Vancomycin-Resistant Enterococci(VRE)빈도,검사법 및 감염관리 대책에 관한 전국 병원 설문조사

Abstract

Background:Vancomcyin-resistantenterococci (VRE) have been an important nosocomial pathogen in the 1990s. Recently, VRE have become an emerging nosocomial pathogen in Korea, but there have been no nationwide study about the status of VRE in Korea. This nationwide questionnaire survey was aimed to determine the prevalence of VRE, the appropriateness of detection method for VRE, and to evaluate the infection control program in hospitals of various size in Korea. Methods:During 4 weeks (September 1 to October 1, 1999), a questionnaire surveillance study was conducted. We had sent the questionnaire to 200 large hospitals in Korea, which were distributed nationwide. Questionnaire included the prevalence of VRE within the hospital, the detection method for VRE, method of enterococci isolation, antibiotics-susceptibility test and infection control method of VRE. Results:The response rate to questionnaire was 42%. The species identification of enterococci was capable in 62.3% but the accurate enterococcal speciation were capable in 18%. Appropriate antibiotic-sus-ceptibility test were produced only in 6.5%. Total 746 VRE were detected in 42 hospitals during 1-year despite of low sensitivity of detection methods. VRE was noted in 54.4% of hospitals at least. The isolation programme of VRE infected patients was presented in 20.3%, regular surveillance of VRE in high-risk population was produced only in 16.5%. Conclusion:The prevalence of enterococci among microorganisms isolated from clinical specimens were increased up to 27.7% in Korea. VRE has been emerged in many big cities as well as in Seoul. The microbiological methods that include the speciation of enterococcal isolates, antimicrobial susceptibility test, and VRE detection appeared to be inappropriate in many hospitals. And, proper control and prevention methods were presented in a few hospitals. Education and training about accurate detection of VRE as well as proper infection control programs for VRE are urgently needed.