• Archives of Pharmacal Research
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• 제28권6호
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• pp.660-666
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• 2005

The intestinal microbiota are important to the host with regard to resistance they impart against bacterial infections and their involvement in mediating metabolic functions. Lactic acid producing bacteria such as Lactobacillus play an important physiological role in these matters. The aim of the present study was to isolate Lactobacillus sp. that inhibits enteric pathogens. Initially, 17 isolates from healthy Koreans were collected on Lactobacillus selective medium. Resistance of the isolates to antibiotics including rifampicin, streptomycin, clindamycin and vancomycin was measured. One of the isolate was identified as Lactobacillus ruminus on the basis of bacterial cell morphology, cultural characteristic and biochemical characteristics, 16S rRNA sequence analysis and PCR-RAPD. Antimicrobial activity of the bacterium against Vancomycin Intermediate Resistant Staphylococcus aureus (VISA) and Vancomycin-Resistant Enterococci (VRE) was measured. About $10^4$ cells of VISA or VRE were mixed with 1, 5, and 9 mL of L. ruminus SPM 0211 and the final volume was adjusted to 10 mL with brain heart infusion (BHI) broth. The cell suspension was incubated for 3, 6, 9, and 24 h, serially diluted and then plated on BHI agar plates. As numbers of L. ruminus SPM 0211 were increased, viable cell count of VISA and VRE decreased. The strongest antimicrobial activity of SPM 0211 was observed after 9 h incubation in any mixture, almost completely inhibiting the growth of these two bacteria. The results suggest that the freshly isolated L. ruminus SPM 0211 may be used as a pro-biotic microbe that prevents the colonization of enteric pathogens and can thereby promote good gastrointestinal health.

• 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.

• 한국의료질향상학회지
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• 제3권2호
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• pp.26-35
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• 1997

Background : Glycopeptide antibiotics are the only drugs for treatment of infections due to beta-lactam-resistant Gram-positive bacteria. As the incidence of infection and colonization with vancomycin-resistant enterococci(VRE) rapidly increases, the hospital infection control practices advisory committee(HICPAC) recommends prudent vancomycin use to detect, prevent and control infection and colonization with VRE. Methods : The inpatients admitted from September to December, 1996 in Pusan National University Hospital, with Gram-positive bacterial infections were evaluated retrospectively to see whether the administrations of glycopeptide antibiotics were appropriate or not, upon comparison with the recommendations for preventing the spread of vancomycin resistance by HICPAC. Results : Teicoplanin has been chosen more frequently than vancomycin of the glycopeptide antibiotics. The indications of administration of glycopeptides in patients with pneumonia, wound infections, sepsis, and in febrile or neutropenic patients with malignancies were appropriate, but the use of glycopeptides for elimination of merely colonized bacteria in the oral cavity could not be excluded. Inappropriate use of glycopeptides was 10.6%, and inappropriately long-term use without positive culture for beta-lactam-resistant Gram-positive organisms was about 40% of total days of drug use. Conclusion : It seems essential for the quality assurance committee to make a plan in teaching the HICPAC recommendations to the medical practitioners who prescribed the glycopeptides inappropriately or used for irrelevantly long to his patient, monitor and survey their use of glycopeptides prospectively and periodically, and if there are repeated inappropriate prescriptions, a certain penalty would be given to the practitioners.

• Pediatric Infection and Vaccine
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• 제14권2호
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• pp.162-170
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• 2007

목 적 : Vancomycin 내성 장구균(이하 VRE)은 1980년대 후반 처음으로 보고된 이후 전세계적으로 그 빈도가 증가하고 있으나 소아 환자에 대한 체계적인 연구는 미흡한 실정이다. 이에 저자 등은 소아 환자의 VRE 감염 빈도 및 임상 검체에서 분리된 VRE 균주의 임상 양상과 VRE 감염의 위험인자 및 경과에 대해 조사하여 VRE 감염에 대한 적절한 대처 방안을 모색하고자 본 연구를 시행하였다. 방 법 : 2001년 1월부터 2006년 12월까지 연세의료원 세브란스병원에 입원한 15세 이하의 소아 환자에서 분리된 VRE 230주를 대상으로 후향적으로 자료를 분석하였다. 대상 환아는 ICU 환자군과 Non-ICU 환자군으로 분류하여 두 군간에 있어 VRE가 분리되기 전 처치형태 및 분리된 균주의 항균제 감수성을 조사하였다. 결 과 : ICU 환자군 및 수술이나 중재적 시술을 받았던 경우, 3세대 cephalosporin이나 glycopeptide등의 광범위 항생제를 투여했던 경우에서 VRE 분리 빈도가 높았으며 대부분의 경우 E. faecium이 분리되었다. 항균제 감수성 검사에서는 tetracycline을 제외한 항생제에 높은 내성을 지니고 있었으며 분리 전 3세대 cephalosporin의 투여 비율이 가장 높았다. 3세대 cephalosporin의 투여 비율은 계속 증가하는 추세이나 2006년에 들어서는 glycopeptide의 사용이 감소하였으며, 2006년에는 VRE가 분리된 환아 수가 감소하였으나 1998년부터 보았을 때 전체적으로는 증가 추세를 보였다. 결 론 : 소아의 경우에서도 VRE는 증가하고 있는 추세로 VRE 감염의 전파를 방지하기 위해서는 위험인자를 가진 환자군에 대한 적극적인 감시와 항균제 사용 제한이 필요하며 이미 분리된 환자에 있어서도 신중한 항생제 선택과 함께 지속적이고 적극적인 감염 관리가 중요할 것으로 사료된다.