• Biomedical Science Letters
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• v.6 no.3
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• pp.201-208
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• 2000

The vancomycin, one of the family of glycopeptide antibiotics, inhibits the synthesis of bacterial cell wall peptidoglycan and has been widely used against gram-positive bacterial infections, especially for a treatment of methicillin resistant S. aureus infection. However, clinical isolate which was intermediately resistant to vancomycin (Mu50: MIC 8 $\mu\textrm{g}$/ml) was isolated in recent years. In this study we performed vancomycin susceptibility test with the increment method and population analysis with clinical isolates S. aureus. Also we did several kinds of tests with three selected isolates (s129: MIC 7 $\mu\textrm{g}$/ml, s134: MIC 7 $\mu\textrm{g}$/ml, s135: MIC 8 $\mu\textrm{g}$/ml) to find out possible mechanism of vancomycin resistance. As a result, the prevalence of vancomycin resistant S. aureus isolates among S. aureus strains resistant to methicillin was 23.3% (25/107). The vancomycin resistances of isolated strains of S. aureus were between those of Mu5O and Mu3 strains. By PCR analysis, none of the isolates with decreased vancomycin susceptibility contained known vancomycin resistant genes such as vanA, vanB, vanC1, vanC2, and vanH. Major bands of 81 kDa, 58 kDa, 33 kDa, 28 kDa were demonstrable in whole cell lysates by SDS-PAGE from all three isolates as well as reference strains. And especially,45 kDa protein was overproduced in Mu50 strains. Among them increased production of NAD$^{+}$-linked-$_{D}$-lactate dehydrogenase (dnLDH) were detected from one clinical strain (s135) and Mu5O strain. From these data, we suggest that the mechanism of vancomycin resistance in these isolates are distinct from that in enterococci.

• Quality Improvement in Health Care
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• v.3 no.2
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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.

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

• Journal of Preventive Medicine and Public Health
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• v.45 no.3
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• pp.174-180
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• 2012

Objectives: An ambulance can be a potential source of contagious or droplet infection of a community. We estimated the prevalence of positive carriage of tuberculosis (TB), methicillin-resistant $Staphylococcus$ $aureus$ (MRSA), and vancomycin-resistant $Enterococci$ (VRE) in patients transported by ambulance. Methods: This was a retrospective observational study. We enrolled all patients who visited a tertiary teaching hospital emergency department (ED). Blood, sputum, urine, body fluid, and rectal swab samples were taken from patients when they were suspected of TB, MRSA, or VRE in the ED. The patients were categorized into three groups: pre-hospital ambulance (PA) group; inter-facility ambulance (IA) group; and non-ambulance (NA) group. Adjusted odds ratio (OR) and 95% confidence intervals (CI) were calculated using a multivariable logistic regression model for the prevalence of each infection. Results: The total number of patients was 89206. Of these, 9378 (10.5%) and 4799 (5.4%) were in the PA and IA group, respectively. The prevalence of TB, MRSA, and VRE infection were 0.3%, 1.1%, and 0.3%, respectively. In the PA group, the prevalence of TB, MRSA, and VRE were 0.3%, 1.8%, and 0.4%. In the IA group, the prevalence of TB, MRSA, and VRE were 0.7%, 4.6%, and 1.5%, respectively. The adjusted ORs (95% CI) of the PA and IA compared to the NA group were 1.02 (0.69 to 1.53) and 1.83 (1.24 to 2.71) for TB, 2.24 (1.87 to 2.69) and 5.47 (4.63 to 6.46) for MRSA, 2.59 (1.78 to 3.77) and 8.90 (6.52 to 12.14) for VRE, respectively. Conclusions: A high prevalence of positive carriage of TB, MRSA, and VRE in patients transported by metropolitan ambulances was found.

• Proceedings of the Microbiological Society of Korea Conference
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• 2005.05a
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• pp.143-147
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• 2005

The non-pathogenic, non-glycopeptide-producing actinomycete Streptomyces coelicolor carries a cluster of seven genes (vanSRJKHAX) that confers inducible, high-level resistance to vancomycin. The van genes are organised into four transcription units, vanRS, vanJ, vanK and vanHAX, and these transcripts are induced by vancomycin in a vanR-dependent manner. vanHAX are orthologuous to genes found in vancomycin resistant enterococci that encode enzymes predicted to reprogramme peptidoglycan biosynthesis such that cell wall precursors terminate in D-Ala-D-Lac, rather than D-Ala-D-Ala. vanR and vanS encode a two-component signal transduction system that mediates transcriptional induction of the seven van genes. vanJ and vanK are novel genes that have no counterpart in previously characterised vancomycin-resistance clusters from pathogens. VanK is essential for vancomycin resistance in S. coelicolor and it is required for adding Gly branch to stem peptides terminating D-Ala-D-Lac. Because VanK can recognise D-Lac-containing precursors but the constitutively expressed femX enzyme, encoded elsewhere on the chromosome, cannot recognize D-Lac-containing precursors as a substrate, vancomycin-induced expression of VanHAX in a vanK mutant is lethal. Further, femX null mutants are viable in the presence of glycopeptide antibiotics but die in their absence. Bioassay using vanJp-neo fusion reporter system also showed that all identified inducers for van genes expression were glycopeptide antibiotics, but teicoplanin, a membrane-anchored glycopeptide, failed to act as an inducer.

• The Journal of Internal Korean Medicine
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• v.31 no.4
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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.

• Quality Improvement in Health Care
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• v.19 no.1
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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.

• Journal of Pharmacopuncture
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• v.26 no.3
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• pp.247-256
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• 2023

Objectives: Enterococcus faecalis is a gram positive diplococci, highly versatile and a normal commensal of the gut microbiome. Resistance to vancomycin is a serious issue in various health-care setting exhibited by vancomycin resistant Enterococci (VRE) due to the alteration in the peptidoglycan synthesis pathway. This study is thus aimed to detect the VRE from the patients with root caries from the clinical isolates of E. faecalis and to evaluate the in-silico interactions between vanA and the Aegles marmelos bio-compounds. Methods: E. faecalis was phenotypically characterized from 20 root caries samples and the frequency of vanA and vanB genes was detected by polymerase chain reaction (PCR). Further crude methanolic extracts from the dried leaves of A. marmelos was assessed for its antimicrobial activity. This is followed by the selection of five A. marmelos bio-compounds for the computational approach towards the drug ligand interactions. Results: 12 strains (60%) of E. faecalis was identified from the root caries samples and vanA was detected from two strains (16%). Both the stains showed the presence of vanA and none of the strains possessed vanB. Crude extract of A. marmelos showed promising antibacterial activity against the VRE strains. In-silico analysis of the A. marmelos biocompounds revealed Imperatonin as the best compound with high docking energy (-8.11) and hydrogen bonds with < 140 TPSA (Topological polar surface area) and zero violations. Conclusion: The present study records the VRE strains among the root caries with imperatorin from A. marmelos as a promising drug candidate. However the study requires further experimentation and validation.

• Korean Journal of Clinical Laboratory Science
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• v.36 no.2
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• pp.76-88
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• 2004

The purpose of this study was to investigate the distribution of Enterococci isolated from clinical specimens, and identify the aspect of antibiotic susceptibility and analyze the genetic difference by executing Rep-PCR over the strains resistant to aminoglycoside-typed antibiotics. From an assortment of the clinical specimens, 100 strains were isolated. The collection consisted of 49 strains of E. faecalis, 34 strains of E. faecium, 9 strains of E. avium, 4 strains of E. gallinarum, 3 strains of E. casseliflavus, and 1 strain of E. hirae. Ninety five were isolated from inpatients, and five strains were isolated from outpatient. Most of the E. faecalis and E. faecium were originated from urine, pus, and sputum. Most Enterococci showed 80% resistance to the cephalosprin-typed antibiotics. E. faecium showed the high resistance to all the antibiotic substances. One tenths of Enterococci showed the resistance to vancomycin. And also, most Enterococci showed the high resistance to amikacin and gentamicin as aminoglycoside-typed antibiotics. Genetic diversity of the resistant strains to aminoglycoside estimated using Rep-PCR was not significanty different.

• Journal of Korean Society of Environmental Engineers
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• v.32 no.10
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• pp.979-985
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• 2010

This study was performed to detect enterococci strain as an indicator of faecal contamination, to identify of 16S rDNA sequence and vancomycin resistance by MIC (Minimum Inhibitory Concentration) test from drinking spring-water samples in Seoul. The detection frequency of enterococci was 42 (19.8%) among 212 samples, and its concentration was ranged from 0 to 110 CFU/100 mL. These results were confirmed the possibility as an indicator microorganisms that similar to the frequency of E. coli detection (t test p-value 0.268, significant level 0.05). Isolated 56 enterococci samples were identified by 16S rDNA sequence data and their NCBI BLAST searching. They were identified to Enterococcus faecalis of 24 samples, E. faecium (10), E. casseliflavus (10), E. gallinarum (3), E. hirae (2), E. durans (2), E. sanguinicola (1). E. faecalis was dominant species that clinical case report of a domestic was similar. Vancomycin resistant enterococci (VRE) of 53 samples showed that vanB and vanC1/C2 type with 2 and 12 case, respectively. These results indicated that the drinking spring-water quarantined to fecal pollution for block out outbreak of gastrointestinal symptom with using such as disinfection process.