• Biomedical Science Letters
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• v.19 no.3
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• pp.280-283
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• 2013

Leuconostoc spp. is intrinsically resistant against vancomycin and rarely causes the infection in immunocompromised patients. In this report, we describe a fatal case of Leuconostoc lactis bacteremia in a patient with biliary tract stent insertion to resolve the biliary tract obstruction by multiple pseudocysts in the pancreatic head region. Leuconostic lactis isolated from the blood of the patients was confirmed by 16S rRNA sequencing and this isolate was susceptible against most antibiotics, including levofloxacin, penicillin, erythromycin and cefotaxime except vancomycin. The septic shock and multi-organ failure was abruptly progressed due to delayed use of adequate antibiotic. Using vancomycin as the empirical antibiotics in a bacteremic patient by Gram positive cocci, the treatment failures by the isolates with intrinsic resistance against vancomycin have to be considered. In addition, the prompt and accurate identification of Leuconostoc spp. are very important to select the adequate antibiotics.

• 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.

• Journal of Microbiology
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• v.42 no.2
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• pp.143-146
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• 2004

Vancomycin-resistant Enterococcus faecium (VREFM) is becoming a threatening pathogen. We identified a gene called DD1.5K by differential display-PCR, which was preferentially expressed in the bloodstream isolates of VREFM. Due to its amino acid similarity to transfer complex protein, trsE, and tissue-specific expression, this gene may be involved in virulence of VREFM.

• Journal of Microbiology and Biotechnology
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• v.11 no.3
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• pp.469-474
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• 2001

The actinomycete strain AMLK-335 was antagonistic to vancomycin-resistant enterococci (VRE). Based on the diaminopimelic acid (DAP) type, and morphological and physiological characteristics revealed by scanning electron microscopy (SEM), AMLK-335 was confirmed to belong to the genus Streptomyces. Analysis of the 16S rDNA nucleotide sequences found AMLK-335 to have a relationship with Streptomyces platensis. The production of antibiotic from this strain was most favorable when cultured on glucose, polypeptone, yeast extract (PY) medium for 6 days at $27^{\circ}$. The antibiotic was identified as cyclo(L-phenylalanyl-L-prolyl) by comparing ti with the reported MS and NMR spectral data. Cyclo(phe-pro) from the PY cultures of AMLK-335 was most effective (K-98-258). Futhermore, cyclo(phe-pro) had antimicrobial activity against Bacillus subtilis, Microcuccs luteus, Staphylococcus aureus, and Saccharomyces cerevisiae, but it wa ineffective against Candida albicans, Streptomyces murinus, and Aspergillus niger.

• Journal of Microbiology and Biotechnology
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• v.19 no.7
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• pp.734-741
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• 2009

Recently, strains of methicillin-resistant Staphylococcus aureus (MRSA) with reduced susceptibility to vancomycin (VCM) have been clinically isolated. The antibacterial activity of a new drug, linezolid (LZD), in such a strain was evaluated by measuring bacterial metabolic activity. A total of 73 MRSA strains having various susceptibilities to VCM were subjected to a novel and highly sensitive chemiluminescence-based assay. LZD MIC in the tested strains, measured by the microbroth dilution method, was within the range 1-4 mg/l (mostly ${\leq}2$mg/l), except for one LZD-resistant strain (NRS127; MIC=7 mg/l), and showed no correlation with VCM resistance. The chemiluminescence assay demonstrated that bacterial metabolic activity was strongly suppressed with increasing LZD concentration. The chemiluminescence intensity curve had a low baseline activity without tailing in most strains. The present results suggest that LZD has strong antibacterial activity against MRSA strains, and would be effective for treatment of infections that are poorly responsive to VCM. The chemiluminescence assay facilitated sensitive and discriminative susceptibility testing within a relatively short time.

• Journal of Korean Academy of Nursing
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• v.43 no.2
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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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• v.33 no.4
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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.

• Natural Product Sciences
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• v.17 no.2
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• pp.160-164
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• 2011

The purpose of this investigation was to extract the bioactive agents from Alpinia officinarum Hance. The methanol with ethylacetate extracts alone and combined were examined for their activities against VRE (vancomycin-resistant enterococci) and pathogenic yeast in vitro. The incidence of infections caused by VRE and other pathogenic microorganisms and the importance of using novel synergistic drug combinations has become important. Previously, we reported the antimicrobial effects of the butanol extract from Lonicera japonica and have evaluated combinations of solvent extracts, with a focus on the MeOH and EtOAc extracts from A. officinarum. In the present study, enhanced inhibitory effects were achieved by employing a combination of the two solvent extracts. The MeOH and EtOAc combination was especially effective against four VRE strains: E. faecalis (K-10-22), E. faecaium (K-11-212), E. faecalis (K-10-57) and E. faecalis (K-10-361) with MIC values of 12.5, 12.5, 6.25 and 25 ${\mu}g/ml$, respectively. Thus, the combination was more effective than other antibiotics such as kanamycin, gentamicin or tetracycline against bacteria including E. coli, Staphylococcus aureus, and Micrococcus luteus. In addition, the combination was effective against yeasts such as Candida albicans, Candida tropicalis and Cryptococcus neoformans.

• Journal of Microbiology and Biotechnology
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• v.20 no.3
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• pp.637-642
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• 2010

We investigated the prevalence and the molecular characteristics of vancomycin-intermediate Staphylococcus aureus (VISA) among methicillin-resistant Staphylococcus aureus (MRSA) strains isolated from clinical samples at tertiary or general hospitals participating in a nationwide surveillance program for VISA and vancomycin-resistant Staphylococcus aureus (VRSA) in Korea during an 8-week period in each year from 2001 to 2006. Of 41,639 MRSAs isolated, 37,856 were screened and 169 grew on brain heart infusion agar supplemented with 4 ${\mu}g/ml$ vancomycin. A vancomycin MIC of 4 ${\mu}g/ml$ was confirmed for 33 VISA isolates of the 169 isolates. Eighteen of the 33 isolates were classified as hetero-VISA (hVISA) by the population analysis profile (PAP) method. All VISA isolates were susceptible to linezolid, tigecycline, and quinupristin-dalfopristin. Most VISA isolates (MIC 4 ${\mu}g/ml$) showed a PFGE C pattern with sec, seg, and sei enterotoxin genes, including ST5-SCCmec type II, or a PFGE A pattern with sea, including ST239-SCCmec type III.

• 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.