Vancomycin-resistant enterococcal infections in Korea

Enterococci recently became the second-to-third most commonly isolated orga nism from nosocomial infections. Enterococci are intrinsically more resista nt to many antimicrobial agents and often show acquired resistance to many antimicrobial agents including high-level aminoglycosides. With the increas ed use of vancomycin, vancomycin-resistant enterococci (VRE) has become an important nosocomial pathogen. In Korea. the proportion of VRE among all en terococcal isolates in most tertiary care hospitals has remained around 1% or teas, bur the rare of carriage of VRE is no longer low in some settings and recent observations of a sudden increase of VRE isolation in several ho spitals in Korea suggests that VRE infection may become a serious problem i n the near future. The most important considerations are that vancomycin-re sistant genes may spread to other highly virulent genera, such as MRSA, and that there are no approved and convincing effective antibiotics for the tr eatment of VRE. Therefore, current efforts have concentrated on limiting th e spread of these organisms within the hospital environment. Prudent else o f antimicrobial agents and strict adherence to preventive measures such as aggressive communication, education and infection control practices are ess ential to control the spread of this organism. However, hospital infection control protocols and the laboratory support they require are costly in ter ms of space and supplies, as self as in personnel resources. These factors add further pressure to already stretched hospital budgets Nevertheless, po licies or programs defining and managing VRE infection or colonization shou ld be established and now is the time to enforce an overall management stra tegy against VRE.