• Clinical and Experimental Pediatrics
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• v.53 no.12
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• pp.1000-1005
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• 2010

Purpose: This study aimed to determine the optimal initial vancomycin dose to achieve appropriate trough levels in pediatric patients. Methods: We analyzed clinical data for 309 children treated with intravenous vancomycin between 2004 and 2009 at 2 different hospitals in South Korea. The patients were 1-16 years old and exhibited normal renal function. Patient data, including reason for treatment and initial dosing regimen, were reviewed. Two subgroups were identified and compared according to initial vancomycin dose: 40 (35-45) mg/kg/day and 60 (55-65) mg/kg/day. Trough levels were obtained at steady state after at least 4 doses of vancomycin. Results: Patients who received vancomycin had post-operation or wound-related infections (37.2%), localized infection (12.9%), catheter-related infections (9.4%), meningitis (8.7%), or endocarditis (6.8%). Pathogens were confirmed in 79 cases: 28 cases of methicillin-resistant $Staphylococcus$ $epidermidis$ (35.4%) and 25 of methicillin-resistant $Staphylococcus$ $aureus$ (31.6%). Out of the 309 patients, 201 (65%) received vancomycin at 40 mg/kg/day and 108 (35%) at 60 mg/kg/day. Average trough concentrations were significantly different between the groups ($P$<0.001). Trough levels over 10 mg/L were less likely to be achieved in the 40 mg/kg/day group (14%) than in the 60 mg/kg/day group (49%) ($P$<0.001). There were no differences in renal function deterioration between the groups. Conclusion: A common vancomycin dosing regimen, 40 mg/kg/day, was not high enough to achieve trough levels of over 10 mg/L in pediatric patients. Careful drug monitoring must be performed, and increasing initial dose of vancomycin should be considered in pediatric patients.

• Korean Journal of Clinical Pharmacy
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• v.21 no.3
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• pp.276-279
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• 2011

We report an unusual case of lupus flare induced by intravenous vancomycin in a patient with systemic lupus erythematosus. Due to methicillin resistant staphylococcus aureus in wound culture, intravenous vancomycin was administered to the patient. The patient had been on vancomycin for several days then she experienced fever, malar rash, and vomiting. Based on laboratory results, it was confirmed as lupus flare. Oral prednisolone was given to the patient for symptom control. However, when vancomycin was readministered, the patient had similar symptom to the previous one more intensively. Vancomycin was stopped then the patient became stable. This case report demonstrates that intravenous vancomycin may manifest as lupus flare in patients with systemic lupus erythematosus.

• Korean Journal of Veterinary Research
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• v.43 no.1
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• pp.103-112
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• 2003

A multiplex PCR assay, which allows simultaneous detection of vancomycin resistant genotypes and Enterococcus species-specific genes, was developed. Vancomycin resistant enterococci (VRE) from chickens and humans could be detected for vanA, vanB, vanC-1, vanC-2, $ddl_{E.faecium}$ and $ddl_{E.faecalis}$ by multiplex PCR. Eight isolates of VRE from humans (n=11) had $ddl_{E.faecium}$ and vanA, and 3 isolates of the VRE had $ddl_{E.faecium}$ and vanB. One isolate of VRE from chickens (n=6) had $ddl_{E.faecium}$ and vanA, and 5 isolates of the VRE had only vanA. E. faecium, E. faecalis, E. gallinarum and E. casseliflavus were also confirmed for the species-specific gene by multiplex PCR. This multiplex PCR could detect E. faecium, E. faecalis, E. gallinarum, E. casseliflavus, vanA, vanB, vanC-1 and vanC-2, simultaneously. The PCR assay established in the present study can be an alternative to time-consuming biochemical tests and antibiotic susceptibility tests of Enterococcus spp.

• Food Science and Biotechnology
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• v.15 no.4
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• pp.511-515
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• 2006

Antibiotic resistance of foodborne pathogens adapted to garlic (Allium sativum Linn.) was determined in order to understand the relationship between antibiotic resistance and garlic. The Gram (-) strains of Escherichia coli and Salmonella typhimurium and the Gram (+) strains of Bacillus cereus and Staphylococcus aureus were subcultured consecutively in a garlic broth, and the surviving colonies on the agar were selected as the adapted strains. Minimal inhibitory concentrations (MIC) for 15 antibiotics on the adapted strains were determined on Muller-Hinton Infusion agar. Adaptation to 1.3%(v/v) garlic juice increased MIC for vancomycin, aminoglycoside, and erythromycin on B. cereus, and for ampicillin and erythromycin on E. coli O157:H7. MIC of aminoglycosides, chloramphenicol, and vancomycin on the adapted S. aureus increased. The adapted S. typhimurium was more resistant to penicillin and vancomycin than the non-treated strain. The adapted S. typhimurium and S. aureus lost their antibiotic resistance in non-garlic stress conditions. However, the adapted B. cereus was still resistant to erythromycin and vancomycin, and the adapted E. coli was also resistant to erythromycin. Antibacterial garlic might increase the antibiotic resistance of E. coli, B. cereus, S. aureus, and S. typhimurium and this resistance can continue even without the stress of garlic. Therefore, garlic as a food seasoning could influence the resistance of such pathogens to these antibiotics temporarily or permanently.

• Pediatric Infection and Vaccine
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• v.6 no.2
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• pp.261-266
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• 1999

Vancomycin-resistant enterococcus(VRE) was first isolated from various specimens of patients with renal failure or leukemia in 1988. Thereafter VRE has been increasing gradually and became one of the clinically important palhogenic organisms currently. We experienced a case of E. faecalis sepsis in a 4 day old neonate. She was born at 39 weeks gestational age with 2,900gm weight by Cesarean section delivery due to breech presentation. She had had swelling and motion limitation of the left knee joint with fever for one day at age of 4 day and was transfered to our hospital. Ultrasonographic examination of her left knee joint showed some inflammatory change. E. faecalis was isolated from the blood. The organism showed resistance to vancomycin on drug susceptibility test using BHI agar screening test and disk diffusion method. After treatment with ampicillin-sulbactam for 3 weeks the baby was improved. Although VRE infection has been considered rare in Korea. considerable number of demonstrative studies about VRE isolation have been reported recently thus adequate countermeasures are needed to reduce the emergence and prevent nosocomial spreading of this organism.

• 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 Fisheries and Aquatic Sciences
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• v.55 no.5
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• pp.505-513
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• 2022

In this study, 143 strains of Enterococcus spp. were isolated from inland pollution sources near shellfish farms on the west coast of South Korea. Not all isolated Enterococcus spp. strains possessed vancomycin resistance genes (VanA and VanB). However, since vancomycin-resistance Enterococcus (VRE) have been detected not only in the clinical field but also out in the world, it is possible that the VRE gene may be transferred to other bacterial strains commonly found in coastal waters where seafood is produced. It is important to monitor trends in the appearance of VRE. In addition, antimicrobial resistance patterns of isolates were examined in this study. Overall antimicrobial resistance rates were high: ciprofloxacin (32.2% of isolates resistant), chloramphenicol (30.8%), quinupristin/dalfopristin (19.6%), and tylosin (15.4%). Eight E. faecium strains (6.2%), out of the 129 strains assessed, showed multidrug resistance. All multidrug-resistant E. faecium showed resistance to erythromycin, quinupristin/dalfopristin, tetracycline, and tylosin, in all 14 strains. All multidrug-resistant E. faecalis showed resistance to erythromycin, quinupristin/dalfopristin, tetracycline, and tylosin. Both multidrug-resistant E. faecium and multidrug-resistant E. faecalis showed common resistance to erythromycin, quinupristin/dalfopristin, tetracycline, and tylosin.

• 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.

• Journal of the Korean Society of Food Science and Nutrition
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• v.41 no.5
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• pp.714-720
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• 2012

To evaluate the antibiotic risk of $Enterococcus$ in fermented soy paste, $Enterococcus$ spp. were isolated and identified from 31 $Cheongkukjang$ and 17 $Doenjang$, samples. Exactly 123 $Enterococcus$ spp., 119 from $Cheongkukjang$ and four from $Doenjang$, were ultimately isolated. The most frequently collected $Enterococcus$ isolates in $Cheongkukjang$ were 69 strains of $E.$ $faecium$ and 20 strains of $E.$ $faecalis$. All four $Enterococcus$ spp. from $Deonjang$ were identified as $E.$ $faecium$. All isolates were sensitive to ampicillin, chloramphenicol, penicillin, and tetracyclin $E.$ However, they showed broad spectra from sensitivity to resistance to erythromycin, ripampin, and streptomycin. Vancomycin minimum inhibition concentration (MIC) of $Enterococcus$ spp. from $Cheongkukjang$ ranged from 0.25 to 8 ${\mu}g/mL$. Almost all strains were sensitive to vancomycin, but eight strains showed intermediate resistance to vancomycin. Seventeen strains showing the highest MIC of 8 ${\mu}g/mL$ among all isolates were evenly distributed among $E.$ $faecalis$, $E.$ $faecium$, $E.$ $gallinarum$, and $E.$ $casselifalvus$, in which the strong resistant genes of $van$A and $van$B for vancomycin were not detected. Overall antibiotic resistance of $Enterococcus$ isolates was relatively low and particularly low vancomycin resistance was similar to those of $Enterococcus$ isolates obtained from other foods. Therefore, the antibiotics resistance of $Enterococcus$ and especially vancomycin-resistant $Enterococcus$ spp. from $Cheongkukjang$ and $Doenjang$, is not hazardous.

• 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.