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 Home > Available Issues |
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 Original Articles |
| Intestinal Colonization of Vancomycin-Resistant Enterococci in a Korean Hospital |
| Kyong Ran Peck, Sungmin Kim, Nam Yong Lee*, Jae-Hoon Song |
| Division of Infectious Diseases, Department of Medicine, Department of Clinical Pathology*, Samsung Medical Center, Seoul, Korea |
Vol.28 Num.3 (p245~251)
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Background : Vancomycin-resistant enterococci(VRE) have become more important nosocomial pathogens in the United States. In Korea, however, only several cases of VRE have been reported since 1992. To investigate the intestinal colonization with VRE, which can predict the appearance of clinical infections with VRE, we carried out the point-prevalence survey on fecal carriage of VRE among hospitalized patients in Samsung Medical Center.
Methods : Stool cultures were performed in 80 patients with bile esculin azide agar plates. Vancomycin-resistance of isolated enterococci was screened by agar screening method using Brain-heart infusion(BHI) agar plates containing vancomycin of 6μg/mL. Minimal inhibitory concentrations(MICs) (μg/mL) of vancomycin and teicoplanin were determined by agar dilution method. As for VRE isolated, amplification of vanA, vanB, and vanC genes by polymerase chain reaction(PCR) was performed.
Results : Six strains out of seventy-four strains(8.1%) of enterococci isolated from 73 patients were not vancomycin-susceptible by agar dilution. Three of 6 VRE strains were resistant to vanocmycin and teicoplanin with MICs of ≥ 512μg/mL and ≥ 128μg/mL respectively, and were classified into vanA genotype by PCR. MICs of the other three strains were 8μg/mL for vancomycin and 4μg/mL for teicoplanin, which belonged to vanC genotype. All 6 VRE strains were detectable by agar screening method.
Conclusion : The study demonstrated the unexpectedly high rate of intestinal colonization of VRE among hospitalized patients in a Korean hospitalk, where VRE infection has been considered very rare. The data suggest that regular surveillance of VRE, proper isolation of patients with VRE, and restriction of vancomycin usage are warranted to prevent the emergence and spread of nosocomial VRE infections in general hospitals in Korea.
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Keywords : Vancomycin-resistant enterococci, Colonization, vanA, vanB, vanC genotype |
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