• Journal of Korean Neurosurgical Society
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• 제46권2호
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• pp.123-129
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• 2009

Objective: This study was aimed to identify the incidence and risk factors of vancomycin-resistant enterococcus (VRE) colonization in neurosurgical practice of field, with particular attention to intensive care unit (ICU). Methods: This retrospective study was carried out on the Neurosurgical ICU (NICU), during the period from January. 2005 to December. 2007, in 414 consecutive patients who had been admitted to the NICU. Demographics and known risk factors were retrieved and assessed by statistical methods. Results: A total of 52 patients had VRE colonization among 414 patients enrolled, with an overall prevalence rate of 6.1%. E. faecium was the most frequently isolated pathogen, and 92.3% of all VRE were isolated from urine specimen. Active infection was noticed only in 2 patients with bacteremia and meningitis. Relative antibiotic agents were third-generation cephalosporin in 40%, and vancomycin in 23%, and multiple antibiotic usages were also identified in 13% of all cases. Multivariate analyses showed Glasgow coma scale (GCS) score less than 8, placement of Foley catheter longer than 2 weeks, ICU stay over 2 weeks and presence of nearby VRE-positive patients had a significantly independent association with VRE infection. Conclusion: When managing the high-risk patients being prone to be infected VRE in the NICU, extreme caution should be paid upon. Because prevention and outbreak control is of ultimate importance, clinicians should be alert the possibility of impending colonization and infection by all means available. The most crucial interventions are careful hand washing, strict glove handling, meticulous and active screening, and complete segregation.

• 대한소아치과학회지
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• 제25권2호
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• pp.450-457
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• 1998

The $Papillon-Lef\`{e}vre$ Syndrome(PLS), a disease with autosomal recessive inheritance, is characterized by diffuse hyperkeratosis of the palms and soles, mostly prepubertal periodontitis and premature loss of primary and permanent dentition. The etiology of the destruction of periodontal tissues has not been completely clarified. In recent years, two main factors are suggested to be responsible for tooth loss ; firstly, the presence of gram negative microorganisms in the periodontal pockets of the patients. The other factor suggested is cellular deficiency in chemotaxic and phagocytic function of neutrophylic granulocytes. Resent data suggestes that mechanical debridement in conjunction with antibiotic therapy may be successful in periodontal management of $Papillon-Lef\`{e}vre$ Syndrome, particularly if administered early. In this study, a $Papillon-Lef\`{e}vre$ Syndrome patient was studied clinically, radiologically, histopathologically and microbiologically. 5 years female patient with gingival swelling and destruction of periodontal structure on the whole dentition were examined and palmar and plantar hyperkeratosis were can be seen. On microbiological analysis, Actinobacillus actino-mycetemcomitans was performed. Concurrently, the children recieved extraction of maxillary anterior teeth and construction of removable prosthetis. The combination of professional oral hygiene care and antibiotic therapy improved the dermatologic and periodontal condition.

• 혜화의학회지
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• 제22권1호
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• pp.145-170
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• 2013

Objectives : This study was carried out to investigate the anti inflammatory and anti allergy effects of Vitex rotundifolia Linne fil. extract(VRE). Results : 1. In vitro test, VRE was used to determine the modulation of cytokine secretion, the activation of inflammatory and allergic factor and the inhibition of gene expression. The cell survival rate of Raw 264.7 and Jurkat T cells didn't decrease and accordingly cytotoxicity wasn't observed. In anti-allergic assay, the secretion of IL-2, TNF-${\alpha}$, IL-4, IL-5 and IFN-${\gamma}$ were suppressed on Jurkat T cells induced by dust mites. And the gene expression of COX-2 was suppressed in HMC-1 stimulated by calcium ionophore A23187. In anti-inflammatory assay, the gene expression of TNF-${\alpha}$, COX-2 were suppressed on LPS-activated Raw 264.7 cells. And the secretion of IL-6 and IL-8 were suppressed on EoL-1 cells induced by dust mites. P38 and ERK activation of MAPK decreased generally. VRE showed potent inhibitory activity of NO production. 2. In vivo test, we used NC/Nga mouse induced by atopic dermatitis to observe the effects of VRE on the weight, water and feed, blood test, weight of organs, total IgE and histological change of main organs. Quantity of water and feed were not changed, therefore it didn't affect the weight directly, and no change was observed in related main organs, thus maybe there is no organ toxicity by test substances. And the symptoms were decreased significantly, and the thickness of epithelial cell layer and the number of mast cells were inhibited significantly by the difference of dosage. The number of total complete blood cells and IgE in serum were not changed significantly. Conclusion : These results suggest that VRE has anti-inflammatory and anti-allergic effects. Therefore VRE could be used effectively on improvement or treatment of atopic dermatitis. However, further study is needed to prove which component of VRE indicates effective pharmacological action.

• 성인간호학회지
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• 제27권3호
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• pp.325-336
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• 2015

Purpose: This study was conducted to identify factors influencing compliance of multidrug-resistant organism infection control in intensive care units (ICU) nurses. Methods: Data were collected from 254 ICU nurses who were working at 6 general and advanced general hospitals in D city and G Province. Results: 77.2% and 84.4% of the subjects correctly answered to questions about Methicillin-Resistant Staphylococcus Aureus (MRSA) and Vancomycin-Resistant Enterococcus (VRE), respectively. The scores of MRSA infection control compliance and VRE infection control compliance were 3.41 and 3.43, respectively. The factors influencing MRSA infection control compliance were empowerment, environmental safety recognition, and education satisfaction, which explained 30% of MRSA infection control compliance. The factors significantly related to VRE infection control compliance were empowerment, hospital types, environmental safety recognition, number of education sessions, and neonatal ICU, which explained 37% of VRE infection control compliance. Conclusion: It is necessary to develop efficient educational programs for infection control including educational contents to improve empowerment and environmental safety recognition of nurses. Furthermore, administrative support for those infection control programs is also necessary.

• 대한임상검사과학회지
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• 제43권3호
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• pp.124-132
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• 2011

The aim of this study was to evaluate the effects of the photosensitizer photogem with light-emitting diode (LED) on vancomycin-resistant enterococci (VRE). Two VRE strains isolated from the feces of patients. that was identificated Enterococcus faecium (vanA) and Enterococcus gallinarum (vanC1) using traditional biochemical tests and confirmed VRE genotyping from using polymerase chain reaction. In addition, three strains were used Enterococcus. faecalis CDC-286 (vanA), E. faecalis CDC-583 (vanB) and E. gallinarum CDC-42 (vanC1). To examine the antimicrobial effect of photogem mediated photodynamic therapy (PDT) against, CFU quantification and Disk diffusion antimicrobial susceptibility test were evaluated. The effects of Photodynamic therapy was not associated with genotype. Photogem mediated PDT perfectly inhibited the colony formation of E. faecalis CDC-286. The number of viable bacteria decreased greatly after PDT application with photogem $50{\mu}g/mL$ and energy density of $15J/cm^2$. The diameter of inhibition zone was increased to after PDT more than before PDT. The case of vancomycin disc on E. faecalis CDC-583 and E. galinanum-Patient were changed from resistant to intermediate resistant, from intermediate resistant to susceptable. These results demonstrate that lethal photosensitization of VRE can be achieved using photogem plus 630 nm LED irradiation.

• Archives of Pharmacal Research
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• 제27권2호
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• pp.246-253
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• 2004

The prevalence, genotype for antibiotic resistance and antibiotic susceptibility of vancomycin resistant enterococci (VRE) were determined. And molecular typings of the Enterococcus faecium isolates were analyzed. Prevalence of VRE in chickens, healthy children and intensive care unit (ICU) patients was 41.6％,7.9％, and 20.4％, respectively. Forty out of 54 isolates from chicken intestines, and 9 out of 11 from ICU patients were identified as Enterococcus faecium. Eleven out of 13 isolates from non-hospitalized young children were E. gallinarium. Twelve strains of E. faecalis were isolated from chicken intestines. The gene for the antibiotic resistance in E. faecium, and E. faecalis was vanA, while that in E. gallinarium was vanC1. E. faecium isolates were resistant to most of antibiotics except ampicillin and gentamicin. Molecular typing of the E. faecium strains obtained by pulse field gel electrophoresis and repetitive sequence-based PCR suggest that VRE transmit horizontally from poultry to humans, especially young children, via the food chains in Korea.

• Pediatric Infection and Vaccine
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• 제6권2호
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• pp.261-266
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• 1999

VRE 감염증은 항균제의 과다한 사용 후 출현하는 새로운 형태의 감염성 질환으로, 현재 심각한 임상 문제로 대두되고 있다. 최근 국내에서도 신경학적 장에나 당뇨병, 종양 등의 기저질환을 가진 성인 환자들에서 소수의 감염 예가 보고되고 있으나 소아기, 특히 신생아에서의 감염증은 잘 알려지지 않았다. 저자들은 생후 4일된 신생아에서 발생한 vancomycin 내성 E. faecalis 패혈증 l례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• 대한수의학회지
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• 제43권1호
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• pp.103-112
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• 2003

A multiplex PCR assay, which allows simultaneous detection of vancomycin resistant genotypes and Enterococcus species-specific genes, was developed. Vancomycin resistant enterococci (VRE) from chickens and humans could be detected for vanA, vanB, vanC-1, vanC-2, $ddl_{E.faecium}$ and $ddl_{E.faecalis}$ by multiplex PCR. Eight isolates of VRE from humans (n=11) had $ddl_{E.faecium}$ and vanA, and 3 isolates of the VRE had $ddl_{E.faecium}$ and vanB. One isolate of VRE from chickens (n=6) had $ddl_{E.faecium}$ and vanA, and 5 isolates of the VRE had only vanA. E. faecium, E. faecalis, E. gallinarum and E. casseliflavus were also confirmed for the species-specific gene by multiplex PCR. This multiplex PCR could detect E. faecium, E. faecalis, E. gallinarum, E. casseliflavus, vanA, vanB, vanC-1 and vanC-2, simultaneously. The PCR assay established in the present study can be an alternative to time-consuming biochemical tests and antibiotic susceptibility tests of Enterococcus spp.

• 한국산학기술학회논문지
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• 제17권7호
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• pp.280-292
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• 2016

본 연구는 중환자실 간호사의 지정감염병인 다제내성균 6종에 대한 감염관리 지식과 이행정도를 파악하고, 다제내성균의 효율적인 감염관리를 위한 중재전략 개발의 기초자료를 제공하기 위하여 시행된 서술적 조사 연구이다. 연구대상자는 종합병원 중환자실에 근무하는 210명의 간호사를 대상으로 구조화된 설문지를 이용하였으며 자료분석은 SPSS/PC 22.0을 이용하여 Independent t-test, Own-way ANOVA, Mann Whitney U test로 분석하였으며, 사후검정은 $scheff{\acute{e}}$ 방법으로 시행하였다. 연구결과, 지식정도에서 MRSA는 10.54점, VRE 11.25점, CRGNB 9.60점이었고 감염관리 이행도는 MRSA 3.39점, VRE는 3.69점, CRGNB 3.49점이었다. 일반적 특성에 따른 MRSA 감염관리 지식정도는 연령, 임상경력, 피교육자 경험에서, 이행도는 연령에서 통계적으로 유의한 차이를 보였다. 일반적 특성에 따른 VRE 감염관리 지식정도는 최종학력, 피교육자 경험, 지침서 유무에서, 이행도는 최종학력, 격리환경 조성에서 통계적으로 유의한 차이를 보였으며, CRGNB 감염관리 지식정도는 최종학력, 피교육자 경험에서, 이행도는 격리환경 조성에서 통계적으로 유의한 차이를 보였다. 이상의 연구결과로 볼 때 지식을 높일 수 있는 교육프로그램과 격리환경을 갖출 수 있는 방안을 중재전략에 포함시켜야 할 것으로 사료된다.

• 대한한방내과학회지
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• 제39권5호
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• pp.939-948
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• 2018

Objectives: We treated a stroke patient with vancomycin-resistant enterococci (VRE) colonization using Gami-sipjeondaebo-tang. Methods: A patient diagnosed with intracranial hemorrhage with VRE colonization was treated with herbal medicine and acupuncture. We checked general conditions every day and performed stool VRE culture once a week. We evaluated the improvement of symptoms by change in VAS grade, general weakness, and stool VRE culture results. Results: After a treatment of Gami-sipjeondaebo-tang combined with acupuncture therapy, improvement of the general condition was observed. Also, VRE colonization was no longer detected in the stool culture. Conclusions: This case report proved the effect of Korean medicine for a stroke patient with VRE colonization, but further study is needed.