During The last 11 years from Jan. 1980 to Dec. 1990, 72 cases of salmonellosis has been admitted to the Department of Pediatrics of National Medical Center and evaluated clinical difference between typhoid fever and salmonella gastroenteritis. The results were as follows: 1) The annual incidence of salmonella gastroenteritis insalmonellosis was increased in the latter half of the eighties. 2) Both salmonellosis had its peak incidence in the summer. 3) Salmonella gastroenteritis was highest in the age of less than 5 year in contrast with the age of 6~9 year in typhoid fever. 4) The specimens isolated salmonellae were blood and stool in most cases, especially blood in typhoid fever and stool in gastroenteritis. 5) S.typhi was 16 cases, salmonella group A was 3 cases, group B was 16 cases and Group D and E were a case in each in isolated salmonellae. 6) On the antibiotic sensitivity test, S.typhi was sensitive to the most antibiotics. but the salmonella group B was relatively resisitant to Ampicillin, Carbenicillin, Tetracycline and Chloramphenicol.
Ampicillin ; Anti-Bacterial Agents ; Carbenicillin ; Chloramphenicol ; Gastroenteritis ; Incidence ; Pediatrics ; Salmonella ; Salmonella Infections* ; Tetracycline ; Typhoid Fever

One hundred and thirty-two cases(132 eyes) of corneal ulcer were analysed on the clinical and etiologic basis. The history of evident ocular trauma was found in 28.8% of the cases and ocular disease was found in 7.6% of the cases. Positive results were 16/55 in smear and 33/61 in culture, and the most common isolate was coagulase negative staphylococcus in bacteriologic studies. In fungal studies, positive results were 1/42 in smear and 5/42 in culture, and Aspergillus was the most common isolate. Cephalexin was the most sensitive antibiotics for Gram positive organism and carbenicillin and gentamicin were the most sensitive antibiotics for Gram negative orgamsm. These results indicate that gentamicin and cephalexin in combination would be recommended as the initial treatment of wide-spectrum antibiotics coverage for bacterial corneal ulcer until the final culture results and senitivity are available.
Anti-Bacterial Agents ; Aspergillus ; Carbenicillin ; Cephalexin ; Coagulase ; Corneal Ulcer* ; Gentamicins ; Staphylococcus

In clinical practice, we have occasionally experienced the difficulty to identify the pathologic changes of the non or faint-visualized kidney induced by ureteral stone on I.V.P. and especially to decide whether upper urinary tract infection of ipsilateral side was in accordance with lower urinary tract infection or not. We have checked routinely the bacteriological study of the urine collected from the ureterolithotomized site on operation during last two years. Following results were obtained: 1) Among the cultured urine of 42 patients, organism detected in 20 patients and no growth in remainder. Colifrom bacilli 11(26.2%) Staphylococci 5(11.9%) Streptococci 1(2.4%) Pseudomonas 1(2.4%) TB bacilli 2(4.7%) 2) Sensitive drug pattern of 18 patients, Coliform bacilli (11): Kanamycin, Streptomycin, Chloramphenicol Staphylococcus (5): Penicillin, Kanamycin Streptococcus (1): Penicillin Pseudomonas (1): Geopen From above results, some advantages has been provided in the post-operative management of upper urinary tract infection after removal of the ureteral stone.
Carbenicillin ; Chloramphenicol ; Enterobacteriaceae ; Humans ; Kanamycin ; Kidney ; Penicillins ; Pseudomonas ; Staphylococcus ; Streptococcus ; Streptomycin ; Ureter* ; Urinary Tract Infections* ; Urinary Tract*

Vibrio alginolyticus is a microorganism of marine environment that occasionally occurs as a human pathogen. We isolated V. alginolyticus from a patient with otitis media. A 37-year-old man had been exposed to seawater one month before admission. The isolate showed typical biochemical and characteristics of this organism such as positive Voges-Proskauer reaction, fermentation of sucrose, growth on 10% sodium chloride media. In vitro susceptibility test shows the isolate was resistant to ampicillin and carbenicillin, but was susceptible to other antimicrobial agents. The patient improved with ciprofloxacin and ofloxacin therapy.
Adult ; Ampicillin ; Anti-Infective Agents ; Carbenicillin ; Ciprofloxacin ; Fermentation ; Humans ; Ofloxacin ; Otitis Media* ; Otitis* ; Seawater ; Sodium Chloride ; Sucrose ; Vibrio alginolyticus* ; Vibrio*

OBJECTIVES: Aeromonas species is a gram-negative, facultative anaerobe of the family Vibrionaceae. The organism has been recognized as a pathogen associated with illness in human, such as acute gastroenteritis, cellulitis, septicemia, and other rare diseases. METHODS: To evaluate the clinical significance of Aeromonas bacteremia in Korea and it's susceptibility of antibiotics, we evaluated the 17patients with Aeromonas bacteremia. Identification was done by use of API 20E system and antibiotic susceptibility was tested with disk diffusion method. RESULTS: Male to female ratio was 11:6, and mean age was 54.1years(8-85years) old. Liver cirrhosis was the most common underlying disease(10cases of 17patients, 58.8%a). Other underlying diseases were as follows: gallstone in 2cases, cholangiocarcinoma in 2cases, and aplastic anemia in 1case, cerebral infarction in 1case. But one had no underlying disease. So Aeromonas bacteremia were occurred in 14immunocompromised patients(82.3%), and in 10patients with hepatobiliary diseases, A. hydrophila was most commonly isolated(13cases, 764%), and the A sobria(4cases, 23.5%) was infrequently isolated. The overall fatality was 47%, and there had no significant difference in fatality between A. hydrophila and A sobria All Aeromonas species had resistance to ampicillin and carbenicillin. CONCLUSION: Because Aeromonas bacteremia may occur through water-borne route, especially in immunocompromised host. We should pay attention to immunocompromised patients, espacially having hepatobiliary disease.
Aeromonas* ; Ampicillin ; Anemia, Aplastic ; Anti-Bacterial Agents ; Bacteremia* ; Carbenicillin ; Cellulitis ; Cerebral Infarction ; Cholangiocarcinoma ; Diffusion ; Female ; Gallstones ; Gastroenteritis ; Humans ; Immunocompromised Host ; Korea ; Liver Cirrhosis ; Male ; Rare Diseases ; Sepsis ; Vibrionaceae

Antimicrobial susceptibility of the bacterial strains isolated from clinical specimens during the period from June, 1983 to June, 1986 in Yeungnam Medical Center was studied and the following results were obtained. 1. Staphylococcus aureus was highly susceptible to cephalothin and its susceptibility to methicillin was gradually reduced. 2. Streptococcus strains except enterococcus were generally susceptible to penicillin, while most enterococci were susceptible to only ampicillin. 3. Gram-negative rods including Escherichia coli were highly susceptible to amikacin and tobramycin. 4. Serratia were generally less susceptible to the amtimicrobials tested than other Enterobacteriaceae. Among them, Serratia marcescens showed the highest susceptibility to amikacin and chloramphenicol. 5. Pseudomonas aeruginosa revealed the highest susceptibility to amikacin and tobramycin and moderate susceptibility to carbenicillin and gentamycin. 6. Acinetobacter calcoaceticus revealed low susceptibility to most antimicrobials tested, showing only 30% susceptibility to amikacin, tobramycin and gentamycin in 1986.
Acinetobacter calcoaceticus ; Amikacin ; Ampicillin ; Bacteria* ; Carbenicillin ; Cephalothin ; Chloramphenicol ; Enterobacteriaceae ; Enterococcus ; Escherichia coli ; Gentamicins ; Methicillin ; Penicillins ; Pseudomonas aeruginosa ; Serratia ; Serratia marcescens ; Staphylococcus aureus ; Streptococcus ; Tobramycin

BACKGROUND: Kluyvera, a new genus in the family Enterobacteriaceae, has been rarely isolated from clinical specimens and regarded as an opportunistic pathogen. Although there were several case reports in Korea, most of them were reported at a genus level except a case of K. cyrocrescens. We isolated Kluyvera species from seven patients from July 1996 to January 1999. We identified them to species level and investigated their clinical significance. METHODS: The medical records of seven patients were reviewed for demographical findings, underlying diseases, diagnoses, the association of Kluyvera isolates with disease, antibiotic treatments, and clinical outcomes. Eight strains were identified and tested for the antimicrobial susceptibilities by MicroScan Neg Combo type 14 and 21 Panel(Dade Behring, USA). Five of the eight strains had been stored at -70degrees C and were tested for ascorbate fermentation, the ability to grow and ferment glucose at 5degrees C, and the zone of inhibition around carbenicillin and cephalothin. RESULTS: Kluyvera isolates were regarded as true pathogens in six of seven cases including Hickman-catheter associated sepsis(HCAS), empyema, peritonitis, necrotizing cholecystitis, sepsis, and liver abscess although the latter four cases yielded mixed cultures. While three of the six patients had underlying diseases, malignant lymphoma, hepatocellular carcinoma and stomach cancer, other three were previousely healthy. Most of them were improved with an empirical therapy, but Kluyvera species was repeatedly isolated from the HCAS case in spite of the antibiotic treatment; it was cured bacteriologically after the removal of the catheter. The five isolates were all confirmed to be K. ascorbata by positive ascorbate test, and failure to grow at 5degrees C. CONCLUSIONS: Six of the seven cases including three with no underlying diseases, isolates of Kluyvera species were found clinically significant, suggesting that Kluyvera species is potentially pathogenic in healthy individuals as well as compromized hosts. MicroScan system is capable of identifying Kluyvera species at the genus level, but not at the species level. The ascorbate test is simple and useful for differ entiation of K. ascorbata from K. cryocrescens.
Carbenicillin ; Carcinoma, Hepatocellular ; Catheters ; Cephalothin ; Cholecystitis ; Diagnosis ; Empyema ; Enterobacteriaceae ; Fermentation ; Glucose ; Humans ; Kluyvera* ; Korea ; Liver Abscess ; Lymphoma ; Medical Records ; Peritonitis ; Sepsis ; Stomach Neoplasms

We have treated 4-year-old with amikacin and rifampin, who suffered from bacterial meningitis due to gentamicin-resistant Pseudomonas aeruginosa. There was no complication during treatment. Even though we didint check audiometry and BUN and/or creatinine, urinalysis was normal and physical examination revealed no abnormalities. He had been treated fora about 3 months with various antibiotics including gentamicin, intravascular and intrathecal, and carbenicillin. Fever, headache and meningeal irritation signs recurred intermittently in spite of continuous treatment. The culture of the CSF showed P. aeruginosa, which initially was sensitive to gentamicin but became resistant to it. The computed tomography of the brain showed diffuse ventricular dilatation with no abnormal shadow in the cerebral hemisphere and posterior fossa. So we decided to administer rifampin 300mg P.O. daily and amikacin 120mg I.M. daily. Faver became normalized after 14 days of treatment. Neurologic examination was normal. The culture of CSF at that time revealed no growth of P. areugicnosa. He was discharged after 40 days of treatment. As mentioned above, no problem due to amilacin alone or amikacin with refampin. Until now, relationship between amikacin and refampin was not clear. Amikacin alone may be efficient to gentamicin-resistant P. aeruginosa infection. But because amikacin was given through intramuscular route in stead of intrathecal route and daily dosage of amikacin was 8mg/kg in stead of 15mg/kg, which was permissible dosage, the role of rifampin might not be neglected as trivial, even though there was no proof that rifampin was effective against Pseudomonase areuginosa espercially which was gentamicin-resistrant.
Amikacin ; Anti-Bacterial Agents ; Audiometry ; Brain ; Carbenicillin ; Cerebrum ; Child, Preschool ; Creatinine ; Dilatation ; Fever ; Gentamicins ; Headache ; Humans ; Meningitis, Bacterial ; Neurologic Examination ; Physical Examination ; Pseudomonas ; Pseudomonas aeruginosa ; Rifampin ; Urinalysis

In a world, ocular infection of Pseudomonas has been found in premature infants. This is so serious that corneal perforation and panophthalmitis are developed. And septicemia is developed. In these days, hospital infection due to pseudomonas tends to increasese. We experienced one case of pseudomonas dacryocystitis in a normal full term infant. At first, we diagnosed it as a blenorrhea neonatorum due to pseudomonas infection. And the smear of vagina of his mother was examined by Gram stain and culture. But, pseudomonas was not found. So, we considered that it was because of hospital infection. The patient was treated with carbenicillin 400 mg/day intramuscularly and 0.5% chloramphenicol solution everyone hour topically for 2 weeks. During this time there wa.s no improvement. After then we found obstruction of nasolacrimal ducts and performed probing once. After that this case was cured.
Carbenicillin ; Chloramphenicol ; Corneal Perforation ; Cross Infection ; Dacryocystitis* ; Eye Infections ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Mothers ; Nasolacrimal Duct ; Panophthalmitis ; Pseudomonas Infections ; Pseudomonas* ; Sepsis ; Vagina

Clinical and bacteriological studies were carried out on 74 cases of infants and children with Shigellosis who were cared from May 1972 to Sept. 1977 in our hospital. 1) The age distribution revealed the range between 6 months and 5 ysers (85% of all) with the sex ratio of 42(57%) of male and 32(43%) of female, 13:1,0. 2) The peak incidence was noted in summer, although there were occurrence throughout the year, even in winter. 3) On bacteriological studies, Shigella flexneri was isolated most frequently (73%) and shigella sonnei was the next(32%). Since 1977, however, the rate of isolation was reversed as the former 32% and the latter 62%. 4) Up to 1976, ampicillin was the most effective (in 93%) and carbenicillin the next (in 87%) on sensitivity test. But gentamicin became hightly sensitive in 88%, kanamycin in 81% and ampicillin in 13% since 1977. 70% to 95% of isolated Shigellae were resistant to Terramycin, Chloromycetin, streptomycin and Colimycin. 5) The average duration from the onset to the clinical improvement including stool character was that of 3.4 days. 6) The mortality rate was 2.7% (2 of 74 patients) and they all were under 2 years of age.
Age Distribution ; Ampicillin ; Carbenicillin ; Child ; Chloramphenicol ; Colistin ; Dysentery, Bacillary* ; Female ; Gentamicins ; Humans ; Incidence ; Infant ; Kanamycin ; Male ; Mortality ; Oxytetracycline ; Sex Ratio ; Shigella ; Shigella flexneri ; Shigella sonnei ; Streptomycin