• Journal of Korean Neurosurgical Society
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• v.39 no.2
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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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• v.40 no.6
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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.

• Biomedical Science Letters
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• v.5 no.2
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• pp.213-217
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• 1999

In order to control resistant strains and to properly select the antimicrobial agents, it is of quite importance to know current trends of bacterial species and changing patterns of antimicrobial resistance rates. The authors studied the results of 542 Gram-positive strains among 1,689 strains isolated at Chung-buk National University Hospital in 1996. The frequently isolated Gram-positive microorganisms were Staphylococcus aureus, Streptococcus pneumoniae, Staphylococcus epidermidis and Enterococcus faecalis in descending order. S. aureus showed high resistance to penicillin, gentamicin, and susceptibility to teicoplanin and vancomycin. Coagulase negative Staphylococcus was highly resistant to all of the antibiotics used in this experiment except teicoplanin and vancomycin. Enterococcus were highly resistant to vancomycin, penicillin and tetracycline. MIC of Gram-positive oaganisms was appeared to be zig-zag pattern.

• Journal of Food Hygiene and Safety
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• v.24 no.4
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• pp.373-377
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• 2009

From April 2008 to January 2009, a total 458 raw milk samples were randomly collected from 15 stock raising farms located in northern area of Kyunggi province and cultured for the presence of Enterococci spp. A total 170 enterococcal isolates were recovered from the raw milk samples. Enterococcus faecalis was predominant species recovered (64.7%), followed by E. faecium (18.8%), E. avium (5.9%), E. gallinarum (5.9%) and E. durans (4.7%). Antimicrobial resistance patterns of 170 Enterococci spp. against ampicillin, erythromycin, tetracyclin, chloramphenicol, vancomycin, ciprofloxacin and streptomycin were tested. According to the result, they showed high level resistance to erythromycin and streptomycin (82,9% and 93,5% respectively), moderately resistance to ampicillin, chloramphenicol and tetracyclin (50%, 45.9% and 32%, respectively) but fortunately, vancomycin and ciprofloxacin are still effective against this species.

• Journal of Korean Neurosurgical Society
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• v.43 no.6
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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.

• YAKHAK HOEJI
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• v.50 no.2
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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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• 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.

• Pediatric Infection and Vaccine
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• v.4 no.2
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• pp.218-224
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• 1997

Purpose: The antimicrobial resistance of S. pneumoniae has encountered with increasing frequency from around the world. In our country, penicillin resistant strains of S. penumococci are rapidly increasing. It has been known that colonized pneumococci in upper respiratory tract cause sinisitis, otitis media, meningitis and pneumonia. We tried to reveal the colonization rate of pneumonocci in upper respiratory tract, their antimicrobial resistance and DNA fingerprinting pattern in normal children. Methods: We got specimens from 117 children of day-care center in Seoul through oropharyngeal swab. After incubation on BAP, optochin test and slide latex agglutination test were used for identification. Antimicobial susceptibility test to penicillin, vancomycin, erythromycin and TMP-SMZ was done with disk diffusion method. Penicillin MIC was gotten through the broth microdilution method. Genotyping of 45 pneumococci was done by rep-PCR using REP1R-Dt and REP2-Dt primer. Results: The carriage rate of pneumococci in the day-care center children was 38%(45/117). The resistance of penicillin, erhthromycin, TMP/SMZ, vancomycin by the disk diffusion method are 89%, 91%, 64% and 0%, respectively. 64% of the isolates showed multiple resistance. 7 types of DNA fingerprinting were gotten and 78% of isolates belonged to three types. Conclusion: We found that the antimicrobial resistance of children attending the day-care center in Seoul was much higher than expected. We assumed that this might be due to their easy and frequent exposure to antimicrobial agents and crowded day-care center environment.

• Archives of Pharmacal Research
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• v.27 no.2
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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.

• 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.