• Journal of Korean Academy of Nursing
• /
• v.43 no.2
• /
• pp.287-295
• /
• 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.

• International Journal of Oral Biology
• /
• v.33 no.4
• /
• pp.213-216
• /
• 2008

Continentalic acid (CA, (-)-pimara-8(14), 15-diene-19-oic acid) was isolated from the roots of Aralia cordata (Araliaceae) using bioassay-guided fractionation of a crude chloroform extract. The antibacterial activity of CA against Enterococcus faecalis and Enterococcus gallinarium was estimated by determining minimum inhibitory concentrations (MICs) and minimum bactericidal concentrations (MBCs). CA exhibited potent activity against standard vancomycin-resistant enterococci (VRE) and vancomycin-susceptible enterococci (VSE), with MICs and MBCs values between 4 and $8{\mu}g/mL$ and 4 and $16{\mu}g/mL$, respectively. This compound exhibited potent activity against strains of VRE, which are highly resistant to clinically useful antibiotics. These findings suggest that continentalic acid may be useful in controlling enterococcal infection.

• Korean Journal of Clinical Laboratory Science
• /
• v.49 no.4
• /
• pp.401-406
• /
• 2017

In this study, using the VITEK 2 system, 74 samples (22.6%) out of 327 specimens were identified by the growth of Enterococcosel media (EV6 agar) supplemented with $6{\mu}g/mL$ of vancomycin. Enterococcus faecium was identified as 55 strains (74.3%), Enterococcus casseliflavus as 2 strains (2.7%), Enterococcus avium as 1 strain (1.4%), and Enterococcus gallinarum as 16 strains (21.6%). Among the 55 phenotypes of Enterococcus faecium, 42 (76.4%), 9 (16.4%), and 4 strains (7.3%) showed the vanA, vanB, and vanC phenotype, respectively. The 16 strains of Enterococcus gallinarum and 2 strains of Enterococcus casseliflavus showed the vanC phenotype and the 1 strain of Enterococcus avium had the vanB phenotype. The one strain of Enterococcus faecium propagated only in EV4 and was susceptible to both vancomycin and teicoplanin according to the antimicrobial susceptibility test using the VITEK 2 system. The vancomycin resistance phenotype gene was not detected by PCR. A total of 327 specimens were cultured in Enterococcosel broth supplemented with $6{\mu}g/mL$ of vancomycin (EV6 broth), and 120 strains (36.7%) were isolated. These 120 strains were subjected to vancomycin resistant genotyping by a multiplex real-time polymerase chain reaction and 51 strains (42.5%) showed vanA; 5 strains (4.2%) showed vanA and vanC; and 18 strains (15%) showed vanC. Vancomycin resistance genotypes were not detected in the remaining 46 strains (38.3%).

• BMB Reports
• /
• v.40 no.6
• /
• pp.881-887
• /
• 2007

It is a hot clinical issue whether newly approved antimicrobial agents such as daptomycin, linezolid, quinupristin/dalfopristin (synercid) and tigecycline are active enough to be used for infections caused by vancomycin resistant bacteria. We performed susceptibility tests for mupirocin, which is in widespread clinical use in Korea, and four new antimicrobials, daptomycin, linezolid, quinupristin/dalfopristin and tigecycline, against vancomycin-resistant Enterococcus faecalis and Enterococcus faecium isolated from Korean patients in 1998 and 2005 to evaluate and compare the in vitro activity of these antimicrobials. Among these agents, quinupristin/dalfopristin, which is rarely used in hospitals in Korea, showed relatively high resistance to several vancomycin-resistant enterococci (VRE) isolated in 2005. Likewise, daptomycin, linezolid and tigecycline have not yet been in clinical use in Korea. However, our results showed that most of the 2005 VRE isolates were already resistant to linezolid and daptomycin (highest minimum inhibitory concentration (MIC) value >$100{\mu}g$/ml). Compared with the other four antimicrobial agents tested in this study, tigecycline generally showed the greatest activity against VRE. However, four strains of 2005 isolates exhibited resistance against tigecycline (MIC >$12.5{\mu}g$/ml). Almost all VRE were resistant to mupirocin, whereas all E. faecium isolated in 1998 were inhibited at concentrations between $0.8\sim1.6{\mu}g$/ml. In conclusion, resistances to these new antimicrobial agents were exhibited in most of VRE strains even though these new antibiotics have been rarely used in Korean hospitals.

• Journal of Microbiology
• /
• v.39 no.2
• /
• pp.116-120
• /
• 2001

The prevalence resistance genotype and antibiotic susceptibility of vancomycin-resistant enterococci (VRE) were determined. Prevalence of VRE in chickens, healthy children and intensive care unit (ICU) patients was 43.0%, 12.7% and 24.1%, respectively. Forty out of 56 isolates from chicken intestines were identified as Enterococcus faecium, and 12 were E. faecalis. All the isolates contained the vanA gene. Nine out of 13 VRE isolates from patients and two out of 21 from healthy young children were identified as E. faecium. The resistance types of E. faecium, E. gallinarium and E. casseliflavus were VanA, VanCl, and VanC2, respectively. The minimum inhibitory concentrations (MICs) of E. faecium, E. gallinarium, and E. casseliflavus to vancomycin were 512,8 and 4 g/ml, respectively. Specifically, E. faecium isolates were resistant to most of antibiotics except ampicillin and gentamicin. This is the first report of high VanA type VRE prevalence in nonhospitalized young children in Korea.

• Journal of Microbiology and Biotechnology
• /
• v.18 no.5
• /
• pp.942-945
• /
• 2008

There have been concerns about possible pathogenicity and antimicrobial resistance in Enterococcus, which constitute more than 50% of probiotics in the worldwide market. In this study, Enterococcus in sixteen products manufactured by ten different companies was tested for the presence of six virulence genes and two vancomycin resistance genes. Results in this study showed the safety of Enterococcus on the Korean market and the importance of screening vanA, vanE, agg, cylA, esp, and gelE. Pulse-field gel electrophoresis showed that the sixteen isolates tested in this study are originated from three strains.

• Journal of Korean Neurosurgical Society
• /
• v.46 no.2
• /
• pp.123-129
• /
• 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.

• Korean Journal of Clinical Laboratory Science
• /
• v.39 no.1
• /
• pp.7-18
• /
• 2007

A total of 1,780 isolates of Enterococcus spp. were isolated from 63,133 clinical specimens from Dec 1, 2005 to Nov 1, 2006 in "C" hospital. Isolation frequencies of Enterococcus spp. were 50.9% for E. faecalis, 41.7% for E. faecium, and 7.4% for other Enterococcus spp. containing E. avium, E. gallinarum, E. casseliflavus, E. durans, E. hirae, and E. raffinosus. There were no significant difference between gender, but according to the age group analysis, Enterococcus spp. were more frequently isolated in patients over 50 years old (20.0~24.6%) than those isolated from the patients under the age of 0~49 (1.3~9.4%). In monthly analysis, Enterococcus spp. were the most frequently isolated in April (11.9%), but presented at lowest frequency in February (5.2%). Seasonal analysis did not show a significant difference. Over half of enterococci were isolated from random urine (44.9%) and catherterized urine (15.7%). Frequencies of vancomycin resistant E. faecalis and E. faecium were 0.1% and 31.0%, respectively. Teicoplanin resistant Enterococcus was 13.3% in E. faecalis, 17.6 % in E. faecium. The Enterococcus species showing over 80% susceptibility against antimicrobial agents were E. faecalis, E. durans and E. hirae in vancomycin; E. faecalis, E. gallinarum, E. casseliflavus, E. durans and E. hirae in ampicillin. The antimicrobial agent showing susceptibility against whole group of Enterococcus species was only linezolid (95.9%), and a selection of antimicrobial agent is necessary to do essential performance identification and susceptibility tests.

• Pediatric Infection and Vaccine
• /
• v.6 no.2
• /
• pp.261-266
• /
• 1999

Vancomycin-resistant enterococcus(VRE) was first isolated from various specimens of patients with renal failure or leukemia in 1988. Thereafter VRE has been increasing gradually and became one of the clinically important palhogenic organisms currently. We experienced a case of E. faecalis sepsis in a 4 day old neonate. She was born at 39 weeks gestational age with 2,900gm weight by Cesarean section delivery due to breech presentation. She had had swelling and motion limitation of the left knee joint with fever for one day at age of 4 day and was transfered to our hospital. Ultrasonographic examination of her left knee joint showed some inflammatory change. E. faecalis was isolated from the blood. The organism showed resistance to vancomycin on drug susceptibility test using BHI agar screening test and disk diffusion method. After treatment with ampicillin-sulbactam for 3 weeks the baby was improved. Although VRE infection has been considered rare in Korea. considerable number of demonstrative studies about VRE isolation have been reported recently thus adequate countermeasures are needed to reduce the emergence and prevent nosocomial spreading of this organism.

• Korean Journal of Food Science and Technology
• /
• v.50 no.6
• /
• pp.581-586
• /
• 2018

Enterococcus spp. have been considered major indicator organisms for antibiotic resistance due to their ability to easily acquire and to harbor antibiotic resistance. In this study, Enterococcus spp. were isolated from 174 retail fresh-cut products (fresh vegetable salads, microgreens, and sprouts) in Korea. Among the 20 Enterococcus isolates obtained, 18 (90.0%) were Enterococcus faecalis and 2 (10.0%) were Enterococcus faecium. The patterns of antibiotic resistance against nine antimicrobials were analyzed. Most of the isolates (85.0%) were resistant to quinupristin/dalfopristin, 40.0% and 50.0% of the isolates showed intermediate resistance to two critically important antimicrobials for human medicine, ciprofloxacin and erythromycin, respectively. Vancomycin-resistant enterococci were not detected in this study. Given the importance of antimicrobial resistance of enterococci in food safety as well as in public health, our results regarding the occurrence (level of contamination) and antimicrobial resistance of Enterococcus spp. could provide useful information that aids the risk analysis of antibiotic resistance.