• Korean Journal of Clinical Pharmacy
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• v.9 no.1
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• pp.1-14
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• 1999

Vancomycin-resistant Enterococci (VRE) have recently emerged in Korean hospitals, as well as in those of other countries. VRE have been partially attributed to the overuse and misuse of vancomycin. The mecbanisms of VRE resistance are related to VanA, VanB, and VanC. Both VanA and VanB produce abnormal ligase enzymes to form D-ala-D-lactate termini in E. faecium and E. faecalis, instead of D-ala-D-ala termini. Meanwhile, Van C produces D-ser-D-ala termini in E. gallinarum and E. casseliflavus. These abnormal termini have a low affinity to vancomycin. As a result, VRE avoid the activity of vancomycin by these mechanisms. Unfortunately, there is no approved therapy for the treatment of VRE. Thus, available but uncommonly prescribed antibiotics (due to their toxicity or unproven efficacy) may become possible options. They include chloramphenicol, novobiocin, fosfomycin, and bacitracin. The combination therapy of available agents may also be the other options. They include high doses of a penicillin- or ampicillin-aminoglycoside combination, high doses of an ampicillin/sulbactam and aminoglyoosidcs combination, an ampicillin and vancomycin combination, and a ciprofloxacin, aminoglycosides, and rifampin combination. With respect to the near future, many types of investigational agents will most likely expand their treatment options for VRE. Teicoplanin, a glycopeptide, can be used for VanB- and VanC-related VRE. LY333328, a new generation of glycopeptide, is effective in treating VanA as well as VanB and VanC. RP59500 (quinupristin/dalfopristin), a streptogramin, is effective in treating vancomycin-resistant E. faecium. New generation quinolones (especially clinatloxacin) are potential options for the treatment of VRE, even though they cannot work as effectively against VRE as they can against Staphylococci. Both glycylcyclines (a new generation of tetracyclines) and ketolides (a new generation of macrolides) show good activity against Enterococci, regardless of vancomycin susceptibility. Oxazolidinones (i. e. eperezolid and 1inezolid) and everninomicins (i. e. SCH27899) are new groups of antibiotics, which also demonstrate good activity against VRE. It is imperative that clinical pharmacists take the responsibility of investigating new treatment options for VRE in order to combat this growing problem throughout the world.

• Korean Journal of Environmental Biology
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• v.26 no.3
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• pp.240-246
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• 2008

From the 4 sampling stations located in the basin of the Han River, total 46 strains of Enterococcus spp. composed of 15 E. faecium strains, 26 E. casseliflavus strains, 1 E. faecalis strain and 4 E. hirae strains were isolated. Among the 46 strains, 45 strains exhibited streptomycin-resistance, while 21 and 19 stains were resistant against tetracycline and quinupristin/dalfopristin, respectively. As for gentamicin and vancomycin, 15 strains and 1 strain showed resistance against the respective antimicrobial agents. Among the 46 strains, 39 strains showed resistance against more than 2 antimicrobial agents, and 10 strains demonstrated resistance to more than 5 antimicrobial agents. Especially, the strain isolated from the station C at Anyangcheon, exhibited resistance against all the 8 kinds of the antimicrobial agents. As the sampling site approached to the lower stream of the Han-river, the antibiotic resistant strains and the multi-drug resistant strains were detected more frequently. The MIC values of the antibiotic resistant strains measured by the disc diffusion method disclosed that 16 strains possessed maximum MIC value of 4,096 ${\mu}g$ mL$^{-1}$ against streptomycin and 17 strains possessed maximum MIC value of 2,048 ${\mu}g$ mL$^{-1}$ against gentamicin. Meanwhile, 1 strain exhibited maximum MIC value of 5121 ${\mu}g$ mL$^{-1}$ against vancomycin. As for quinupristin/dalfopristin and tetracycline, 2 and 33 strains showed maximum MIC value of 641 ${\mu}g$ mL$^{-1}$, respectively. Comparison of the MIC values of the strains of the this study with those of the strains of the other research groups isolated from the hospital drainage and also those from the live stock farm drainage indicated that the strains resistant against vancomycin and quinupristin/dalfopristin may be originated from the livestock farm drainage.

• Proceedings of the Microbiological Society of Korea Conference
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• 2005.05a
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• pp.211.4-211
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• 2005

• Pediatric Infection and Vaccine
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• v.10 no.2
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• pp.167-177
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• 2003

Purpose : To know the trends of antimicrobial susceptibility is critical for antimicrobial treatment. We studied the organisms isolated from blood, urine, stool, and cerebrospinal fluid from 1997 to 2001 to reveal the trends of their antimicrobial susceptibility. Methods : We conducted a retrospective study with isolates obtained from 0~18 year old outpatients and inpatients from 1997 to 2001 at Department of Pediatrics, Hanil general hospital. We gathered the data through the laboratory test files and the origin of microorganisms cultured from blood, urine, stool and cerebrospinal fluid and their antimicrobial susceptibility. Results : Microorganisms were isolated from 226(3.3%) out of 6,974 blood cultures, 365 (8.0%) out of 4,549 urine cultures, 50(1.9%) out of 2,593 stool cultures and 9(1.4%) in 655 cerebrospinal fluid cultures. The most frequently isolated organisms from blood cultures was Staphylococcus epidermidis(33.5%) which was followed by Staphylococcus aureus(19.7%), Escherichia coli(13.8%), and Burkholderia cepacia(9.0%). Among the urine cultures, E. coli was the most common(74.7%) which was followed by Group D Enterococcus(11.3%), Klebsiella pneumoniae(7.1%) and Proteus mirabilis(2.5%). The positive stool cultures all yield Salmonella species. Group D Salmonella was obtained most frequently. Among the positive cerebrospinal fluid cultures, Group B Streptococcus was isolated most frequently. Among the 40 cases of S. aureus in blood cultures, 27 cases were methicillin-resistant. The rates of susceptibility for amikacin, ceftizoxime and ceftriaxone of E. coli isolated from blood cultures were 80%, 100% and 60% in 1997 and 60%, 80% and 60% in 2001. The rates of susceptibility for amikacin, ceftizoxime and ceftriaxone of K. pnumoniae isolated from urine cultures. were 80%, 100% and 80% in 1997 and 50%, 83% and 50% in 2001 Enterococcus was isolated from 6.7% to 15.8% and vancomycin-resistant Enterococcus was observed in 17% of Group D Enterococcus isolated from urine cultures. The rates of susceptibility for amikacin, ceftizoxime and ceftriaxone of Group D Salmonella were 96%, 96% and 92% during the study period. Conclusion : Among the blood cultures S. epidermidis, S. aureus, E. coli and B. cepacia were isolated in order of frequency and among the urine cultures E. coli, Group D Enterococcus, K. pneumoniae and P. mirabilis were isolated in order of frequency. During the study period there was no big difference in major organisms isolated from blood and urine. The methicillin-resistant S. aureus was observed in 67% of S. aureus isolated from blood cultures but vancomycin-reistant S. aureus or vancomycin intermediate resistant S. aureus was not observed. The rates of susceptibility to amikacin and the third generation cephalosporin of E. coli isolated from blood cultures and K. pneumoniae from urine cultures have decreased. The isolation rates of Group D Enterococcus and vancomycin resistant Enterococcus have increased.

• Korean Journal of Microbiology
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• v.48 no.2
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• pp.116-124
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• 2012

Identification was performed in March 2008 for the 76 Enterococcus strains isolated from the Han-river, which is used as water supply for Seoul citizens. The antibiotic susceptibility, antibiotic resistant structural analysis, trans-conjugation, pulsed-field gel electrophoresis (PFGE) and multi-locus sequence typing (MLST) were also carried out for the isolated strains. Among the isolated strains, 25 strains were E. casseliflavus, 4 strains were E. faecalis and 1 strain was E. hirae. Investigation of antibiotic susceptibility indicated that 15 strains demonstrated tolerance against vancomycin, and that 11 strains of E. faecium and 4 strains of E. casseliflavus were VRE. The vanA gene detection of the VRE strains revealed that 6 E. faecium strains were vancomycin-resistant Enterococcus faecium (VREF) possessing vanA. Analyses of transposon Tn1546 structure containing vanA demonstrated that Km36 and Km37 belonged to Tn1 type, Km20 and Km38 was Tn2 type, and Km39 and Km40 was Tn3 type. PFGE disclosed that among the 6 VREF strains, Km36 and Km37 exhibited equivalent subtype, while the rest 4 strains showed subtypes different to each other. MLST for the 6 VREF strains disclosed that 3 strains were ST78, while the rest 3 strains were ST18, ST192 and ST230, respectively. All these clonal complexes were derived from CC17 which has been isolated from clinical sources. 4 strains belonged to CC78, while the rest 2 strains were CC18 and CC192, respectively.

• Proceedings of the Zoological Society Korea Conference
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• 1999.10b
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• pp.60.1-60
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• 1999

No Abstract, See Full Text

• Journal of Food Hygiene and Safety
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• v.25 no.2
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• pp.122-128
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• 2010

From April to December in 2009, microbial investigation is accomplished for 100 frozen foods asked to microbial control team that corresponds with total aerobic viable bacteria, coliform group, Escherichia coli, Enterococcus spp. and antibiotic resistance patterns of Enterococcus spp. isolates are investigated. Average of total erobic viable bacteria numbers is $4.3{\times}10^4CFU/g$. Average of coliform group numbers is $4.3{\times}10^3CFU/g$. Average f Enterococcus spp. numbers is $1.8{\times}10^3CFU/g$. Escherichia coli from 100 frozen foods is not detected and detection ate is 0.0%. 22 Enterococcus spp. are isolated from 100 frozen foods. 12 of 22 Enterococcus spp. strains are identified as E. faecium. 7 of 22 Enterococcus spp. strains are identified as E. faecalis. 2 of 22 Enterococcus spp. trains are identified as E. gallinarum. 1 of 22 Enterococcus spp. strains is identified as E. hirae. Enterococcus spp. solates show a high resistance to erythromycin, rifampin, tetracycline, ciprofloxacin, chlorampenicol, penicillin and susceptibility to vancomycin, ampicillin, gentamicin, strepomycin, linezolid. 15 of 22 Enterococcus spp. strains are multi-resistant and the most frequent multi-resistant pattern is erythromycin-rifampin for 6 Enterococcus spp. strains.

• Food Science of Animal Resources
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• v.38 no.2
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• pp.391-402
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• 2018

The aim of the present work was to provide information about Enterococcus strains isolated from pre-packaged chicken samples in Ankara (Turkey), focusing on their prevalence, phenotypic and genotypic characteristics, and antibiotic resistance. We report the first study on the occurrence of antibiotic resistant enterococci in pre-packaged chicken samples in Ankara. A total of 97 suspicious enterococcal isolates were identified from 122 chicken samples. All isolates were identified to species level by phenotypic and molecular methods. In the 16S rDNA sequence analysis, Enterococcus faecium (61.85%) and Enterococcus faecalis (38.15%) were found to be the most frequently detected Enterococcus spp. Of the 97 isolates tested for hemolytic activity, 12.37% enterococcal strains were ${\beta}$-hemolytic. ${\beta}$-Hemolysin was most prevalent among E. faecium (58.33%) compared to E. faecalis (41.66%). Disk diffusion method was used for determining of antibiotic resistance. The analysis of the antimicrobial resistance of the 97 Enterococcus isolates revealed that the resistance to kanamycin (98.96%), rifampicin (80.41%) and ampicillin (60.82%) was most frequent. Furthermore, resistance to erythromycin (38.14%) and ciprofloxacin (34.02%) was also observed. The frequencies of resistance to tetracycline (9.27%), penicillin G (8.24%), and chloramphenicol (3.09%), gentamicin (2.06%) and streptomycin (1.03%) were low. None of the isolates was resistant to vancomycin. Multi-drug resistance was found in 97.93% of Enterococcus strains. E. faecium strains showed a more resistant phenotype than E. faecalis strains according to the antibiotic resistance levels. The results of this study indicated that chicken meat is a potential reservoir for the transmission of antibiotic resistance from animals to humans.

• The Korean Journal of Food And Nutrition
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• v.25 no.1
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• pp.188-195
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• 2012

To produce rapidly the traditional Kanjang soy sauce-like product with rich flavors, lactic acid bacteria of Enterococcus spp. isolated from Chungkukjang was used as one of starter cultures. Among 119 Enterococcus spp., eight strains were selected by protease-secreting activities and identified as four E. faecium, three E. faecalis, and one E. gallinarium. The strains showed low resistances toward eight antibiotics and had no resistant genes to the vancomycin. Especially, E. faecium O24 was cultivated well on 5% NaCl medium that was selected for further study as the starter. E. faecium O24 grew well on the steamed soybean and the counts increased by ten times overnight, which produced mostly 80 mg% glutamic acid and aspartic acid as the seasoning amino acids on the product. Various organic acids including principal lactic acid were also produced. Flavors of maltol and guaiacol, typical soy-sauce flavor, were produced in the mixed cultures of Zygosaccharomyces rouxii and Candida versatilis. Therefore, E. faecium O24 could be a starter of soybean fermentation for soy sauce-like product with rich flavors rapidly.

• Journal of Microbiology
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• v.45 no.5
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• pp.466-472
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• 2007

A total of 98 vancomycin-resistant Enterococcus faecium (VREF) isolates (58 isolates from patients and 40 isolates from poultry) were compared based on their antimicrobial susceptibility, Tn1546 element organization, and pulsed-field gel electrophoresis (PFGE) patterns. This comparison aided in determining the relationships between the groups of isolates. All the VREF isolates harbored the vanA gene; however, 29 (29.6%) of the isolates exhibited the VanB phenotype-vanA genotype. Furthermore, the VREF isolates from humans and poultry exhibited distinct antimicrobial resistance patterns. The PCR mapping of the Tn1546 elements exhibited 12 different transposon types (A to L). The VREF isolates of poultry were classified into types A to D, whereas the human isolates were classified into types E to L. A PFGE analysis demonstrated a high degree of clonal heterogeneity in both groups of isolates; however, the distinct VREF clones appeared in each group of isolates. The deletion of the vanX-vanY genes or insertion of IS1216V in the intergenic region from the vanX-vanY genes is directly associated with the incongruence of the VanB phenotype-vanA genotype in human VREF isolates. These data suggest that the VREF isolates exhibit distinct phenotypic and genotypic traits according to their origins, which suggests that no evidence exists to substantiate the clonal spread or transfer of vancomycin resistance determinants between humans and poultry.