• Korean Journal of Clinical Pharmacy
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• v.9 no.1
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• pp.35-43
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• 1999

Over the last 50 years, a number of antibiotic agents have been developed and clinically used in the area of infectious diseases. Due to antimicrobial resistance problems and increasing health care costs, the rational use of antibiotics has been required. As a drug of choice to treat infections caused by MRSA, vancomycin has been extensively prescribed since the late 1970's. Recently, reports of vancomycin-resistant organisms such as VRE and VRSA have been increased to draw medical concerns. The objectives of this study were to evaluate the rational use of vancomycin and the appropriateness of the Restrictional Program of Antibiotic Utilization (RPAU) which has been operated at Samsung Medical Center. A retrospective chart review was performed in 132 hospitalized patients treated with vancomycin in the surgery departments from. January to June 1998. The guidelines of ASHP and HICPAC for vancomycin were modified and used as our criteria to determine the vancomycin DUE. In one hundred out of the patients, uses of vancomycin were approved by the Department of Infectious Diseases (DID) based on the RPAU. Vancomycin was appropriately used in $62.5\%$ of the 100 patients according to the criteria of justification of use, while $60.0\%,\;60.0\%,\;79.0\%,\;and\;51.0\%$ of the patients showed appropriate according to those of lab reports such as applicable culture obtained, pretreatment SCr, WBC and serum drug concentration monitoring, respectively. Although the rest 32 patients were not approved to receive vancomycin by the DID, twenty two percent continued receiving vancomycin treatment. This might result from the fact that the RPAU was started not before the use of antibiotics but in the middle of antimicrobial therapy. Continual education should be provide to the related health professionals and the RPAU should be simultaneously modified in order to increase the rate of appropriate uses of antibiotics.

• Korean Journal of Microbiology
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• v.49 no.2
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• pp.146-149
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• 2013

Bacteria of genus Vibrio are Gram-negative, curved, halophilic, nonspore-forming bacteria, autochthonous inhabitans of the marine and estuarine environments. Some of the Vibrio species such as V. parahaemolyticus, V. vulnificus, and V. cholerae are associated with human disease. Each year many people have been suffering from food-borne disease caused by the ingestion of seafood. In this study, we have monitored antibiotic resistance of this microorganism in 6 coastal areas of West Sea by sampling shellfish monthly. Vibrio spp. were detected from 23.3% of 120 samples analyzed using TCBS agar plates as well as API 20E kit. Among 16 antibiotics tested, resistance to vancomycin and ampicillin was observed in 82.1% of the isolates, and Vibrio spp. resistant to rifampin (71.4%) and cephalothin (53.6%) were also high. Most of the isolates were sensitive to chloramphenicol (92.9%), sulfamethoxazole/trimethoprim (92.9%), and tetracycline (96.4%). About 71.4% of the isolates showed multiple drug resistance toward 3 antibiotics including vancomycin and ampicillin.

• Korean Journal of Clinical Pharmacy
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• v.20 no.3
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• pp.221-228
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• 2010

In 2009, American Journal of Health-System Pharmacy (AJHP) recommended that targeting vancomycin trough concentrations of 10 mg/L or more because of therapeutic failure and potential risk of developing vancomycin resistance. Therefore, new dosage guidelines that could achieve to these higher target were needed. The aims of this study were to develop dosage guidelines targeting new vancomycin trough concentration and to evaluate the performance of these new guidelines. All data analysis were performed using NONMEM(R). Population pharmacokinetic model was first developed from vancomycin dosage and concentration data collected retrospectively during routine therapeutic drug monitoring in 441 patients, then new vancomycin dosage guidelines were developed by using the model to predict vancomycin trough and peak concentrations in a simulated dataset. The estimates, such as, vancomycin concentration trough level, time to achieve target level, mean error were performed to evaluate and compare difference between conventional dosage and new dosage guidelines. The proposed dosage guidelines were predicted to achieve 43.5% of vancomycin trough level within 10~20 mg/L, which is significantly higher than current guidelines (26.3%). Time to achieve target trough level was 19.4 hours in new guidelines comparing to 93.1 hours in the conventional dosage. Thus, new vancomycin dosage guidelines have been developed to achieve new target trough concentrations earlier and more consistently than conventional guidelines.

• Journal of Microbiology
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• v.40 no.2
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• pp.170-172
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• 2002

To determine the occurrence of vancomycin-resistant Enterococci in a raw milk sample, raw milk samples were examined for a period of 6 months. Enterococci were isolated directly from Enterococcal selective agar plates supplemented with 2 mg of vancomycin per liter, Nineteen strains were selected and identified by applying the Vitek system. To determine resistance patterns, 19 isolates were tested with vancomycin and teicoplanin. Vancomycin-resistant Enterococci were genotyped by using a PCR analysis and 5 out of 19 isolates were of the VanC type.

• Food Science of Animal Resources
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• v.33 no.1
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• pp.133-138
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• 2013

In this study, a total of 256 samples of retail raw meats (beef, pork and chicken) and sashimi were investigated for the presence of Enterococcus faecalis and Enterococcus faecium. We isolated a total of 117 E. faecalis and E. faecium from the samples, with contamination rates ranging from 18.8% for sashimi samples to 68.8% of chicken samples. E. faecalis was the predominant species recovered from all of the retail raw meats beef (42.2%), pork (42.2%), chicken (65.6%) and sashimi (12.5%). Among 117 isolates, 61 isolates (52.1%) were resistant to tetracycline, 32 isolates (27.4%) were resistant to erythromycin, 23 isolates (19.7%) were resistant to chloramphenicol, 16 isolates (13.7%) were resistant to ripampin, 10 isolates (8.5%) were resistant to gentamycin, 9 isolates (7.7%) were resistant to ciprofloxacin and 1 isolate (0.9%) was resistant to ampicillin and penicillin G. No resistance to amoxicillin + clavulanic acid and vancomycin was observed. Although no strain was resistant to vancomycin, the vanB gene was observed in 9 of 117 of Enterococcus (7.7%) demonstrating potential risk of vancomycin-resistant Enterococcus (VRE). Our results indicate that E. faecalis and E. faecium were highly prevalent in retail raw meats, but most strains were sensitive to tested antibiotics.

• Molecules and Cells
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• v.44 no.3
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• pp.179-185
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• 2021

Vancomycin response regulator (VncR) is a pneumococcal response regulator of the VncRS two-component signal transduction system (TCS) of Streptococcus pneumoniae. VncRS regulates bacterial autolysis and vancomycin resistance. VncR contains two different functional domains, the N-terminal receiver domain and C-terminal effector domain. Here, we investigated VncR C-terminal DNA binding domain (VncRc) structure using a crystallization approach. Crystallization was performed using the micro-batch method. The crystals diffracted to a 1.964 Å resolution and belonged to space group P212121. The crystal unit-cell parameters were a = 25.71 Å, b = 52.97 Å, and c = 60.61 Å. The structure of VncRc had a helix-turn-helix motif highly similar to the response regulator PhoB of Escherichia coli. In isothermal titration calorimetry and size exclusion chromatography results, VncR formed a complex with VncS, a sensor histidine kinase of pneumococcal TCS. Determination of VncR structure will provide insight into the mechanism by how VncR binds to target genes.

• 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.

• Archives of Pharmacal Research
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• v.28 no.6
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• pp.660-666
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• 2005

The intestinal microbiota are important to the host with regard to resistance they impart against bacterial infections and their involvement in mediating metabolic functions. Lactic acid producing bacteria such as Lactobacillus play an important physiological role in these matters. The aim of the present study was to isolate Lactobacillus sp. that inhibits enteric pathogens. Initially, 17 isolates from healthy Koreans were collected on Lactobacillus selective medium. Resistance of the isolates to antibiotics including rifampicin, streptomycin, clindamycin and vancomycin was measured. One of the isolate was identified as Lactobacillus ruminus on the basis of bacterial cell morphology, cultural characteristic and biochemical characteristics, 16S rRNA sequence analysis and PCR-RAPD. Antimicrobial activity of the bacterium against Vancomycin Intermediate Resistant Staphylococcus aureus (VISA) and Vancomycin-Resistant Enterococci (VRE) was measured. About $10^4$ cells of VISA or VRE were mixed with 1, 5, and 9 mL of L. ruminus SPM 0211 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 h, serially diluted and then plated on BHI agar plates. As numbers of L. ruminus SPM 0211 were increased, viable cell count of VISA and VRE decreased. The strongest antimicrobial activity of SPM 0211 was observed after 9 h incubation in any mixture, almost completely inhibiting the growth of these two bacteria. The results suggest that the freshly isolated L. ruminus SPM 0211 may be used as a pro-biotic microbe that prevents the colonization of enteric pathogens and can thereby promote good gastrointestinal health.

• Microbiology and Biotechnology Letters
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• v.36 no.2
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• pp.142-148
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• 2008

To evaluate the antibiotic resistance of Enterococcus from salad and sprout, Enterococcus were isolated and identified from 47 salad samples and 37 sprout samples, and then their antibiotic resistances were analyzed. Ninety five Enterococcus, 41 strains from salad and 54 strains from sprout, were ultimately isolated. The frequent Enterococcus in salad and sprout were E. gallinarum, E. faecalis, E. faecium, E. hirae, and E. avium. Minimum inhibitory concentrations of the isolates for vancomycin were below $4{\mu}g/mL$, which were not high levels of resistance. All Enterococcus proved to be resistant to streptomycin and chloramphenicol. Twenty two percentage of the isolates were resistant to penicillin, however, almost the isolates were sensitive to tetracycline. Eighteen percentage of the isolates were resistant to erythromycin. All E. faecium and E. faecalis were found to be ampicillin-resistant, and seven E. faecalis and five E. faecium were resistant to rifampicin. Overall antibiotic resistances of Enterococcus isolates were relatively low and low resistance to vancomycin was similar to those evidenced by Enterococcus isolated from the other foods. Therefore, there may be no special risk from the antibiotics resistances of Enterococcus and especially vancomycin-resistant Enterococcus from the fresh-cut salads and the sprouts.

• Korean Journal of Microbiology
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• v.48 no.1
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• pp.22-28
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• 2012

Vibrio parahaemolyticus is one of the major agents responsible for food poisoning during summer in Korea, which is transmitted via seawater or seafoods. Recently, distribution of the bacteria in the marine environment has been increased due to global warming. Great concern also has been raised regarding public hygiene as well as marine culture by the emergence of pathogens with antibiotic resistance. Therefore, distribution of V. parahaemolyticus and antibiotic resistance of the isolates were monitored in 7 coastal areas of Kyonggi Province and Incheon by sampling seawater, fishes and clams monthly. V. parahaemolyticus was detected from 47.7% of 966 samples (seawater 61.9%, seafoods 41.8%) analyzed using $CHROMagar^{TM}$ and TCBS agar plates as well as multiplex PCR. Among 13 antibiotics tested, resistance to vancomycin and ampicillin was observed in 97.3% and 87.3% of the isolates, respectively, and the ratios of them resistant to cephalothin (48.8%) and rifampin (46.1%) were also high. The isolates were most highly sensitive to chloramphenicol (91.7%) and trimethoprim-sulfamethoxazole (91.8%). The ratio of sensitivity for other antibiotics was also high in the descending order of gentamycin (82.3%), tobramycin (74.8%), nalidixic acid (71.6%), tetracyclin (69.4%), cefotaxime (63.0%). About 69% of the isolates showed multiple drug resistance toward 3 antibiotics including vancomycin and ampicillin. Two of them exhibited resistance for 11 antibiotics used in this study. Plasmid profile analysis of the isolates with antibiotic resistance revealed that 55.1% of them retained plasmids of 24 different types. However, no clear inter-relationship between the resistance and the plasmid profile has been observed.