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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Nontuberculous mycobacterial infections, which are often acquired from environmental sources such as water and soil, exhibit a variety of cutaneous manifestations that frequently lead to misdiagnoses and delays in treatment. A 77-year-old woman presented with multiple skin lesions in a sporotricoid distribution on her right leg, which persisted despite standard antibiotic treatments. Based on the skin biopsy, revealing granulomatous inflammation with acid-fast bacilli, and PCR testing, a nontuberculous mycobacterial infection was diagnosed. Antimycobacterial drug combinations, including clarithromycin, isoniazid, and rifampicin for 4 months, complete the skin lesion's clearance. This case underscores the need for heightened suspicion and the use of appropriate diagnostic techniques, including tissue biopsies and molecular methods such as PCR.
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Antimicrobials were one of the great invention of modern era. However, the abuse of antimicrobial both in human and animals has led to a high rate of occurrence of antimicrobial resistant microbes. Disease treatment caused by antimicrobial resistant microbes including superbacteria has emerged as critical issue worldwide. Communication and cooperation among researchers in diverse fields are needed to solve the resistance to antimicrobials. Culture Collection of Antimicrobial Resistant Microbes (CCARM) has taken a leadership role an intermediary among various research fields by providing certified antimicrobial resistant microbes with their information since 1999. CCARM collects antimicrobial resistant microbes from clinical, agricultural animals and products, and environmental fields, and classifies and stores them according to their origins, species and antimicrobial resistance mechanisms. CCARM is performing the roles (collection, deposit, preservation, distribution, service, and consulting) of Biological Resource Center designated by Organisation for Economic Co-operation and Development.
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The pathogenesis of fungus ball has been unclear yet. This study was performed to find a clue to the pathogenesis of fungus ball and to clarify the role of ostiomeatal unit(OMU) obstruction in the fungus ball through the comparative study of fungus ball and chronic bacterial sinusitis.
35 patients with fungus ball(fungus group) and 42 patients with chronic unilateral bacterial sinusitis(bacteria group) were analyzed in terms of radiologic findings and endoscopic findings.
Fungus ball was observed in older patients than chronic bacterial sinusitis(59.7 vs. 41.1). The total Lund scores of bacteria group were higher than those of fungus group(6.0 vs. 4.6)(
This study may suggest that fungus ball is not associated with the obstruction of OMU comparing with chronic bacterial sinusitis and that fungus ball has another pathogenic mechanism different from that of bacterial sinusitis.