방글라데시 도시와 시골 지역의 5살과 5살 미만 어린이의 대변에 있는 살모넬라 유전자 비교

학위논문(박사) -- 서울대학교대학원 : 의과대학 의학과, 2021.8. 석승혁.배경. 방글라데시에서 어린이의 장티푸스 발병률이 시골 지역보다 도시 지역에서 더 높게 나온다. 본 연구자는 건강한 도시 지역 어린이가 건강한 시골 어린이들 보다 살모넬라 관련 유전자 수치가 더 높은지 조사하였다. 실험방법. 실험을 위해 대도시, 농촌 지역의 어린이 대변 샘플 각 70개를 확보하여 대변 180~200 mg 에서 DNA 를 추출하였다. 건강한 아이의 대번에서 추출한 DNA 에서 중첩 PCR 통해 살모넬라 관련 유전자를 검사하였다. 16S rRNA 와 살모넬라의 유전자인 Salmonella pathogenicity island I gene (hilA), Salmonella enterotoxin gene (stn), invA gene, Fur-regulated gene (iroB), 그리고 histidine transport operon (hisJ) 를 표적으로 증폭시켜 비교하였다. 결과. 도시 어린이의 대변 샘플 (median 4, IQR 3-4) 에서 시골 어린이 (median 3, IQR 3-4) 보다 더 많은 살모넬라 관련 유전자가 검출이 되었다. 이는 방글라데시 도시 지역의 어린이의 장에 시골 지역 아이 보다 살모넬라 유전자가 더 많은 것을 제시한다. 특히 1살 미만의 도시 지역 어린이의 살모넬라 유병률이 우세하였다. 1살 미만의 도시 어린이 (median 4, IQR 4-5) 에게서 같은 나이의 시골 어린이 (median 3, IQR 2.5-4) 보다 더 많은 살모넬라 유전자가 발견되었다. 물의 공급원이 수돗물인 도시 어린이에서 (median 4, IQR 3-5) 관 우물 (median 3, IQR 2-4), 끓인 연못물을 (median 3, IQR 3-3.5) 섭취하는 시골 어린이 보다 더 많은 살모넬라 유전자가 검출되었다. 그러나 도시 어린이 중 수돗물과 우물이 물의 공급원인 군에서는 살모넬라 유전자의 유의성이 없었다 (median 4, IQR 3-4). 결론. 본 연구 결과로 식수 공급 시스템을 포함한 도시 환경으로 인해시골 어린이 보다 도시 어린이에게 장에서의 잠재적 병원성 살모넬라 균의 감염이 높다는 것을 알 수 있었다.Introduction. Typhoid incidence in children is higher in urban areas than in rural areas of Bangladesh. This study examined whether healthy urban children harbored more increased levels of Salmonella genes than healthy rural children. Methodology. Stool samples from 140 children were studied: 70 from rural areas and 70 from urban metropolitan areas. DNA was extracted from 180 to 200 mg of stool samples according to the manufacturer’s instructions using NucleoSpin Stool DNA extraction kit (Macherey-Nagel, Düren, Germany). We used nested PCR with a thermal cycler (Veriti 96-well thermal cycler, Applied Biosystems, Foster City, CA) to screen for the presence of Salmonella genes in healthy children’s stool specimens. Six Salmonella gene targets were used for amplification. Salmonella gene targets included 16S rRNA [75], Salmonella pathogenicity island I gene (hilA) [76], Salmonella enterotoxin gene (stn) [77], invA gene [78], Fur-regulated gene (iroB) [79], and histidine transport operon (hisJ) [80]. Results. The stool samples of urban children contained more Salmonella genes (median 4, IQR 3-4) than rural children (median 3, IQR 3-4). This suggests that urban Bangladeshi children have more Salmonella genes in their guts than rural children. Especially in those under one year of age, the Salmonella gene prevalence in urban children was unique. They had more Salmonella genes (median 4, IQR 4-5) than rural children in the same age group (median 3, IQR 2.5-4). We also found more Salmonella genes in urban children who drank tap water (median 4, IQR 3-5) than in rural children whose water source was tube well water (median 3, IQR 2-4) and boiled pond water (median 3, IQR 3-3.5). However, there was no significant difference in Salmonella genes between urban children who drank tap water and children whose water source was a tube-well (median 4, IQR 3-4). Conclusions. These data suggest that the urban environment, including the drinking water supply system, increases the likelihood of healthy children in urban areas harboring more potentially pathogenic Salmonella organisms in their gut than found in rural healthy children.Introduction 1 Literature Review 6 Methodology 32 Result 41 Discussion 63 Conclusion 92 Acknowledgment 93 Bibliography 94 Abstract in Korean 119박

An ETL Metadata Model for Data Warehousing

Metadata is essential for understanding information stored in data warehouses. It helps increase levels of adoption and usage of data warehouse data by knowledge workers and decision makers. A metadata model is important to the implementation of a data warehouse; the lack of a metadata model can lead to quality concerns about the data warehouse. A highly successful data warehouse implementation depends on consistent metadata. This article proposes adoption of an ETL (extracttransform-load) metadata model for the data warehouse that makes subject area refreshes metadata-driven, loads observation timestamps and other useful parameters, and minimizes consumption of database systems resources. The ETL metadata model provides developers with a set of ETL development tools and delivers a user-friendly batch cycle refresh monitoring tool for the production support team

Inducible clindamycin resistance among staphylococci isolated from clinical samples in an urban hospital of Dhaka city

Inducible clindamycin resistance was deremined in 200 clinical isolates of staphylococci from pus (53.5%) and wound swab (46.5%). The study was done from July 2009 to June 2010, in the Department of Microbiology, BIHS Hospital Dhaka. Inducible clindamycin resistance was demonstrated by placing an erythromycin disc (15 mg) 15 mm apart from the edge of a clindamycin (2 mg) disc in Mueller Hinton agar. When the clindamycin inhibited zone becomes D- shaped the organism was regarded as postive for inducible resistance (D- test positive). Out of 200 staphylococci, 20% had inducible clindamycin resistance, 5% had constitutive clindamycin resistance and remaining 75% was clindamycin sensitive. In case of methicillin resistant Staphylococcus aureus (MRSA), 48% had inducible clindamycin resistance while 11.5% was constitutively resistant to clindamycin and remainder were clindamycin sensitive. All clindamycin resistant strains were 100% sensitive to vancomycin and linezolid followed by gentamycin (42%) and tetracycline (42.3%). The findings demonstrated that a substantial proportion of staphylococci in our tertiary care hospital had inducible resistance to clindamycin. Ibrahim Med. Coll. J. 2011; 5(1): 6-

Frequency and Sensitivity of Extended Spectrum Beta-Lactamase Positive Organisms in a Secondary and Tertiary Level Hospital Network in Dhaka

Background: Extended spectrum β-lactamase (ESBL) positive organisms are now a global health concern including in Bangladesh. These are associated with treatment failure, increased morbidity and mortality and increased health care costs. In this study, frequency of ESBL positive organisms in some health care centres in Dhaka city has been observed and their current status of antibiogram has also been observed. Objective: To observe the current status of antibiogram of ESBL positive organisms. Materials and Methods: This cross-sectional study was done in the Department of Microbiology, Bangladesh Institute of Health Sciences (BIHS) General Hospital, Dhaka, Bangladesh from March, 2012 to February, 2013. Only E. coli and Klebsiella spp. from pus and urine specimens were included in this study. Isolation, identification and antibiotic sensitivity of the organisms were done by standard procedures. Results: Organisms (Escherichia coli and Klebsiella spp.) isolated from urine and pus collected from different sites of 472 subjects were studied. Predominant organisms were Escherichia coli (82.8%) and remaining 17.2% were Klebsiella spp. ESBL positive organisms were higher in Escherichia coli (54.5%) than in Klebsiella spp. (44.4%) and higher in pus (77.0%) than in urine (49.1%) isolates. Imipenem is the most effective drug for treating ESBL positive organisms followed by colistin, tigecycline and piperacillin/tazobactam. Conclusion: Imipenem, colistin, tigecycline and piperacillin/tazobactam drugs should be kept reserved and used only when other effective drugs are not available so that emergence of resistance against these drugs is deferred. While reporting the culture and sensitivity tests, the ESBL positive organisms should be pointed out with comment like this – “The organisms are ESBL positive and resistant to penicillins, cephalosporins and monobactams”