, Pyoeng Gyun Choe The rise of multidrug-resistant organisms represents a serious global public health concern. In Korea, the increasing prevalence of carbapenem-resistant Enterobacterales (CRE) is particularly concerning due to the difficulties associated with treatment. Data from the Korea Global Antimicrobial Resistance Surveillance System indicate a yearly increase in CRE cases, with carbapenemase-producing Enterobacterales being the predominant type. The capacity of CRE to resist multiple broad-spectrum antibiotics leads to higher medical costs and mortality rates, underscoring the need for urgent action. Effective prevention is crucial to curbing CRE outbreaks and transmission. Antimicrobial stewardship programs (ASPs) play a key role and require commitment from healthcare professionals to minimize unnecessary antibiotic use, as well as from policymakers to ensure adherence to ASP guidelines. Given the complexity of CRE transmission, ASP efforts must be integrated with infection control strategies for maximum effectiveness. These strategies include adherence to standard and contact precautions, environmental disinfection, preemptive isolation, and comprehensive education and training for healthcare personnel. Additionally, surveillance testing for patients at high risk for CRE and the use of real-time diagnostic kits can facilitate early detection and reduce further transmission. Strategies for the prevention of CRE infection should be tailored to specific healthcare settings. Ongoing research is essential to update and refine infection control guidelines and effectively prevent CRE outbreaks.
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Metabolic syndrome (MetS) is a cluster of metabolic abnormalities that include hypertension, altered glucose metabolism, dyslipidemia, and abdominal obesity and is strongly associated with an increased risk for diabetes and cardiovascular disease onset in obese adults and children. A progressively greater number of children and adolescents are being affected by this syndrome due to the constant increase in the prevalence of obesity. Like obesity, childhood MetS highly tracks to adulthood. The pathogenesis of MetS includes the interaction between obesity, insulin resistance, and inflammation. Early diagnosis and intervention are important in order to conduct lifestyle modification. In this article, we review the definition and pathophysiology of MetS, the importance of screening, and prevention and treatment options for MetS in childhood.
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, Nadhum Abdulnabi Awad, Amel Hussein Mohammed We aimed to evaluate the effect of insulin resistance (IR) on serum Intelectin-1 and endocrinological hormones levels in obese and non-obese women with and without polycystic ovary syndrome (PCOS) in Basrah, Iraq.
From 124 women volunteers, 60 patients with primary and 64 patients with secondary, while 56 normal ovulatory women were taken as controls. Their fasting insulin hormone, intelectin-1, anti-Mullerian hormone, luteinizing hormone (LH), follicle stimulating hormone (FSH), prolactin (PRL), estradiol (E2) and testosterones (T) were determined by ELISA methods. BMI, glucose and quantitative insulin sensitivity check index as well as IR was determined by the homeostasis model assessment.
A significant changes (P<0.05) were seen in the level of homeostasis model assessment-IR, E2 and T. Levels of anti-Mullerian hormone, LH, LH/FSH ratio and prolactin were significantly (P<0.01) increased and level of intelectin-1 and E2/T ratio were significantly (P<0.01) decreased, while quantitative insulin sensitivity check index level was not significantly different (P>0.05) between the patients (1°PCOS and 2°PCOS) and control groups. On the other hand, our data reported that FSH level was significantly (P<0.05) lower in obese and higher in non-obese patients with PCOS as compared to control group.
Levels of intelectin-1 and endocrinological hormones have significantly associated with body mass index, IR and physical activity in patients and normal groups and the strategies that can modulate levels of these parameters would improve metabolic disarrangements in women with PCOS.
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Various mechanisms are involved in drug resistance of tumor cells. Among them one such mechanism is the overexpression of the multidrug resistance(mdr1) gene product P-glycoprotein(Pgp) that functions as an energy - dependent drug efflux pump.
The expression of P-glycoprotein by immunohistochemistry was examined in 20 cases of laryngeal squamous cell carcinoma and vocal nodules as a control pump using a newly developed monoclonal antibody(MDR/JSB-1) which is specipic to human mdr1 gene product and recognizes an external epitope of the protein. Mdr1 gene product expression was compared with clinical response to chemotherapy in six patients who received mdr1 dependent drugs.
The results are summerized as follows.
1) Among 20 laryngeal cancer tissues, P-glycoprotein was detected in 8 patients and none of 20 vocal nodules showed expression of P-glycoprotein.
2) There is a correlation in between positive P-glycoprotein staining and tumor differentiation.
3) No correlation in between positive P-glycoprotein standing and tumor stage of tumor site is observed.
4) 2 patients with negative clinical response to chemotherapy among 6 patients who received inductive chemotherapy with cisplatin, vincristine and p pepleomycin revealed positive P-glycoprotein staining.
Therefore, analyzing the expression of P-glycoprotein may play a role when planning chemotherapeutic regimens for patients with head and neck cancer and may be an additional prognostic and diagnostic tools in these patients.
, Kyung Pyo Cho, Jae Sung Lee, Yong Moon Woo, Ji Seok Seong, Chang Suk Noh Since the 1990s, drug-resistant bacteria have become common pathogens of hospital-acquired infections. In recent years, healthcare-associated infections have come to the fore, and it is reported that distribution rates of these bacteria are comparable to those of hospital-acquired infections. However, there have been few studies on differences in resistant bacteria depending on the size of hospitals. Thus, the authors studied differences in drug-resistant bacteria between a tertiary hospital and smaller medical institutions.
We retrospectively analyzed the clinical findings and sputum culture results of patients transferred from tertiary hospitals (group A, n=74) and those transferred from smaller medical institutions (group B, n=65).
The number of patients with malignancy was higher in group A than in group B. The length of intensive care unit stay was longer in group A than in group B. Antibiotic therapy and mechanical ventilation were more frequently used in group A than in group B. There were no significant differences between the 2 groups in bacterial species (
In this study, there were significant differences between the 2 groups in the bacterial species and resistance rates to carbapenem for
, Bong Suk Shim Recently, antibiotic resistant organisms have increasing tendency. So, we studied causative organisms in urinary tract infection and investigated the resistance to each antibiotics.
From January 2004 to March 2004, uropathogens and antibiotic sensitivity tests in urine culture of patients with urinary tract infection were analyzed retrospectively. One hundredeleven women and 51 men in 168 adults were included.
Incidence of positive urine culture was 66.1% in women, and 33.9% in men. Mean age was 62.6 years old in men, and 61.7 years old in women. The most common uropathogen was
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