• 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.

• 대한한방내과학회지
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• 제31권4호
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• pp.908-913
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• 2010

Bojungiki-tang is a traditional oriental medicine to boost the immune system. In this study, we investigated the effects of Bojungiki-tang by withdrawal of isolation of VRE colonization. Four cases of post-stroke patients with VRE colonization took Bojungiki-tang and continuously were followed up with stool cultures. After three times negative stool VRE, we withdrew isolation of VRE colonization. One case patient was diagnosed with VRE colonization in another hospital and had no withdrawal during that period. He was admitted to Kyung-hee University Oriental Medicine where he took Bojungiki-tang. After three times negative stool VRE, we withdrew isolation of the patient. These results demonstrate that Bojungiki-tang is effective on boosting immunity level. Further studies are needed to better characterize this protective effect of Bojungiki-tang.

• 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.

• 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.

• Clinical and Experimental Pediatrics
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• 제48권9호
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• pp.946-952
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• 2005

목 적 : 병원 입원환자의 임상 검체에서 vancomycin-resistant enterococci(VRE)의 출현은 1980년대 후반부터 증가하기 시작했으나 국내에서 신생아에 대한 보고는 드물다. 최근 본 병원 신생아 중환자실에서 신생아 대변내 VRE 검출이 증가되어 연도별 발생추이와 위험인자를 알아보고자 하였다. 방 법 : 2000년 1월부터 2004년 12월까지 전남대학교병원 신생아 중환자실과 소아과 병동에 입원한 교정연령 4주 미만의 신생아들 중 대변 배양 검사가 시행된 환아 294명에 대해 병력 기록지를 후향적 조사하였다. VRE의 연도별 분리빈도를 조사하였고 대변 배양검사상 VRE 양성인 군을 연구군, VRE 음성인 군을 대조군으로 하여 VRE 집락형성의 위험인자 및 예후 등을 조사하였다. 결 과 : 전체 신생아 환아 중 대변 내 VRE 검출률은 2000년 0명, 2001년 1명(3.7%), 2002년 74명(60.7%), 2003년 52명(38.2%)으로 최근 들어 증가하는 추세이며 2004년에는 2명(0.8%)으로 줄어들었다. 평균 재태연령은 VRE군 $237.9{\pm}28.7$일, Non-VRE군 $265.7{\pm}18.7$일로 VRE군에서 의의있게 짧았다(P<0.001). 출생체중은 VRE군이 $2,124.9{\pm}893.8g$으로, Non-VRE군 $3,023.8{\pm}718.0g$에 비해 유의하게 작았고(P<0.01), 입원기간도 VRE군이 $30.5{\pm}26.5$일로 Non-VRE군의 $12.3{\pm}11.0$일에 비해 길었다(P<0.001). Vancomycin 사용 빈도는 VRE군이 7.0%로 Non-VRE군 1.2%에 비해 높았고(P<0.05), cepalosporin 사용 빈도는 VRE군이 68.5%로 Non-VRE군 48.5%에 비해 더 높았다(P<0.001). VRE 감염으로 인한 직접적인 사망례는 없었다. 결 론 : 신생아 대변내 VRE 감시 배양 결과 연도별로 VRE 검출이 증가하는 추세였는데, 재태연령이 짧을수록, 출생체중이 작을수록, 3세대 cephalosporin 사용 또는 vancomycin 사용이 잦을수록 의의있게 증가하였다. VRE의 발생을 막기 위해서는 극소 저출생 체중아에 대한 무균적 간호와 불필요한 항생제 남용을 줄여야 할 것으로 사료된다.

• Pediatric Infection and Vaccine
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• 제22권1호
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• pp.16-22
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• 2015

목적: 소아에서 VRE의 자발적 소실 기간에 대한 영향인자들을 밝히는 것이다. 방법: 2005년 1월부터 2010년 11월까지 VRE 양성인 환자의 의무기록을 후향적으로 분석하였다. 집락소실 기간의 평균 325일을 기준으로 하여 조기소실군과 만기소실군을 나누어 임상특징을 비교하였다. 결과: VRE가 확인된 환자 중 관찰기간이 1년 이상이 되었거나 VRE 집락 소실이 확인된 수는 151명이었다. 조기소실군(41명)에서 처음 VRE 집락이 되었을 때 나이는 만기소실군(110명)에 비하여 많았다(44.9개월 vs 40.9개월, P=0.040). 그리고 조기소실군보다 만기소실군에서 VRE 집락 후 반코마이신 치료를 한 경우가 더 많았다(7% vs 27.2%, P=0.008). 결론: VRE 집락기간에 있어, 처음 VRE를 획득하였을 당시의 나이와 항생제의 사용여부가 중요하다. 감염질환을 치료하고 항생제 저항성 세균의 집락을 억제하기 위하여 적절하고 신중한 항생제 사용이 필요하다.

• Journal of Korean Medical Science
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• 제33권48호
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• pp.295.1-295.7
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• 2018

Background: Vancomycin-resistant enterococci (VRE) infections have become a major healthcare-associated pathogen problem worldwide. Nosocomial VRE infections could be effectively controlled by screening patients at high risk of harboring VRE and thereby lowering the influx of VRE into healthcare centers. In this study, we evaluated factors associated with VRE colonization in patients transferred to emergency departments, to detect patients at risk for VRE carriage. Methods: This study was conducted in the emergency department of a medical college-affiliated hospital in Korea. Every patient transferred to the emergency department and admitted to the hospital from January to December 2016 was screened for VRE using rectal cultures. In this cross-sectional study, the dependent variable was VRE colonization and the independent variables were demographic and clinical factors of the patients and factors related to the transferring hospital. Patients were divided into two groups, VRE and non-VRE, and previously collected patient data were analyzed. Then we performed logistic regression analyses of characteristics that differed significantly between groups. Results: Out of 650 patients, 106 (16.3%) had positive VRE culture results. Significant variables in the logistic analysis were transfer from geriatric long-term care hospital (adjusted odds ration [aOR]: 8.017; 95% confidence interval [CI]: 1.378-46.651), hospital days (4-7 days; aOR: 7.246; 95% CI: 3.229-16.261), duration of antimicrobial exposure (1-3 days; aOR: 1.976; 95% CI: 1.137-3.436), and age (aOR: 1.025; 95% CI: 1.007-1.043). Conclusion: VRE colonization in patients transferred to the emergency department is associated primarily with factors related to the transferred hospitals rather than demographic and clinical characteristics.

• Pediatric Infection and Vaccine
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• 제17권1호
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• pp.1-8
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• 2010

목 적:부산대학교병원 신생아 중환자실에서 2006년 3월 VRE 유행이 나타나 입원 환아를 대상으로 대변VRE 감시 배양을 시행하였다. 본 연구는 VRE 감염의 정착정도를 파악하고, 위험인자를 분석하여 향후 VRE의 출현을 예방하고자 본 연구를 시행하였다. 방 법: 2006년 3월부터 2007년 3월까지 본원 신생아 중환자실 환아 192명을 대상으로 주 1회 대변 감시배양 검사를 시행하였다. VRE가 분리된 환아의 위험인자를 규명하고자 성별, 재태 기간, 기저 질환, 이전 치료에 사용된 항생제의 종류, 침습적 처치의 유무 등을 의무기록을 바탕으로 후향적으로 조사하였다. 결 과:총 192명의 환아 중 VRE 양성군은 48명(25%), VRE 음성군은 189명(75%)이었다. VRE 양성 환아 중 본원 출생아는 12명(25.0%), 타병원 출생아는 36명(75.0%)이었다. VRE 양성 환아의 기저 질환으로는 선천성 심질환이 25명(52.1%)으로 VRE 양성 빈도가 유의하게 높았다(P =0.005). 항생제 중 VRE 양성군에 서 3세대 cephalosporin 사용(45.8% vs. 15.3%, P < 0.001)과 vancomycin 사용(95.8% vs. 40.9%, P < 0.05)의 기왕력이 통계적으로 유의하게 높음을 알 수 있었다. 또한 VRE 양성군에서 중심 정맥 도관(41.7% vs. 15.3%, P <0.001)이나 인공 호흡기(41.7% vs 25.0%, P =0.017)를 사용한 예가 많았고, 수술 여부(41.7% vs 16.7%, P =0.001)나 흉관 삽입의 기왕력(10.4% vs 2.7%, P =0.021)이 통계적으로 유의하게 높았다. VRE양성군 48명 중 11명(22.9%)에서 VRE 음전을 확인 하였고 VRE의 음전기간의 중앙값은 101일 이었다. 결 론: VRE 감염은 신생아 중환자실에서 중요한 원내 감염으로 부각되고 있다. 이러한 VRE 집락을 차단하기 위해서는 철저한 감염 관리와 격리를 해야 하며 침습적인 기구의 사용 및 불필요한 항생제의 사용을 줄이려는 노력이 필요하다.

• 대한한방내과학회지
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• 제41권6호
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• pp.1191-1199
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• 2020

We studied the effect of Korean medicine treatment on the clearance of vancomycin-resistant enterococcus (VRE) colonization and on improvement in symptoms in a stroke patient. The patient was continuously followed up with stool VRE cultures while being treated with herbal medicine, Chunglijagam-tang, acupuncture, and oxygen therapy. We also checked the coccygeal pressure sore condition and the oxygen levels during therapy. No VRE colonization was found after treatment and the oxygen levels and pressure sores had improved. This study proved that Korean medicine treatment could be effective for the clearance of VRE colonization and improvement of symptoms.

• 기본간호학회지
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• 제15권4호
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• pp.522-530
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• 2008

Purpose: In this study active surveillance culture for ICU patients, in whom the risk of VRE infection was high were conducted, and through this the VRE colonization rate and the characteristics of the colonization were examined and risk factors involved in VRE colonization and acquisition were analyzed. Method: This research was performed with 635 patients admitted to ICU between July 1 and December 31, 2006. Results: On admission to ICU, the VRE colonization rate was 2.36%, 93% identified from active surveillance culture. The VRE colonization rate was significantly higher in those patients with cancer (OR=9.43; 95% CI=1.38${\sim}$62.50; P=.022), liver cirrhosis (OR=55.5; 95% CI=7.29${\sim}$500; P=.005), transferred from other hospitals (OR=200; 95% CI=22.73${\sim}$1000; P=.000), high APACHE II score (OR=1.107; 95% CI=1.010${\sim}$1.213; P=.029), or antibiotics within the last 3 months (OR=15.87; 95% CI=2.27${\sim}$111.11; P=.005). The VRE acquisition rate was 5.2%. It was significantly higher in those who were using a ventilator (OR=26.31; 95% CI=5.13${\sim}$142.86; P=.000), three or more kinds of antibiotics during admission (OR=58.82; 95% CI=16.13${\sim}$200; P=.000), or high APACHE II score (OR=1.16; 95% CI=1.08${\sim}$ 1.24; P=.000). Conclusion: The results of this study show that active surveillance culture can detect VRE colonization on admission to ICU and those who have acquired VRE in ICU. The analyzed VRE colonization and risk factors of VRE acquisition are expected to be useful in establishing guidelines for preventing VRE infection in ICU.