• Journal of Korean Neurosurgical Society
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• 제39권2호
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• pp.141-143
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• 2006

Vancomycin-resistant enterococci[VRE] are rare cause of meningitis, occurring in immunocompromised patients, severely ill, hospitalized patient, and patients who have undergone neurosurgical procedures. Resistance to vancomycin has increased in frequency during the past few years. Limited therapeutic options are available for VRE infectionsandtheoptimumtherapy has not been established. We report a case of VRE meningitis that was successfully treated with administration of quinupristin-dalfopristin [Synercid] by both intravenous and intraventricular routes. A brief review of the literature is provided, which indicates that optimal management with Synercid should include daily intraventricular doses of at least 2mg and intravenous 0.5mg/kg every 8 hours. We also review the previously reported cases of VRE meningitis.

• BMB Reports
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• 제40권6호
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• pp.881-887
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• 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.

• 대한의생명과학회지
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• 제5권2호
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• pp.213-217
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• 1999

임상검체에서 분리되는 병원균을 주기적으로 분석하고 이에 대한 항균제 감수성의 변화 양상을 파악하는 것은 임상에서의 적절한 항균제의 선택이나 내성균의 감독과 조절을 위해 필수 적이라 할 수 있다. 저자들은 충북대학병원에 1996년 1년간 내원 환자의 미생물 배양 검사에서 분리, 동정된 1,689균주중 Gram양성인 542균주의 분리 빈도 및 주요 균종에 대하여 항생제 감수성 양상을 조사하였다. Gram 양성 균종은 S. aureus, S. pneumoniae, S. epidermidis, S. hemolyticus, coagulase negative Staphylococcus (CNS), Enterococcus faecalis 순으로 분리되었다. 한편, 항생제 감수성 시험 결과 S. aureus의 항생제 감수성은 penicillin과 gentamicin에 대한 저항성이 현저히 높았으며, teicoplanin 과 vancomycin (MIC$_{50}$ $\mu\textrm{g}$/ml)에 감수성이 높은 것으로 나타났다. CNS의 경우도 S. aureus와 대동소이 한 결과를 보였으나, S. epidermidis의 경우에는 ciprofloxacin과 clindamycin에 감수성 이 높은 것으로 나타났다. Enterococcus spp.는 vancomycin, penicillin, tetracycline 등에 저항성이 매우 높았으며, 검사한 모든 항생제에 대하여 대부분의 감수성이 zig-zag pattern을 보였다.

• 한국식품위생안전성학회지
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• 제24권4호
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• pp.373-377
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• 2009

2008년 4월부터 2009년 1월 사이에 경기도 북부 지역에 위치한 축산 농가 15곳으로부터 458개의 원유 시료를 공급받아 장구균속 세균을 분리 동정하였다. 총 170개의 장구균속 세균이 분리되었으며 그 중 Enterococcus faecalis가 가장 우세하게 분리된 균주이며 (64.7%) E. faecium이 18.8%, E. avium이 5.9%, E. gallinarium이 5.9%, E. durans가 4.7%의 순으로 분리되었다. 분리된 170종의 장구균을 대상으로 ampicillin, erythromycin, tetracyclin, chloramphenicol, vancomycin, ciprofloxacin 및 streptomycin에 대한 감수성 검사를 실시하였다. 그 결과 erythromycin (82.9%)과 streptomycin (93.5%)에 대해서는 고도의 저항성을 나타내었으며 ampicillin (50%), chloramphenicol (45.(%) 및 tetracyclin (32%)에 대해서는 중증도의 저항성을 나타내었으나 vanocomycin 및 ciprofloxacin에 대해서는 다행이 감수성인 결과를 나타내었으며 앞으로도 지속적인 모니터링이 필요한 것으로 판단된다.

• Journal of Korean Neurosurgical Society
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• 제43권6호
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• pp.307-310
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• 2008

Limited therapeutic options are available for vancomycin intermediate-resistant Staphylococcus epidermidis (VISE) infections and no optimum therapy has been established. We report a case of VISE skull osteomyelitis that was successfully treated with linezolid. The patient was a 53-year-old man who presented with headache, nausea and dysphasia. Brain computerized tomography (CT) demonstrated a subdural hematoma in the left hemisphere. Craniotomy and hematoma evacuation was performed and he showed good recovery despite a scalp wound infection caused by methicillin-resistant Staphylococcus aureus (MRSA). The organism isolated from the scalp wound was sensitive to vancomycin. The patient was treated with intravenous vancomycin for 44 days. However, he showed a high fever, persistent positive methicillin-resistant Staphylococcus epidermidis (MRSE) blood cultures, and a deteriorating clinical status. He underwent infected skull bone flap removal and linezolid treatment for 35 days. During one year of follow up, he has not had any further episodes of osteomyelitis or fever. Linezolid has shown to be effective agent to eradiate osteomyelitis caused by VISE.

• 약학회지
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• 제50권2호
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• pp.78-83
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• 2006

VISA and VRE are the main causes of surgical infection, urinary tract infections and bacteremia in hospitals. In this study; we selected VISA (Vancomycin Intermediate resistant Staphylococcus aureus) and VRE (Vancomycin Resistant Enterococcus) isolated from the clinical isolates. One of the isolated strains indicated the high resistance to severel anti-biotics (Vancomycin, Teicoplanin, Mupirocin, Synercid, Ciprofloxacin, Gentamicin, Lincomycin, Cefotaxim, Meropenem). Antimicrobial activity of Bifidobacterium spp. against VISA and VRE were measured. About $10^4$ cells of VISA or VRE were mixed with 1,5 and 9 ml of Bifidobacterium 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 hr, serially diluted and then plated on BHI agar plate. As numbers of Bifidobacterium were increased viable cell count of VISA and VRE decreased. The strongest antimicrobial activity of the Bifidobacterium was observed after 9hr incubation in any mixture, almost completely inhibiting the growth of VISA and VRE.

• Journal of Microbiology and Biotechnology
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• 제24권3호
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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.

• Pediatric Infection and Vaccine
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• 제4권2호
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• pp.218-224
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• 1997

목 적 : 전 세계적으로 폐구균의 항균제 내성이 증가하고 있고, 우리 나라의 경우 그 어느 나라보다 급속한 폐구균 내성의 증가가 보고 되고 있다. 일반적으로 상기도에 정착되어 있던 폐구균은 부비동염, 중이염, 수막염, 폐렴들을 일으키는 것으로 알려져 있어 저자들은 정상 소아의 구인강에서 폐구균의 보균율을 알아보고 이들의 항균제 내성양상과 DNA분자 형별을 조사하였다. 방 법 : 1997년 4월 서울 한 유치원의 어린이 117명에서 구인강 점막을 면봉으로 도말하여 검체를 얻었다. 이들을 배양후 optochin검사와 capsule에 대한 다가항체를 이용하여 Latex 방법으로 폐구균을 동정하였고, 디스크확산법으로 페니실린, vancomycin, erythromycin, TMP-SMZ에 대한 감수 검사를 시행하였다. 분리된 폐구균에 대하여 액체배지 미량 희석법을 이용하여 페니실린의 MIC값을 구하였다. 또 분리된 폐구균들에 대하여 REP1R-Dt와 REP2-Dt primer를 사용한 rep-PCR법으로 DNA 분자 형별을 시행하였다. 결 과 : 서울지역의 유치원에서 폐구균 보유율은 38%(45/117)였고, 디스크 확산법에 의한 페니실린 내성 폐구균의 비율은 89%(40/45)였고, erythromycin은 91%, TMP/SMZ은 63%였고 vancomycin에는 모두 감수성을 보였다. 그리고 페니실린에 고도 내성균주는 21예로 전체의 47%를 차지하였고 다제내성 폐구균은 64%였다. DNA 분자형은 7가지로 분류할 수 있었고, 이중 3가지 유형이 전체의 78%를 차지하였다. 결 론 : 서울 지역의 건강한 유치원 어린이들이 보유하고 있는 폐구균의 항균제 내성이 예상보다 훨씬 높았고, 이는 이들 어린이들이 빈번한 항균제 노출과 유치원의 밀집환경의 때문이라 추정된다.

• Archives of Pharmacal Research
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• 제27권2호
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• pp.246-253
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• 2004

The prevalence, genotype for antibiotic resistance and antibiotic susceptibility of vancomycin resistant enterococci (VRE) were determined. And molecular typings of the Enterococcus faecium isolates were analyzed. Prevalence of VRE in chickens, healthy children and intensive care unit (ICU) patients was 41.6％,7.9％, and 20.4％, respectively. Forty out of 54 isolates from chicken intestines, and 9 out of 11 from ICU patients were identified as Enterococcus faecium. Eleven out of 13 isolates from non-hospitalized young children were E. gallinarium. Twelve strains of E. faecalis were isolated from chicken intestines. The gene for the antibiotic resistance in E. faecium, and E. faecalis was vanA, while that in E. gallinarium was vanC1. E. faecium isolates were resistant to most of antibiotics except ampicillin and gentamicin. Molecular typing of the E. faecium strains obtained by pulse field gel electrophoresis and repetitive sequence-based PCR suggest that VRE transmit horizontally from poultry to humans, especially young children, via the food chains in Korea.

• 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.