• Korean Journal of Clinical Laboratory Science
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• v.49 no.4
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• pp.401-406
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• 2017

In this study, using the VITEK 2 system, 74 samples (22.6%) out of 327 specimens were identified by the growth of Enterococcosel media (EV6 agar) supplemented with $6{\mu}g/mL$ of vancomycin. Enterococcus faecium was identified as 55 strains (74.3%), Enterococcus casseliflavus as 2 strains (2.7%), Enterococcus avium as 1 strain (1.4%), and Enterococcus gallinarum as 16 strains (21.6%). Among the 55 phenotypes of Enterococcus faecium, 42 (76.4%), 9 (16.4%), and 4 strains (7.3%) showed the vanA, vanB, and vanC phenotype, respectively. The 16 strains of Enterococcus gallinarum and 2 strains of Enterococcus casseliflavus showed the vanC phenotype and the 1 strain of Enterococcus avium had the vanB phenotype. The one strain of Enterococcus faecium propagated only in EV4 and was susceptible to both vancomycin and teicoplanin according to the antimicrobial susceptibility test using the VITEK 2 system. The vancomycin resistance phenotype gene was not detected by PCR. A total of 327 specimens were cultured in Enterococcosel broth supplemented with $6{\mu}g/mL$ of vancomycin (EV6 broth), and 120 strains (36.7%) were isolated. These 120 strains were subjected to vancomycin resistant genotyping by a multiplex real-time polymerase chain reaction and 51 strains (42.5%) showed vanA; 5 strains (4.2%) showed vanA and vanC; and 18 strains (15%) showed vanC. Vancomycin resistance genotypes were not detected in the remaining 46 strains (38.3%).

• Biomedical Science Letters
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• v.5 no.1
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• pp.95-100
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• 1999

It is generally difficult, time-consuming, and expensive for the clinical laboratory to detect vancomycin resistant enterococci (VRE). The aim of this study was to develop and evaluate the multiplex polymerase chain reaction (PCR) assay system as a diagnostic tool for the rapid detection of VRE from clinical samples and/or for the identification of VRE from the bacterial strains isolated from clinical specimens. Specific primers, designed from the nucleotide sequences respectively encoding the vanA, vanB, vanC-1, vanC-2/3 genes in enterococci, were coupled in a multiplex PCR assay system. With this multiplex PCR assay system, we investigated the incidence rates and types of VRE isolated from clinical samples. A total of 75 strains of enterococci were isolated in 3 general hospitals in Korea. Of these isolates, 36 strains showed a pattern of high-level vancomycin resistance which associated with vanA gene, whereas 18 strains showed low-level vancomycin resistance associated with vanC-1 or vanC-2/3 gene. Thus, multiplex PCR assay method established in this study could be applied for the rapid detection of VRE.

• Journal of Korean Biological Nursing Science
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• v.11 no.1
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• pp.42-50
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• 2009

Purpose: The purpose of this study was to identify the influence of Vancomycin-resistant enterococcus (VRE) knowledge and awareness with VRE infection control in compliance with VRE infection control among nurses in intensive care units. Method: Participants (N=154) were recruited in B city from August 2007 to October 2007. Data were analyzed with SPSS PC+. Result: The degree of VRE knowledge of the participants was 12.41 out of the total score, 17; that of awareness with VRE infection control was 3.87 out of the total score, 4; that of compliance with VRE infection control 3.75 out of the perfect score, 4. A significantly positive relationship between awareness of VRE infection control and compliance with VRE infection control has been observed. Awareness with VRE infection control and type of intensive care unitpredicted 21.1% of the variance in compliance with VRE infection control. Conclusion: The study indicated that awareness with VRE infection control has the most important impact on the compliance with VRE infection control for the participants. Based on the finding, a suggestion is made to continue the research on VRE knowledge and nosocomical infection on the subject of nurse and nurse managers who are responsible for infection control in a medical institution.

• Korean Journal of Adult Nursing
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• v.21 no.4
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• pp.435-445
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• 2009

Purpose: This study was to examine whether VRE infection control strategies have an effect on the decrease in incidence rates for VRE acquisition and VRE nosocomial infection in ICU. Methods: All the patients were examined for VRE carriers on ICU admission. Among them, patients hospitalized for over 48 hours were investigated for VRE acquisition rates and VRE nosocomial infection rate using VRE infection control strategies in ICU for the experimental group from September 2007 to April 2008. Before that, incidence of VRE acquisition and VRE nosocomial infection for the control group without Intervention were investigated from May to August 2007 retrospectively. Results: VRE acquisition rate in clinical specimens was 0.6% in the experimental group, that was significantly lower when compared to the control group. VRE carrier rate at admission to ICU was 15.4%. Out of 182 VRE carriers, 180 patients were identified by the active surveillance culture. Conclusion: These results suggested that active surveillance culture at admission was considered to be an essential measure for detection of VRE carrier. But without strict isolation and adherence rating after each intervention, hand washing and contact isolation alone did not significantly decrease VRE nosocomial infection, although it did significantly decrease incidence of VRE acquired from clinical specimen.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.15 no.4
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• pp.522-530
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• 2008

Purpose: In this study active surveillance culture for ICU patients, in whom the risk of VRE infection was high were conducted, and through this the VRE colonization rate and the characteristics of the colonization were examined and risk factors involved in VRE colonization and acquisition were analyzed. Method: This research was performed with 635 patients admitted to ICU between July 1 and December 31, 2006. Results: On admission to ICU, the VRE colonization rate was 2.36%, 93% identified from active surveillance culture. The VRE colonization rate was significantly higher in those patients with cancer (OR=9.43; 95% CI=1.38${\sim}$62.50; P=.022), liver cirrhosis (OR=55.5; 95% CI=7.29${\sim}$500; P=.005), transferred from other hospitals (OR=200; 95% CI=22.73${\sim}$1000; P=.000), high APACHE II score (OR=1.107; 95% CI=1.010${\sim}$1.213; P=.029), or antibiotics within the last 3 months (OR=15.87; 95% CI=2.27${\sim}$111.11; P=.005). The VRE acquisition rate was 5.2%. It was significantly higher in those who were using a ventilator (OR=26.31; 95% CI=5.13${\sim}$142.86; P=.000), three or more kinds of antibiotics during admission (OR=58.82; 95% CI=16.13${\sim}$200; P=.000), or high APACHE II score (OR=1.16; 95% CI=1.08${\sim}$ 1.24; P=.000). Conclusion: The results of this study show that active surveillance culture can detect VRE colonization on admission to ICU and those who have acquired VRE in ICU. The analyzed VRE colonization and risk factors of VRE acquisition are expected to be useful in establishing guidelines for preventing VRE infection in ICU.

• Microbiology and Biotechnology Letters
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• v.33 no.2
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• pp.90-95
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• 2005

An Actinomycetes producing an anti-VRSA (vancomycin-resistant Staphylococcus aureus) substance was isolated from soil. The cultural, morphological, physiological and phylogenetic analyses of an isolated strain were investigated for identification. Cultural characteristics based on ISP (International Streptomyces Project) were as follows: white aerial mycelium, yellow reverse side, and good growth on various medium. Also, the isolate did not produce the soluble pigment. Morphological characteristics were showed cylindrical spore chain and smooth spore surface by SEM (Scanning Electron Microscope). Physiological characteristics were showed LL-type by DAP isomer analysis and detected glycine, glutamic acid and alanine. A phylogenetic analysis of the 16S rDNA provided a clue that the isolated strain was actually a member of the genus Streptomyces, because the determined sequence exhibited a higher homology with Streptomyces echinatus. The isolate was identified to be a genus of Streptomyces sp.. The optimal culture conditions for the maximum production of anti-VRSA substance by Streptomyces sp. were attained in a culture medium composed of $2.0\%$ (w/v) glucose, and $0.4\%$ (w/v) yeast extract. The anti-VRSA substance was highly produced after 5 days of culture. Optimal pH and temperature conditions for the production of anti-VRSA substance were pH 7.0 and $28^{\circ}C$, respectively.

• The Journal of Internal Korean Medicine
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• v.40 no.5
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• pp.974-982
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• 2019

Objective: Modern medicine offers no efficient way to clear colonization by vancomycin-resistant enterococci (VRE). However, VRE decolonization needs to be cleared as soon as possible to prevent VRE transmission. This study reports six cases in which the duration of vancomycin resistant enterococcus (VRE) colonization was reduced by Bojungikki-tang-gami. Methods: Six inpatients with VRE colonization were administered Bojungikki-tang-gami and continuously followed up with cultures. After three negative stool cultures, the patients were declared cleared of VRE colonization. We recorded the duration of VRE colonization. Results: The duration of VRE colonization in the six patients was a mean of 58 days and a median of 45 days. This was shorter than the duration reported in most previous studies. No side effects were noted. Conclusions: The findings of this study suggest that Bojungikki-tang-gami might be effective in shortening the duration of VRE colonization.

• Pediatric Infection and Vaccine
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• v.29 no.1
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• pp.46-53
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• 2022

It is challenging to treat ventriculitis with parenteral treatment alone in some cases because of the difficulty involved in maintaining an appropriate level of antibiotics in cerebrospinal fluid (CSF). We report two cases of ventriculitis who did not respond to intravenous (IV) antibiotics but were successfully treated with intraventricular antibiotics using IV agents. The first case was a four-month-old male patient with X-linked hydrocephalus. He showed ventriculitis due to Klebsiella pneumoniae not producing extended-spectrum β-lactamase and susceptible to third-generation cephalosporins and gentamicin, following ventriculoperitoneal (VP) shunt. His condition did not improve during the 47 days of treatment with IV cefotaxime and meropenem. We achieved improvement in clinical presentation and CSF profile after three times of intraventricular gentamicin injection. The patient was discharged from the hospital with antiepileptic drugs. The second case was a six-month-old female patient with a history of neonatal meningitis complicated with hydrocephalus at one month of age, VP shunt at two months of age, followed by a methicillin-resistant coagulase-negative staphylococci (CoNS) shunt infection with ventriculitis after the shunt operation. CoNS ventriculitis recurred four weeks later. We failed to treat intractable methicillin-resistant CoNS ventriculitis with IV vancomycin for ten days, and thus intraventricular antimicrobial treatment was considered. Five times of intraventricular vancomycin administration led to improvement in clinical parameters. There were only neurological sequelae of delayed language development but no other major complications. Patients in these two cases responded well to intraventricular antibiotics, with negative CSF culture results, and were successfully treated for ventriculitis without serious complications.

• The Journal of Internal Korean Medicine
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• v.45 no.2
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• pp.167-175
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• 2024

Hospital-acquired bacterial infections, including vancomycin-resistant enterococci (VRE) infection (MIC: 32 mcg/ml), are common. We describe the case of a 63-year-old female patient with subarachnoid hemorrhage and VRE infection treated with Jashin-bowon-tang and Samhuang-sashim-tang for 57 days and 22 days, respectively. The therapeutic effect was assessed weekly via culture, color and viscosity of pus from a coccyx sore, and C-reactive protein (CRP). Vital signs were checked four times a day. Seventeen days after treatment, VRE was not colonized in patient and color and viscosity of pus, CRP and vital sign were improved. This case report suggests that Jashin-bowon-tang and Samhuang-sashim-tang might be an alternative option for VRE infection patients reducing the need for extended isolation periods and speeding up recovery times.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.19 no.1
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• pp.122-133
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• 2012

Purpose: The purpose of this study was to develop a web-based education program on control vancomycin-resistant enterococci (VRE) infections and to identify the effects of the program on knowledge and performance of nursing students. Methods: The web-based VRE infection control education program was developed by using the network-based instructional systems design model. The nursing students in the experimental group could access this web-based education program at any time, and as many times as they wanted, during the clinical training period. Effects were evaluated by assessing knowledge and performance of VRE infection control measures during the clinical training period. Results: The contents of the education program included diagnosis, transmission, and treatment of VRE, contact precautions, hand washing, personal protective equipment, environment management, and quizzes. The lecture portion was filmed in a virtual screen studio using flash animation, video, and sound effects, and it was uploaded on an internet site. The knowledge and performance scores of the experimental group after using the education program were significantly higher than those of the control group. Conclusion: The results suggest that the web-based VRE infection control education program is an effective educational method to enhance knowledge and performance of VRE infection control measures.