으로 기대되며, 병원별로 항생제 사용에 대한 지속적인 감시가 필요할 것이다.

오미자 열수추출물의 대장암세포 증식억제 효과

유민주;정하숙 덕성여자대학교 대학원 2011 덕성여자대학교 대학원 논문집 Vol.13 No.-

This study investigated anticancer activity of Schizandra chinensis Baillon for the evaluation as a functional food resources. Schizandra chinensis Baillon were extracted with water for 3 hr at 90 °C. In the present study, we investigated the antiproliferative activity of the water extract of Schizandra chinensis Baillon in human colon cancer cell line(HT-29) via cell viability assay, morphology study, cell cycle analysis and RT-PCR. The HT-29 cells were cultured in the presence of several concentrations(0, 1.0, 2.0, 4.0 mg/mL) of water extracts of Schizandra chinensis Baillon. As a result, Schizandra chinensis Baillon could inhibit the colon cell growth in a dose-dependent manners, which was associated with morphological changes and apoptotic cell death with cell shrinking, chromatin condensation and apoptotic bodies. In cell cycle analysis, treatment with Schizandra chinensis Baillon resulted in marked increases of colon cells in the GO(sub-Gl) and decrease in the G0/G1 phases. And p53 mRNA expression were increased. These results suggest that Schizandra chinensis Baillon inhibits the growth of human colon cancer cells by various apoptosis-aiding activities as well as apoptosis itself.

한국 자생 구절초 종류의 정유성분 비교분석 및 항생제 내성 Salmonella 속 균주에 대한 억제효과

변연희,정은영,정하숙,이연희,신승원 德成女子大學校 藥學硏究所 2008 藥學論文誌 Vol.19 No.-

The essential oils from the aerial parts of three varieties of Chrysanthemum zawadskii cultivated in the herbal garden of Duksung Women' s University were extracted by steam distillation method and their compositions were compared by GC-MS analysis. The composition of essential oil fractions from the three varieties of C. zawadskii significant differences in their compostion. While the predominant components of C. zawadskii were camphor and borneol, C. zawadskii var. tenuisectum contained myrtenol and germacrene D as representing compound of its essential oil. C. zawadskii var. nakdongense oil showed higher contents of germacrene D than other two varieties of C. zawadskii. As the results of the determination of the effects of this oil and its main components on antibiotic-susceptible and -resistant strains of Salmonella enteritidis and S. typhimurium, the main components of C. zawadskii oil fraction, borneol and camphor, significantly inhibited all strains of the two Salmonella species examined, while its oil fraction showed relatively weak activity. In evaluation tests of the combination effects of the oils with kanamycin or streptomycin using a checkerboard microtiter assay, C. zawadskii oil fraction combined with streptomycin resulted the most significant synergism in this study with the fractional inhibiting concentration index (FICI) of 0.19.

열분해가스크로마토그라피/질량분석기에 의한 자동차 페인트의 분석 및 검색프로그램의 응용

손성건,박하선,이진숙,정영호,홍성욱,박종신,박성우 內務部 國立科學搜査硏究所 2001 國立 科學 搜査 硏究所 年報 Vol.33 No.-

일부 지하철 근로자와 소방공무원의 직무 스트레스 요인 비교

윤석환,최숙정,신동훈,정인성,하정숙 대한산업의학회 2007 대한직업환경의학회지 Vol.19 No.3

보건간호활동으로 추진한 노인건강증진 프로그램

유인영(In-Young Yoo),조정민(Chung0Min Cho),최영숙(Young-Sook Choi),정문희(Moon-Hee Jung),김미혜(Mi-Hye Kim),유광수(Kwang-Soo You),윤숙례(Suk-Rye Yoon),한명화(Myung-Hwa Han),최선하(Sun-Ha Choi),하영(Young Ha),김규성(Kyu-Sung Kim),이현주 한국보건간호학회 1997 韓國保健看護學會誌 Vol.11 No.1

한국인 직무 스트레스 측정도구의 개발 및 표준화

장세진,고상백,강동묵,김성아,강명근,이철갑,정진주,조정진,손미아,채창호,김정원,김정일,김형수,노상철,박재범,우종민,김수영,김정연,하미나,박정선,이경용,김형렬,공정옥,김인아,김정수,박준호,현숙정,손동국 大韓産業醫學會 2005 대한직업환경의학회지 Vol.17 No.4

Background and Purposes: Over the past three decades, numerous studies performed in Korea have reported that job stress is a determinant risk factor for chronic diseases and work disability. Every society has its own culture and occupational climate particular to their organizations, and hence experiences different occupational stress. An occupational stress measurement tool therefore needs to be developed to estimate it objectively. The purpose of this study is to develop and standardize the Korean Occupational Stress Scale (KOSS) which is considered to be unique and specific occupational stressors in Korean employees. Subjects and Methods: Data were obtained from the National Study for Development and Standardization of Occupational Stress (NSDSOS Project: 2002-2004). A total of 12,631 employees from a nationwide sample proportional to the Korean Standard Industrial Classification and the Korean Standard Occupational Classification were administered. The KOSS was developed for 2 years (2002-2004). In the first year, we collected 255 items from the most popular job stress measurement tools such as JCQ, ERI, NIOSH and OSI, and 44 items derived from the a qualitative study (depth interview). Forty-three items of KOSS, in the second year, were retained for use in the final version of the KOSS by using Delphi and factor analysis. Items were scored using conventional 1-2-3-4 Likert scores for the response categories. Results: We developed eight subscales by using factor analysis and validation process: physical environment (3 items), job demand (8 items), insufficient job control (5 items), interpersonal conflict (4 items), job insecurity (6 items), organizational system (7 items), lack of reward (6 items), and occupational climate (4 items). Together they explained 50.0% of total variance. Internal consistency alpha scores were ranged from 0.51 to 0.82. Twenty-four items of the short form of the KOSS (KOSS-SF) were also developed to estimate job stress in the work setting. Because the levels of the subscales of occupational stress were gender dependent, gender-specific standard norms for both the 43-item full version and the 24-item short form using a quartile for the subscales of KOSS were presented. Conclusion: The results of this study suggest that KOSS might be an appropriate measurement scale to estimate occupational stress of Korean employees. Further and more detailed study needs to be conducted to improve the validity of this scale.

Inhibition of Monamine Oxidase by a Flavone and Its Glycoside from Ixeris dentata Nakai

Ha Sook Chung 한국식품영양과학회 2003 Preventive Nutrition and Food Science Vol.8 No.2

Ixeris dentata Nakai (Compositae) is a perennial herb which has been used as a folk medicine for treating diabetes and gastroenteric troubles in Korea. Active compounds were isolated from the aerial parts of Ixeris dentata through the bioassay-guided fractionation and isolation method evaluated for inhibition of monoamine oxidase (MAO) in vitro. The compounds were identified as 5,7,3',4'-tetrahydroxyflavone (1) and 5,7,3',4'- tetrahydroxyflavone 7-glucoside (2), based on physical and spectroscopic characteristics. Compounds 1 and 2 showed a selective inhibition of type B MAO (MAO-B) activity, with IC_(50) values of 15.3 μM and 36.4 μM, respectively, but did not inhibit type A MAO (MAO-A) activity.

Induction of Apoptosis of DK-5-62, a Novel (-)-Catechin Derivative Through MAPKs Signaling Pathway in HCT116 Cells

Ha Sook Chung 대한화학회 2022 대한화학회지 Vol.66 No.4

The present study was designed to investigate the molecular mechanisms of DK-5-62, a novel (-)-catechin derivative on HCT116 human colorectal cancer cells. DK-5-62 inhibited the proliferation in dose- and time-dependent manner accompanied by the morphological changes. Effects of DK-5-62 appeared to be mediated by the induction of apoptosis, as manifested through DNA-binding dye Hoechst 33258 staining. Analysis of the mechanism of these events indicated that DK- 5-62-treated cells exhibited an increased ratio of Bax/Bcl-2, resulting in the activation of caspase-9, caspase-3, and poly-ADPribose polymerase in a dose-dependent manner. Moreover, DK-5-62-induced apoptosis was accompanied by phosphorylation of the mitogen-activated protein kinase family, c-Jun N-terminal kinase, p38, and extracellular signal-regulated kinase. These results suggest that HCT116 cells are moderately sensitive to growth inhibition by DK-5-62 via apoptosis, as evidenced by activation of ERK/p38/Bcl-2 family signaling, as well as alteration in caspase-9 and caspase-3.