• Korean Journal of Adult Nursing
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• v.27 no.3
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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.

• Journal of Microbiology and Biotechnology
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• v.24 no.3
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• pp.427-430
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• 2014

We developed a novel immunochromatographic assay (ICA) (EZ-Step VanA rapid kit; Dinona, Korea) for the detection of VanA ligase from vancomycin-resistant enterococci (VRE). Of eight monoclonal antibodies screened by ELISAs, the VanA ligase ICA constructed with 1H9 plus 3G11 showed the greatest reactivity. The detection limit of the kit was $6.3{\times}10^6$ CFU per test. Of 127 vancomycin-resistant microorganisms, 100 vanA VRE were positive in the VanA ligase ICA, and 27 non-vanA vancomycin-resistant isolates were negative. These results were consistent with those of the PCR analyses. Thus, our ICA is a reliable and easy-to-use immunological assay for detecting VanA-producing VRE in clinical laboratories.

• The Korean Journal of Health Service Management
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• v.8 no.4
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• pp.163-173
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• 2014

This study was performed to investigate the current status of isolation precautions of multidrug resistant organisms(MDROs) in general hospitals with more than 200bed. The questionnaires were mailed from 3rd, April 2013 to 30th, April 2013. Methicillin resistant Staphylococcus aureus:(MRSA), vancomycin resistant Staphylococcus aureus:(VRSA), vancomycin resistant Enterococcus(VRE), multidrug-resistant Acinetobacter baumannii, carbapenem-resistant Enterobacteriaceae multidrug-resistant Pseudomonas aeruginosa were enrolled. MRSA(100.0%) and VRE(98.7%) were isolated respectively. VRE(97.3%) and MRSA(64.0%) were regulated strictly respectively. VRE(91.5%) and VRSA(50.7%) were isolated in a single room respectively. Hospital being located in Seoul(p<0.001), and beds(${\geq}600$)(p=0.008) were different significantly. The isolation space limitation(71.1%) was the highest difficulty. The development of refunding the costs of the extra supplies and other hygienic materials for infection control was discovered as the most urgent strategy.

• The Journal of Internal Korean Medicine
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• v.40 no.5
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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.

• Korean Journal of Veterinary Service
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• v.35 no.2
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• pp.99-104
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• 2012

Otitis externa (OE) is a frequent disease in the ear canals of dogs. To identify the pathogens causing OE in dogs and to determine their antimicrobial resistances, specimens were collected from animal hospitals in Daejeon. The isolates were examined by morphological and biochemical tests, 16S rRNA analysis and antimicrobial susceptibility tests. We analyzed correlation between the isolated pathogens and external factors of dogs such as breed, age, gender, ear mite, hair in ears and experience with antibiotic therapy. Thirty three strains of bacteria were isolated from 26 of the 68 heads of dogs with OE. The most isolated bacteria were Enterococcus faecalis (E. faecalis) followed by Staphylococcus aureus (Sta. aureus), Sta. pseudointermedius, E. faecium, E. avium and Streptococcus canis (Strep. canis) in order of frequency of occurrence. Isolation frequency of Enterococcus spp. and Staphylococcus spp. were 51.5% and 45.5%, respectively. E. faecalis and E. faecium isolates showed VanB phenotype, which is resistant to vancomycin but sensitive to teicoplanin were 58% and 25%, respectively. Nine isolates among total twelve isolates of E. faecalis were isolated from the dogs treated with antibiotics. There was no methicillin-resistant Sta. aureus (MRSA), but were MR-Sta. pseudointermedius (MRSP) (57.1%) and vancomycin-resistant (VR)-Sta. pseudointermedius (14.3%) (VRSP) showing VanB phenotype. However, vanA, vanB and vanC genes were not detected in VR isolates from the dogs. Taken together, VR-Enterococcus spp. (VRE) is one of the major pathogens in domestic animals, as well as community-and hospital-acquired infection.

• Journal of Microbiology
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• v.44 no.4
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• pp.453-456
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• 2006

16 chicken isolates and four clinical isolates of VanB-vanA incongruent vancomycinresistant Enterococcus faecium strains without vanS were isolated in 1999. Pulsed-field gel electrophoresis revealed only a peripheral relationship between the chicken isolates and clinical isolates, but suggested clonal spread in the chicken isolates.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.19 no.1
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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.

• Biomedical Science Letters
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• v.18 no.1
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• pp.83-85
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• 2012

Vancomycin-resistant (VR)-E. faecium and VR-E. faecalis were isolated simultaneously from a rectal swab of a patient diagnosed with pneumonia in an intensive care unit (ICU). The patient was treated with various antibiotics including vancomycin. Only VR-E. faecium was continually isolated from the rectal swab at one and two weeks of the treatment. Identical vanA, IS1216V, and IS1542 genes were detected in both VR-E. faecium and VR-E. faecalis isolates which showed equal resistance against vancomycin and teicoplanin, but IS1251 was not detected. VR-E. faecium showed stronger multi-drug resistance than VE-E. faecalis. This result supports the reason why VR-E. faecium is one of the major pathogens in nosocomial infections.

• Korean Journal of Clinical Laboratory Science
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• v.45 no.1
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• pp.16-20
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• 2013

Outbreaks of vancomycin-resistant enterococci (VRE) are being reported more frequently in many countries. While seven glycopeptide resistance genotypes have been described in Enterococci, vanA and vanB are the most common resistance genotypes. The aim of this study was to detect antibiotic susceptibilities of 23 Enterococcus faecium strains, which caused an outbreak in a University hospital by a disk diffusion test to investigate the presence of the species specific gene, and the resistant genotypes, vanA and vanB by duplex PCR. PCR for vanA and vanB was performed on 23 enterococci. Twenty three were identified as E. faecium and were tested positive for the vanA genotype. This study will report on the validation of a simple and accurate VRE detection method that can be easily incorporated into the daily routine of a clinical laboratory. Early detection of VRE strains, including those with susceptibility to vancomycin, is of paramount clinical importance as it allows rapid initiation of strict infection control practices, as well as the therapeutic guidance for confirmed infections. The PCR method developed in the present study is simple and reliable for the rapid characterization of VRE.

• Korean Journal of Clinical Pharmacy
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• v.9 no.1
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• pp.1-14
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• 1999

Vancomycin-resistant Enterococci (VRE) have recently emerged in Korean hospitals, as well as in those of other countries. VRE have been partially attributed to the overuse and misuse of vancomycin. The mecbanisms of VRE resistance are related to VanA, VanB, and VanC. Both VanA and VanB produce abnormal ligase enzymes to form D-ala-D-lactate termini in E. faecium and E. faecalis, instead of D-ala-D-ala termini. Meanwhile, Van C produces D-ser-D-ala termini in E. gallinarum and E. casseliflavus. These abnormal termini have a low affinity to vancomycin. As a result, VRE avoid the activity of vancomycin by these mechanisms. Unfortunately, there is no approved therapy for the treatment of VRE. Thus, available but uncommonly prescribed antibiotics (due to their toxicity or unproven efficacy) may become possible options. They include chloramphenicol, novobiocin, fosfomycin, and bacitracin. The combination therapy of available agents may also be the other options. They include high doses of a penicillin- or ampicillin-aminoglycoside combination, high doses of an ampicillin/sulbactam and aminoglyoosidcs combination, an ampicillin and vancomycin combination, and a ciprofloxacin, aminoglycosides, and rifampin combination. With respect to the near future, many types of investigational agents will most likely expand their treatment options for VRE. Teicoplanin, a glycopeptide, can be used for VanB- and VanC-related VRE. LY333328, a new generation of glycopeptide, is effective in treating VanA as well as VanB and VanC. RP59500 (quinupristin/dalfopristin), a streptogramin, is effective in treating vancomycin-resistant E. faecium. New generation quinolones (especially clinatloxacin) are potential options for the treatment of VRE, even though they cannot work as effectively against VRE as they can against Staphylococci. Both glycylcyclines (a new generation of tetracyclines) and ketolides (a new generation of macrolides) show good activity against Enterococci, regardless of vancomycin susceptibility. Oxazolidinones (i. e. eperezolid and 1inezolid) and everninomicins (i. e. SCH27899) are new groups of antibiotics, which also demonstrate good activity against VRE. It is imperative that clinical pharmacists take the responsibility of investigating new treatment options for VRE in order to combat this growing problem throughout the world.