BACKGROUND: The aim of this study was to determine the in vitro activity of cefditoren, an oral third-generation aminothiazolyl cephalosporin, against Streptococcus pneumoniae and Haemophilus influenzae clinical isolates in a tertiary hospital. METHODS: We have studied the in vitro activities of cefditoren and other oral antibiotics against 120 S. pneumoniae isolates, including 80 penicillin non-susceptible isolates and 80 H. influenzae isolates from clinical specimens of patients at the Asan Medical Center. Minimal inhibitory concentrations (MICs) were determined by the agar dilution method. RESULTS: All S. pneumoniae strains tested were inhibited by 1 g/mL of cefditoren (MIC50/MIC90 0.25/1 microgram/mL; range 0.015~1 microgram/mL). The MICs were lower for penicillin-susceptible S. pneumoniae (MIC90 0.015 g/mL) as compared to penicillin-intermediate resistant (MIC90 0.5 g/mL) or penicillin- resistant strains (MIC90 1 microgram/mL). Cefditoren was active against all tested H. influenzae strains (MIC50/MIC90 0.015/0.03 microgram/mL; range <0.008~0.03 g/mL) and its activity was comparable to levofloxacin and cefixime. CONCLUSIONS: Cefditoren had an excellent activity against S. pneumoniae and H. influenzae irrespective of penicillin or ampicillin resistance, respectively. The results of this study suggest that cefditoren is a good choice of an antibiotic to use for empirical oral treatment of community-acquired respiratory tract infections.
Agar ; Ampicillin Resistance ; Anti-Bacterial Agents ; Cefixime ; Chungcheongnam-do ; Haemophilus influenzae* ; Haemophilus* ; Humans ; Influenza, Human ; Levofloxacin ; Penicillins ; Pneumonia ; Respiratory Tract Infections ; Streptococcus pneumoniae* ; Streptococcus* ; Tertiary Care Centers

We report a case of pyelonephritis caused by Candida kefyr, which has been previously described as C. pseudotropicalis. The patient who had been having multiple intrarenal stones and ureteral stones for ten years was admitted for fever, left flank pain, and dysuria. In the blood culture, C. kefyr was isolated. These symptoms and signs were successfully resolved with a new antifungal agent, voriconazole. After the resolution of symptoms and signs, the patient took extracorporeal shock wave lithotripsy for intrarenal stones and ureteral stones.
Candida* ; Dysuria ; Fever ; Flank Pain ; Humans ; Lithotripsy ; Pyelonephritis* ; Shock ; Ureter

BACKGROUND: Clean intermittent catheterization is one of the management of the neurogenic bladder caused by such disease as spinal injury. The purpose of this study is to assess the amount of time in a microwave oven required to eliminate seven pathogens isolated from urine of the patients, and to evaluate the effect of repeated use of a microwave oven on the patency and pliability of silicon catheter. METHODS: Seven microorganisms isolated from urine of patients were used as inoculating pathogens. These included Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Enterococcus faecalis, Enterococcus faecium, Staphylococcus aureus, Candida albicans. The silicon catheter was divided into six pieces (4 cm) and sterilized by ethylene oxide gas, Each piece of catheter was incubated for 60 minutes in a suspension of microorganisms, and placed in a plastic container. The piece was microwaved for 0 (control catheters) to 15 minutes a dose of 1,000 watts. Two methods were used. First method was a water-free method that was microwaved after removing water from the catheter. Second method was a water-added method that was microwaved after adding 5 mL of sterile water around the catheter. Then, that was placed in 15 mL sterile phosphate buffer in a conical tube. The fluid was cultured. Using a new silicon catheter, the microwave procedure was repeated until the catheter was no longer patent or pliable. RESULTS: Using a water-free method, E, coli, C. albicans were eliminated at 5 minutes, P. aeruginosa was at 8 minutes, K. pneumoniae, E. faecalis was at 12 minutes, but S. aureus was remained until 15 minutes, Using a water-added method, all strains were eliminated at 8 minutes. The characteristics of the silicon catheter after repeated procedures were not changed in patency or pliability until 100 times. CONCLUSION: The disinfection of silicon catheters using a microwave oven after adding water around the catheter was able to sterilize the frequent pathogens including C. albicans within 8 minutes. It was clinically useful to sterilize repeatedly the catheter using microwave oven without distorting the characteristics of the silicon catheter.
Candida albicans ; Catheters* ; Disinfection ; Enterococcus faecalis ; Enterococcus faecium ; Escherichia coli ; Ethylene Oxide ; Humans ; Intermittent Urethral Catheterization ; Klebsiella pneumoniae ; Microwaves* ; Plastics ; Pliability ; Pneumonia ; Pseudomonas aeruginosa ; Silicones ; Spinal Injuries ; Staphylococcus aureus ; Sterilization ; Urinary Bladder, Neurogenic ; Water

Bacterial aortitis is rare and without surgical intervention, it usually leads to uncontrolled sepsis or catastrophic hemorrhage, ultimately, resulting in death. In the postantibiotic era, the dominant infecting organisms are Staphylococcus aureus and Salmonella spp.. In spite of frequent pneumococcal bacteremia, vascular seeding is rare and there is only one published report in Korea. We describe a 77-year-old female with primary pneumococcal bacteremia followed by aortitis of the descending aorta, which was successfully treated by aneurysmectomy, wide excision of periaortic tissue, aortobiiliac bypass via prosthetic graft, and antibiotic therapy.
Aged ; Aorta, Thoracic ; Aortitis* ; Bacteremia* ; Female ; Hemorrhage ; Humans ; Korea ; Salmonella ; Sepsis ; Staphylococcus aureus ; Streptococcus pneumoniae* ; Streptococcus* ; Transplants

BACKGROUND: Aeromonas is not a common cause of bacteremia, but can result in a grave outcome when present. In this study, clinical characteristics and prognostic factors of Aeromonas bacteremia were analysed. We also compared the clinical characteristics of community-acquired and nosocomial Aeromonas bacteremia. MATERIALS AND METHODS: We retrospectively reviewed 182 cases of Aeromonas bacteremia at Asan Medical Center from 1991 to 2000. RESULTS: Male patients predominated (67.0%) and the majority of cases occurred in the warmer months of the year. Almost all the patients (97.8%) had underlying conditions; liver disease (48.9%), biliary disease (30.2%), hematologic malignancy (10.9%), diabetes mellitus (10.9%), congestive heart failure (10.9%), and solid tumor (7.1%). An accompanying infection focus was found in 112 (61.5%) cases and the biliary tract was the most common site of infection. Compared to nosocomial bacteremia, patients with community-acquired Aeromonas bacteremia were more likely to have liver cirrhosis and complications (septic shock, altered consciousness). Nosocomial bacteremia occurred more often in patients with hematologic malignancy. Mortality directly related to Aeromonas bacteremia was 24.1%. Mortality was significantly associated with old age (> or =65 years), skin and soft tissue infection, septic shock, and altered consciousness by univariate analysis. Multivariate analysis revealed septic shock and altered consciousness as independent prognostic factors. CONCLUSION: Aeromonas bacteremia usually occurred in patients with hepatobiliary disease or malignancy and heralded a poor prognosis, especially when associated with complications (septic shock or altered consciousness).
Aeromonas* ; Bacteremia* ; Biliary Tract ; Chungcheongnam-do ; Consciousness ; Diabetes Mellitus ; Heart Failure ; Hematologic Neoplasms ; Humans ; Liver Cirrhosis ; Liver Diseases ; Male ; Mortality ; Multivariate Analysis ; Prognosis ; Retrospective Studies ; Shock ; Shock, Septic ; Skin ; Soft Tissue Infections

BACKGROUND: Cefcapene pivoxil hydrochloride is a new oral cephem which has a broad-spectrum activity with expanded potency against Gram-positive bacteria, including Staphylococcus aureus and Streptococcus, as well as Gram-negative bacteria. In this study, we examined the in vitro activity of cefcapene against recently isolated clinical specimens from patients in a tertiary hospital. MATERIALS AND METHODS: We tested the in vitro antimicrobial activities of cefcapene and other cephalosporins against 450 clinical isolates from of patients in Asan Medical Center. Minimal inhibitory concentrations (MICs) were determined by agar dilution method according to the recommendations of National Committee for Clinical Laboratory Standards. RESULTS: Compared with other cephalosporins (cefaclor, cefpodoxime, and cefixime), cefcapene had lower MIC distributions for Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, and methicillin-susceptible S. aureus. Cefcapene had variable activity against Enterobateriaceae. CONCLUSION: Cefcapene had excellent in vitro antimicrobial activities against common typical bacterial respiratory tract pathogens and methicillin-susceptible S. aureus. Cefcapene appears to be a promising agent for treatment of community-acquired respiratory tract infections and infections caused by methicillin-susceptible S. aureus.
Agar ; Cephalosporins ; Chungcheongnam-do ; Gram-Negative Bacteria ; Gram-Positive Bacteria ; Haemophilus influenzae ; Humans ; Moraxella (Branhamella) catarrhalis ; Respiratory System ; Respiratory Tract Infections ; Staphylococcus aureus ; Streptococcus ; Streptococcus pneumoniae ; Tertiary Care Centers

Bacterial aortitis is rare and without surgical intervention, it usually leads to uncontrolled sepsis or catastrophic hemorrhage, ultimately, resulting in death. In the postantibiotic era, the dominant infecting organisms are Staphylococcus aureus and Salmonella spp.. In spite of frequent pneumococcal bacteremia, vascular seeding is rare and there is only one published report in Korea. We describe a 77-year-old female with primary pneumococcal bacteremia followed by aortitis of the descending aorta, which was successfully treated by aneurysmectomy, wide excision of periaortic tissue, aortobiiliac bypass via prosthetic graft, and antibiotic therapy.
Aged ; Aorta, Thoracic ; Aortitis* ; Bacteremia* ; Female ; Hemorrhage ; Humans ; Korea ; Salmonella ; Sepsis ; Staphylococcus aureus ; Streptococcus pneumoniae* ; Streptococcus* ; Transplants

BACKGROUND: Aeromonas is not a common cause of bacteremia, but can result in a grave outcome when present. In this study, clinical characteristics and prognostic factors of Aeromonas bacteremia were analysed. We also compared the clinical characteristics of community-acquired and nosocomial Aeromonas bacteremia. MATERIALS AND METHODS: We retrospectively reviewed 182 cases of Aeromonas bacteremia at Asan Medical Center from 1991 to 2000. RESULTS: Male patients predominated (67.0%) and the majority of cases occurred in the warmer months of the year. Almost all the patients (97.8%) had underlying conditions; liver disease (48.9%), biliary disease (30.2%), hematologic malignancy (10.9%), diabetes mellitus (10.9%), congestive heart failure (10.9%), and solid tumor (7.1%). An accompanying infection focus was found in 112 (61.5%) cases and the biliary tract was the most common site of infection. Compared to nosocomial bacteremia, patients with community-acquired Aeromonas bacteremia were more likely to have liver cirrhosis and complications (septic shock, altered consciousness). Nosocomial bacteremia occurred more often in patients with hematologic malignancy. Mortality directly related to Aeromonas bacteremia was 24.1%. Mortality was significantly associated with old age (> or =65 years), skin and soft tissue infection, septic shock, and altered consciousness by univariate analysis. Multivariate analysis revealed septic shock and altered consciousness as independent prognostic factors. CONCLUSION: Aeromonas bacteremia usually occurred in patients with hepatobiliary disease or malignancy and heralded a poor prognosis, especially when associated with complications (septic shock or altered consciousness).
Aeromonas* ; Bacteremia* ; Biliary Tract ; Chungcheongnam-do ; Consciousness ; Diabetes Mellitus ; Heart Failure ; Hematologic Neoplasms ; Humans ; Liver Cirrhosis ; Liver Diseases ; Male ; Mortality ; Multivariate Analysis ; Prognosis ; Retrospective Studies ; Shock ; Shock, Septic ; Skin ; Soft Tissue Infections

BACKGROUND: Cefcapene pivoxil hydrochloride is a new oral cephem which has a broad-spectrum activity with expanded potency against Gram-positive bacteria, including Staphylococcus aureus and Streptococcus, as well as Gram-negative bacteria. In this study, we examined the in vitro activity of cefcapene against recently isolated clinical specimens from patients in a tertiary hospital. MATERIALS AND METHODS: We tested the in vitro antimicrobial activities of cefcapene and other cephalosporins against 450 clinical isolates from of patients in Asan Medical Center. Minimal inhibitory concentrations (MICs) were determined by agar dilution method according to the recommendations of National Committee for Clinical Laboratory Standards. RESULTS: Compared with other cephalosporins (cefaclor, cefpodoxime, and cefixime), cefcapene had lower MIC distributions for Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, and methicillin-susceptible S. aureus. Cefcapene had variable activity against Enterobateriaceae. CONCLUSION: Cefcapene had excellent in vitro antimicrobial activities against common typical bacterial respiratory tract pathogens and methicillin-susceptible S. aureus. Cefcapene appears to be a promising agent for treatment of community-acquired respiratory tract infections and infections caused by methicillin-susceptible S. aureus.
Agar ; Cephalosporins ; Chungcheongnam-do ; Gram-Negative Bacteria ; Gram-Positive Bacteria ; Haemophilus influenzae ; Humans ; Moraxella (Branhamella) catarrhalis ; Respiratory System ; Respiratory Tract Infections ; Staphylococcus aureus ; Streptococcus ; Streptococcus pneumoniae ; Tertiary Care Centers

Melioidosis is an infectious disease caused by a gram-negative saprophyte bacterium, Burkholderia pseudomallei. It is endemic to Southeast Asia and Northern Australia. It mostly infects adults with predisposing conditions, mainly diabetes mellitus. The lung is the most commonly affected organ. The spectrum of melioidois in human varies from subclinical to overwhelming protean manifestations resembling other acute and chronic bacterial infections. We report herein a case of septicemia and septic pneumonia due to Burkholderia pseudomallei in 47-year-old man with diabetes mellitus who has history of traveling to Malaysia. This is the first report of melioidosis in Korea.
Adult ; Asia, Southeastern ; Australia ; Bacterial Infections ; Burkholderia pseudomallei* ; Burkholderia* ; Communicable Diseases ; Diabetes Mellitus ; Humans ; Korea ; Lung ; Malaysia ; Melioidosis ; Middle Aged ; Pneumonia* ; Sepsis*