• 대한임상검사과학회지
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• 제45권1호
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• pp.1-4
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• 2013

Vancomycin-resistant enterococci (VRE) have emerged as important healthcare-associated infection since last two decades. ChromID VRE agar (cIDVA) is useful for VRE rectal swab screening. We investigated all VRE were isolated on the cIDVA. A total of 363 rectal swabs of 85 patients to test VRE screening were inoculated into bile-esculin (B-E) broth with $6{\mu}g/mL$ vancomycin. After 24 hours incubation, we subcultured B-E broths were changed to black onto cIDVA. All isolates were identified by the MICROSCAN and VITEK2. The vanA gene and vancomycin minimal inhibition concentration (MIC) were detected by PCR and E-test respectively. 277 E. faecium (84.7%), 16 E. faecalis (4.9%), 25 E. avium (7.6%), 8 E. gallinarum (2.4%) and 1 E. raffinosus (0.3%) were isolated. 10.3% of VRE detected on cIDVA were other than E. faecium and E. faecalis that presented various color from colorless to pale violet. All isolates contained vanA and vancomycin MIC were > $256{\mu}g/mL$. VRE isolates other than E. faecium and E. faecalis should be objective to the contact precautions for healthcare-associated infection control if they possess vanA gene. Due to emerging enterococci carrying vanA such as E. avium, E. gallinarum, and E. raffinosus, VRE surveillance should be expanded to all isolates on chromogenic agar.

• 대한간호학회지
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• 제43권2호
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• pp.287-295
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• 2013

Purpose: The purpose of this study was to identify vancomycin-resistant enterococcus (VRE) colonization rate in patients admitted to the intensive care unit (ICU), associated risk factors and clinical outcomes for VRE colonization. Methods: Of the 7,703 patients admitted to the ICUs between January, 2008 and December, 2010, medical records of 554 VRE colonized and 503 uncolonized patients were reviewed retrospectively. To analyzed the impact of colonization on patients' clinical outcomes, 199 VRE colonized patients were matched with 199 uncolonized patients using a propensity score matching method. Results: During the study period, 567 (7.2%) of the 7,703 patients were colonized with VRE. Multivariate analysis identified the following independent risk factors for VRE colonization: use of antibiotics (odds ratio [OR]=3.33), having bedsores (OR=2.92), having invasive devices (OR=2.29), methicillin-resistant Staphylococcus aureus co-colonization (OR=1.84), and previous hospitalization (OR=1.74). VRE colonized patients were more likely to have infectious diseases than uncolonized patients. VRE colonization was associated with prolonged hospitalization and higher mortality. Conclusion: Strict infection control program including preemptive isolation for high-risk group may be helpful. Further research needs to be done to investigate the effects of active surveillance program on the incidence of colonization or infection with VRE in the ICU.

• Pediatric Infection and Vaccine
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• 제8권2호
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• pp.199-205
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• 2001

목 적 : 1986년 vancomycin 내성 장구균(이하 VRE)이 보고된 이후 10여년간 빈도는 급격한 증가 추세에 있다. 이에 저자 등은 본 병원에 입원한 소아환자들의 임상검체에서 분리된 VRE의 양상과 해당 환자들의 사용형태에 대한 조사를 시행하여 VRE의 증가양상에 적절히 대처할 수 있는 방안을 모색하고자 본 연구를 시행하였다. 방 법 : 1998년 1월부터 2000년 12월까지 연세의료원 세브란스병원에 입원한 소아 환자에서 분리된 VRE 36주를 대상으로 하여 검체 종류 및 균종, 항균제 감수성과 사용양상을 조사하였고, ICU 환자군과 Non ICU 환자군으로 분류하여 두 군간에 있어서 수술이나 중재적 시술을 시행한 경우와 내과적인 투약처치만을 시행한 경우 등의 분리 전 처치형태를 조사하였고 항균제 감수성을 파악하였으며 중복감염의 여부가 ICU군과 Non ICU군간에서 차이를 보이는지 조사하였다. 결 과 : 본 연구에서, VRE가 분리된 수가 급속히 증가함을 알 수 있었고, ICU 환아군과 수술이나 중재적 시술을 한 경우에서 높은 빈도를 보였으며, E. faecium이 E. faecalis 보다 많이 분리되었다. VRE 항균제 감수성 검사에서 tetracyclin을 제외한 항생제에 높은 내성을 지니고 있었고, 검출된 cephalosporin의 투여비율이 가장 높았으며 검출 후에는 teicoplanin의 투여비율이 증가함을 볼 수 있었고, teicoplanin에 대한 항균제 감수성 결과에 따른 투여비율의 차이는 없었다. 또한, ICU 환자군이 Non ICU 환자군에 비해 중복감염의 경우가 많았다. 결 론 : 증가하고 있는 VRE의 집단 발생과 전파에 이은 합병증을 막기 위해서, 본 연구에서 ICU 단위로 분류하였던 병동과 같은 병원내 VRE의 상재 위험지역에 대한 집중 감시조사와 이의 관리를 위한 여러 행정적 문제의 해결, 적절한 항생제의 사용과 철저한 관리가 필요하리라 사료된다.

• 한국의료질향상학회지
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• 제19권1호
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• pp.30-42
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• 2013

Objectives: This study was intended to check if the "Creating Clean Wards" project, which is an innovative reinforced campaign activity targeting infection control strategies and active surveillance cultures for VRE (vancomycin resistant enterococci) high-risk patients to be admitted in the NS (neuro-surgery) wards, would be reduced the incidence rates of VRE acquisition, transmission rates. Methods: 75 subjects of the VRE high-risk patients were surveyed by carrying out active surveillance cultures of VRE colonization 11 times from January to March, 2012. And the retrospective study was conducted dividing them into two groups. Results: The incidence rates of VRE acquisition was reduced to 3.67 cases per 1,000 patients day in the control group and to 2.88 cases in experimental group, which was not statistically significant (p = .753). VRE transmission rates of 0.0015 per day before the project tended to increase to 0.0019, although not statistically significant (p = .650). As a result of multivariate analysis with regard to using glycopeptide antibiotics in order to find out risk factors of VRE colonization, the patients who had been treated with glycopeptide until VRE colonization showed 274.41 times higher rate. Conclusion : For effective VRE infection control in NS wards, We should carry out active surveillance culture regularly, especially patient of using glycopeptide. And block the spread of VRE by strengthening infection control through the strict isolation and the changed mind-set of members motivated by the "Creating Clean Wards" campaign.

• 대한의생명과학회지
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• 제5권1호
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• pp.95-100
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• 1999

일반적으로 임상검사실에서 vancomycin resistant enterococci (VRE)를 검출하는 일은 어렵고, 시간이 많이 들며, 검체처리 비용도 많이 든다. 따라서 본 실험은 임상검체에서 분리된 세균으로부터 VRE를 신속하게 확인하고, 진단하기 위한 방법으로서 다중 중합효소 연쇄반응을 확립하였다. 본 실험에 사용된 primer는 장구균에 특이 한 유전자인 vanA, vanB, vanC-1, vanC-2/3 각각의 염기서열을 기초로 primer를 제작하고, 다중 중합효소 연쇄 반응을 실시하여 임상검체로부터 분리된 VRE 유전자의 type및 분포율을 조사하고자 하였다. 국내에서 분리된 75주의 장구균을 대상으로 다중 중합효소 연쇄반응을 실시한 결과 36주의 분리균주에서 vancomycin에 대해 높은 저항성을 보이는 vanA 유전자를 가진 것으로 나타났다. 그리고 18주에서는 vancomycin에 낮은 저항성을 내성을 보이는 vanC-1 또는 vanC-2/3 유전자를 보유한 것으로 나타났다. 따라서 본 실험에서 확립한 다중 중합효소 연쇄 반응 기법은 신속한 VRE 진단 방법으로 이용할 수 있을 것이다.

• 대한한방내과학회지
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• 제40권5호
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• pp.974-982
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• 2019

Objective: Modern medicine offers no efficient way to clear colonization by vancomycin-resistant enterococci (VRE). However, VRE decolonization needs to be cleared as soon as possible to prevent VRE transmission. This study reports six cases in which the duration of vancomycin resistant enterococcus (VRE) colonization was reduced by Bojungikki-tang-gami. Methods: Six inpatients with VRE colonization were administered Bojungikki-tang-gami and continuously followed up with cultures. After three negative stool cultures, the patients were declared cleared of VRE colonization. We recorded the duration of VRE colonization. Results: The duration of VRE colonization in the six patients was a mean of 58 days and a median of 45 days. This was shorter than the duration reported in most previous studies. No side effects were noted. Conclusions: The findings of this study suggest that Bojungikki-tang-gami might be effective in shortening the duration of VRE colonization.

• Pediatric Infection and Vaccine
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• 제29권2호
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• pp.105-109
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• 2022

다제내성 반코마이신 저항성 장내구균(multidrug-resistant vancomycin-resistant enterococci, VRE)에 의한 침습감염의 치료는 특히 기저질환을 가진 소아 환자들에게 어려운 점이 있다. 소아환자들에게서 VRE 감염을 치료하기 위한 새로운 항생제에 대한 연구가 충분히 이루어지지 않았다. 본 증례는 심폐이식을 받은 생후 6개월 된 영아에서 linezolid 중단 이후 재발된 VRE 균혈증에 대해 daptomycin과 tigecycline 조합으로 성공적으로 치료하여 이를 보고하는 바이다.

• 기본간호학회지
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• 제19권1호
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• pp.122-133
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• 2012

Purpose: The purpose of this study was to develop a web-based education program on control vancomycin-resistant enterococci (VRE) infections and to identify the effects of the program on knowledge and performance of nursing students. Methods: The web-based VRE infection control education program was developed by using the network-based instructional systems design model. The nursing students in the experimental group could access this web-based education program at any time, and as many times as they wanted, during the clinical training period. Effects were evaluated by assessing knowledge and performance of VRE infection control measures during the clinical training period. Results: The contents of the education program included diagnosis, transmission, and treatment of VRE, contact precautions, hand washing, personal protective equipment, environment management, and quizzes. The lecture portion was filmed in a virtual screen studio using flash animation, video, and sound effects, and it was uploaded on an internet site. The knowledge and performance scores of the experimental group after using the education program were significantly higher than those of the control group. Conclusion: The results suggest that the web-based VRE infection control education program is an effective educational method to enhance knowledge and performance of VRE infection control measures.

• 기본간호학회지
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• 제19권2호
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• pp.212-222
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• 2012

Purpose: The purpose of this study was to examine the effects of infection control education for families of patients infected with vancomycin resistant enterococcus (VRE). Method: Forty family members of VRE patients were chosen from a university hospital and assigned to the experimental or control group. The experimental group was provided infection control education that consisted of one-on-one instruction using an information booklet, hand-washing video, and demonstration of hand washing practice. Dependent variables were self-reported knowledge and performance of VRE infection control measures, and the number of hand washings when entering and leaving patients' rooms. Results: Knowledge and performance scores were significantly higher for the experimental group compared to the control group. The experimental group washed their hands significantly more often when entering and leaving patients' rooms than the control group. Conclusion: Infection control education for family members of VRE patients was effective in improving knowledge and performance of infection control measures as well as improving the practice of hand washing. Further investigation is needed on the effects of infection control education for families on the actual VRE colonization and/or infection rate.

• Journal of Yeungnam Medical Science
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• 제37권2호
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• pp.112-121
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• 2020

Background: Vancomycin-resistant Enterococcus (VRE) has become more common in nosocomial infections, especially in urine samples. However, until now, no treatment regimen has been proven to effectively eradicate urine VRE colonization. Therefore, to evaluate the efficacy of doxycycline in eradicating urine VRE and shortening VRE isolation period, we compared VRE colony detection period between doxycycline-treated and untreated patients. Methods: A retrospective cohort study of 83 patients with VRE colonization in urine cultures was conducted at a tertiary academic hospital from January 2011 to February 2018. Kaplan-Meier survival analysis was used to evaluate eradication rates in the treatment and non-treatment groups. Factors affecting urine VRE colonization persistence were analyzed by multiple logistic regression analysis. Results: The overall rate of VRE eradication during the entire hospital stay was higher in the doxycycline treatment group (90.5%) than in the non-treatment group (58.1%, p=0.014). Survival analysis showed that the 5-, 10-, and 20-day cumulative eradication rates were 78.3%, 100%, and 100% in the doxycycline treatment group, and 18.5%, 45.7%, and 67.8% in the non-treatment group, respectively, thereby indicating that eradication rates were higher in the doxycycline treatment group than in the non-treatment group (p<0.001). Only doxycycline treatment was shown to affect urine VRE colonization persistence in multivariate logistic regression analysis. Conclusion: Doxycycline treatment enhanced the eradication rate of urine VRE colonization and appeared to be useful in shortening VRE isolation period.