Staphylococcus aureus and Staphylococcus epidermidis strains isolated at eight large medical centers in Korea were examined for methicillin resistance and resistance to eight other antibiotics; cefazolin, cefamandole, cefuroxime, cefoxitin, cefotaxime, moxalactam, penicillin G and vancomycin. Methicillin resistance was found in 296 of 1225 strains (24.2%) of S. aureus and 126 of 348 strains (36.2%) of S. epidermidis. Methicillinresistant strains were isolated from all sources with the frequency of isolation ranging from 11% to 60%. From pleural effusion, throat swab and blood, methicillin-resistant strains of S. aureus were more frequently isolated with statistical significance (Chi-squared test, 95% confidence). Almost all of Methicillin-resistant S. aureus (MRSA) and S. epidermidis (MRSE) strains were multiply resistant to one or more tested eight antibiotics. However only 7(2.4%) of 296 MRSA strains and 2(1.6%) of 126 MRSE strains were resistant to vancomycin. Vancomycin was the most effective antibiotic against staphylococcal isolates as well as MRSA and MRSE.
Anti-Bacterial Agents/*pharmacology ; Cross Infection/microbiology ; Drug Resistance, Microbial ; Humans ; Korea ; Staphylococcal Infections/microbiology ; Staphylococcus aureus/*drug effects/isolation & purification ; Staphylococcus epidermidis/*drug effects/isolation & purification

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Azithromycin ; pharmacology ; Bacteremia ; microbiology ; Child ; Child, Preschool ; Culture Media ; Drug Resistance, Bacterial ; Drug Resistance, Multiple, Bacterial ; Escherichia coli ; drug effects ; isolation & purification ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Methicillin Resistance ; Middle Aged ; Penicillin G ; pharmacology ; Salmonella paratyphi A ; drug effects ; isolation & purification ; Staphylococcus aureus ; drug effects ; isolation & purification ; Staphylococcus epidermidis ; drug effects ; isolation & purification

OBJECTIVEDespite progress in antibiotic therapy and intensive care, childhood bacterial meningitis (BM) remains a devastating disease. We conducted this study to investigate the changes in clinical characteristics, the etiologic agents and antimicrobial susceptibility of BM during the past 10 years in children under 14 years of age.

METHODSThese 126 patients were divided into two groups according to their date of admission. Group 1 included 64 patients admitted from January 1998 to December 2002, and group 2 included 62 cases admitted from January 2003 to December 2007. All pediatric medical charts of them were reviewed.

RESULTSThe predominant isolated bacteria from CSF were coagulase-negative staphylococcus (17/62, 27.4%) and Escherichia coli (9/62, 14.5%) in group 2. The resistance rate of staphylococcus against oxacillin (MRS) was 68.4% (13/19) in group 2, significantly higher than that of group 1 (16.7%, 2/12). Among 126 cases, 42 had seizure attack and 16 had consciousness disturbance, the proportions of them in group 2 (11/62, 17.7%; 4/62, 6.4%) were lower than those in group 1 (31/64, 48.4%; 12/64, 18.8%, P < 0.05). Cases in group 2 survived with complications [13/62 (21.0%)] and sequelae [11/62 (17.7%)] were lower than those in group 1 (24/64, 37.5%, 23/64, 35.9%, P < 0.05), but the rate of empirical therapy modification in group 2 (21/62, 33.9%) was higher than that in group 1 (7/64, 10.9%, P < 0.01).

CONCLUSIONThe predominant bacteria in children with BM are staphylococcus and Escherichia coli in recent years. The antibiotic resistance rate of bacteria has been higher year after year. The clinical patterns of pediatric BM have changed with a decrease in clinically serious cases, complications and sequelae, but an increase in modification of empirical therapy.

Anti-Bacterial Agents ; pharmacology ; Child ; Child, Preschool ; Cross Infection ; microbiology ; Drug Resistance, Bacterial ; Escherichia coli ; drug effects ; isolation & purification ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Meningitis, Bacterial ; epidemiology ; microbiology ; Retrospective Studies ; Staphylococcus epidermidis ; drug effects ; isolation & purification

The crude extracts of the fermentation broth from a marine sediment-derived actinomycete strain, Saccharothrix sp. 10-10, showed significant antibacterial activities against drug-resistant pathogens. A genome-mining PCR-based experiment targeting the genes encoding key enzymes involved in the biosynthesis of secondary metabolites indicated that the strain 10-10 showed the potential to produce tetracenomycin-like compounds. Further chemical investigation of the cultures of this strain led to the identification of two antibiotics, including a tetracenomycin (Tcm) analogs, Tcm X (1), and a tomaymycin derivative, oxotomaymycin (2). Their structures were identified by spectroscopic data analysis, including UV, 1D-NMR, 2D-NMR and MS spectra. Tcm X (1) showed moderate antibacterial activities against a number of drug-resistant pathogens, including methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococci (VRE) pathogens, with the MIC values in the range of 32-64 microg x mL(-1). In addition, 1 also displayed significant cytotoxic activities against human cancer cell lines, including HL60 (leukemia), HepG2 (liver), and MCF-7 (breast) with the IC 50 values of 5.1, 9.7 and 18.0 micromol x L(-1), respectively. Guided by the PCR-based gene sequence analysis, Tcm X (1) and oxotomaymycin (2) were identified from the genus of Saccharothrix and their 13C NMR data were correctly assigned on the basis of 2D NMR spectroscopic data analysis for the first time.
Actinomycetales ; chemistry ; genetics ; Anti-Bacterial Agents ; chemistry ; isolation & purification ; pharmacology ; Antineoplastic Agents ; chemistry ; isolation & purification ; pharmacology ; Benzodiazepinones ; chemistry ; isolation & purification ; pharmacology ; Cell Line, Tumor ; Data Mining ; methods ; Drug Resistance, Bacterial ; Enterococcus faecalis ; drug effects ; Fermentation ; Genomics ; Humans ; Inhibitory Concentration 50 ; Marine Biology ; Methicillin-Resistant Staphylococcus aureus ; drug effects ; Microbial Sensitivity Tests ; Molecular Structure ; Naphthacenes ; chemistry ; isolation & purification ; pharmacology ; Phylogeny ; Staphylococcus epidermidis ; drug effects

Sclerosing peritonitis is an uncommon complication of peritoneal dialysis. It is characterized by peritoneal fibrosis and sclerosis. The most common clinical presentations of sclerosing peritonitis in peritoneal dialysis patients are ultrafiltration failure and small bowel obstruction. The prognosis and response to immunosuppressive therapy of sclerosing peritonitis presenting with ultrafiltration failure or small bowel obstruction are poor. Here, we describe the case of a 28-yr-old man with end-stage renal disease on peritoneal dialysis showing fulminant sclerosing peritonitis presented like acute culture-negative peritonitis and was successfully treated with corticosteroid therapy. It is not well recognized that sclerosing peritonitis may present in this way. The correct diagnosis and corticosteroid therapy may be life-saving in a fulminant form of sclerosing peritonitis.
Acute Disease ; Adult ; Anti-Inflammatory Agents/therapeutic use ; Humans ; Kidney Failure, Chronic/therapy ; Male ; Peritoneal Dialysis/adverse effects ; Peritonitis/*diagnosis/drug therapy/etiology ; Prednisolone/therapeutic use ; Sclerosis ; Staphylococcus epidermidis/isolation & purification ; Tomography, X-Ray Computed