• 대한간호학회지
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• 제43권2호
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• pp.287-295
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• 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
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• 제33권4호
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• pp.213-216
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• 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.

• 대한임상검사과학회지
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• 제49권4호
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• pp.401-406
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• 2017

이 연구에서 VITEK 2 시스템을 사용하여 $6{\mu}g/mL$ vancomycin이 첨가된 Enterococcosel (EV6 agar에서 배양한 327개의 검체 중 74개의 분리균(22.6%)으로 확인하였다. E. faecium은 55주(74.3%), E. gallinarum 16주(21.6%), E. casseliflavus 2주(2.7%) 및 E. avium 1주(1.4%)로 확인되었다. E. faecium의 55가지 표현형 중 vanA가 42주(76.4%), vanB가 9주(16.4%), vanC 표현형이 4주(7.3%)로 나타났다. E. gallinarum 16주와 E. casseliflavus 2주 모두 vanC 표현형을 보였으며 E. avium 1주는 vanB 표현형을 나타내었다. EV4에서만 증식된 E. faecium 1주는 VITEK2 시스템을 이용한 항균제 감수성 검사 결과 vancomycin과 teicoplanin에 모두 감수성이었고 vancomycin 내성 표현형 유전자는 PCR에 의해 검출되지 않았다. 총 327 검체를 $6{\mu}g/mL$ vancomycin (EV6 broth)을 첨가 한 Enterococoscosel broth에서 배양하여 120 균주(36.7%)가 분리되었다. 120균주에서 다중 중합 효소 연쇄반응에 의한 반코마이신 내성 유전형 실험을 실시한 결과, vanA가 51주(42.5%), vanA와 vanC가 5주(4.2%), vanC가 18주(15%), 나머지 46주(38.3%)에서는 vancomycin 내성 유전형 유전자는 검출되지 않았다.

• 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.

• Journal of Microbiology
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• 제39권2호
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• pp.116-120
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• 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
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• 제18권5호
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• pp.942-945
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• 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
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• 제46권2호
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• pp.123-129
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• 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.

• 대한임상검사과학회지
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• 제39권1호
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• pp.7-18
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• 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
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• 제6권2호
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• pp.261-266
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• 1999

VRE 감염증은 항균제의 과다한 사용 후 출현하는 새로운 형태의 감염성 질환으로, 현재 심각한 임상 문제로 대두되고 있다. 최근 국내에서도 신경학적 장에나 당뇨병, 종양 등의 기저질환을 가진 성인 환자들에서 소수의 감염 예가 보고되고 있으나 소아기, 특히 신생아에서의 감염증은 잘 알려지지 않았다. 저자들은 생후 4일된 신생아에서 발생한 vancomycin 내성 E. faecalis 패혈증 l례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• 한국식품과학회지
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• 제50권6호
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• pp.581-586
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• 2018

본 연구에서는 서울과 경기도 지역 소매점 및 대형마트에서 판매되고 있는 샐러드, 어린잎, 새싹채소로부터 Enterococcus의 존재를 파악하고 9개 항생제에 대한 항생제 저항성 프로파일을 확보했다. Quinupristin/dalfopristin에 저항성을 가지는 분리주가 85.0%에 이르렀고, 특히 E. faecalis 분리주는 18종 중 17종이 저항성을 나타냈다. 또한 critically important 항생제 중 highest priority로 분류되는 ciprofloxacin과 erythromycin에 대해 각각 40.0, 50.0%가 중간 정도의 저항성을 보였으며, vancomycin에 대한 저항성을 가지는 분리주는 검출되지 않았다. Enterococci의 항생제 저항성 정도는 식품 안전뿐만 아니라 공중 보건에 있어서도 중요하다는 측면에서 본 연구의 Enterococcus 오염 정도, 항생제 내성율에 대한 결과는 향후 신선 편이식품 섭취가 인체 건강에 미치는 위험분석을 위한 기초자료로서 유용한 정보를 제공할 것으로 보이며 앞으로 특별한 열처리 없이 섭취하는 신선 편이식품에 대한 지속적인 모니터링이 필요할 것이라 사료된다.