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      반코마이신 내성 장알균 집락이 확인된 환자를 격리해야 하는가? = It Is Time to Address the Isolation Policy for Patients Colonized with Vancomycin-resistant Enterococci

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      https://www.riss.kr/link?id=A107696941

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      다국어 초록 (Multilingual Abstract) kakao i 다국어 번역

      Vancomycin-resistant enterococci (VRE) are one of the most important pathogens causing healthcare-associated infections. If VRE is detected in the culture tests of a patient’s clinical specimen, the patient should be isolated in a single room (preferred to a cohort room), and contact precautions should be initiated based on the infection control guidelines for multidrugresistant organisms by the Korea Disease Control and Prevention Agency. VRE is known to transmit vancomycin resistance genes to other bacteria; hence, isolation of VRE-colonized patients is recommended. However, many studies have shown that the probability of the spread of vancomycin resistance genes from VRE to other bacteria is rare and that the discontinuation of isolation and contact precaution does not significantly increase the rate of VRE colonization or infection. Notably, the healthcare qualities for diagnosis and treatment were more improved in the group without isolation than in the group with isolation. Further investigations on the effects of discontinuing the isolation of VRE-colonized patients are warranted, because the characteristics of the Korean healthcare system are distinct from those of other countries. The study designs of quasi-experimental studies, which do not require randomization for analysis, would be useful in conducting studies on the effects of discontinuing the isolation of VRE-colonized patients. Considering the results of the previous and future studies and the unique features of the Korean healthcare system, the isolation protocols could be relaxed gradually and applied only to specific cases, such as residents of nursing hospitals and immunosuppressed patients.
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      Vancomycin-resistant enterococci (VRE) are one of the most important pathogens causing healthcare-associated infections. If VRE is detected in the culture tests of a patient’s clinical specimen, the patient should be isolated in a single room (prefe...

      Vancomycin-resistant enterococci (VRE) are one of the most important pathogens causing healthcare-associated infections. If VRE is detected in the culture tests of a patient’s clinical specimen, the patient should be isolated in a single room (preferred to a cohort room), and contact precautions should be initiated based on the infection control guidelines for multidrugresistant organisms by the Korea Disease Control and Prevention Agency. VRE is known to transmit vancomycin resistance genes to other bacteria; hence, isolation of VRE-colonized patients is recommended. However, many studies have shown that the probability of the spread of vancomycin resistance genes from VRE to other bacteria is rare and that the discontinuation of isolation and contact precaution does not significantly increase the rate of VRE colonization or infection. Notably, the healthcare qualities for diagnosis and treatment were more improved in the group without isolation than in the group with isolation. Further investigations on the effects of discontinuing the isolation of VRE-colonized patients are warranted, because the characteristics of the Korean healthcare system are distinct from those of other countries. The study designs of quasi-experimental studies, which do not require randomization for analysis, would be useful in conducting studies on the effects of discontinuing the isolation of VRE-colonized patients. Considering the results of the previous and future studies and the unique features of the Korean healthcare system, the isolation protocols could be relaxed gradually and applied only to specific cases, such as residents of nursing hospitals and immunosuppressed patients.

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      참고문헌 (Reference)

      1 강지연, "일 대학병원 간호사의 다약제 내성균 감염관리지침에 대한 지식과 수행정도" 한국간호과학회 39 (39): 186-197, 2009

      2 김유정, "요양병원 감염관리 현황 및 감염관리 담당자의 중요도 인식 조사" 한국산학기술학회 18 (18): 466-475, 2017

      3 Gysin DV, "Variability in contact precautions to control the nosocomial spread of multi-drug resistant organisms in the endemic setting: a multinational cross-sectional survey" 7 : 81-, 2018

      4 Vehreschild MJGT, "Vancomycin-resistant enterococci (VRE):a reason to isolate?" 47 : 7-11, 2019

      5 O’Driscoll T, "Vancomycin-resistant enterococcal infections: epidemiology, clinical manifestations, and optimal management" 8 : 217-230, 2015

      6 Walters MS, "Vancomycin-resistant Staphylococcus aureus - Delaware" 64 : 1056-, 2015

      7 de Niederhäusern S, "Vancomycin-resistance transferability from VanA enterococci to Staphylococcus aureus" 62 : 1363-1367, 2011

      8 Hemming K, "Use of multiple period, cluster randomised, crossover trial designs for comparative effectiveness research" 371 : m3800-, 2020

      9 Rossi F, "Transferable vancomycin resistance in a community-associated MRSA lineage" 370 : 1524-1531, 2014

      10 McDonald EG, "Timeseries analysis of health care-associated infections in a new hospital with all private rooms" 179 : 1501-1506, 2019

      1 강지연, "일 대학병원 간호사의 다약제 내성균 감염관리지침에 대한 지식과 수행정도" 한국간호과학회 39 (39): 186-197, 2009

      2 김유정, "요양병원 감염관리 현황 및 감염관리 담당자의 중요도 인식 조사" 한국산학기술학회 18 (18): 466-475, 2017

      3 Gysin DV, "Variability in contact precautions to control the nosocomial spread of multi-drug resistant organisms in the endemic setting: a multinational cross-sectional survey" 7 : 81-, 2018

      4 Vehreschild MJGT, "Vancomycin-resistant enterococci (VRE):a reason to isolate?" 47 : 7-11, 2019

      5 O’Driscoll T, "Vancomycin-resistant enterococcal infections: epidemiology, clinical manifestations, and optimal management" 8 : 217-230, 2015

      6 Walters MS, "Vancomycin-resistant Staphylococcus aureus - Delaware" 64 : 1056-, 2015

      7 de Niederhäusern S, "Vancomycin-resistance transferability from VanA enterococci to Staphylococcus aureus" 62 : 1363-1367, 2011

      8 Hemming K, "Use of multiple period, cluster randomised, crossover trial designs for comparative effectiveness research" 371 : m3800-, 2020

      9 Rossi F, "Transferable vancomycin resistance in a community-associated MRSA lineage" 370 : 1524-1531, 2014

      10 McDonald EG, "Timeseries analysis of health care-associated infections in a new hospital with all private rooms" 179 : 1501-1506, 2019

      11 Jeong SY, "The status of healthcareassociated infection control among healthcare facilities in Korea" 12 : 353-366, 2014

      12 Jung J, "The pitfall of cohort isolation in an outbreak of linezolid-resistant, vancomycin-resistant enterococci" 25 : 1568-1569, 2019

      13 Cho SY, "The impact of vancomycin-resistant Enterococcus (VRE) screening policy change on the incidence of healthcare-associated VRE bacteremia" 2021

      14 Schrank GM, "The discontinuation of contact precautions for methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus: impact upon patient adverse events and hospital operations" 29 : 1-2, 2020

      15 Furtado GH, "Risk factors for vancomycin-resistant Enterococcus faecalis bacteremia in hospitalized patients: an analysis of two case-control studies" 34 : 447-451, 2006

      16 Lee S, "Results of healthcare-associated infection surveillance in South Korea, 2013-2017" 12 : 485-490, 2019

      17 Faron ML, "Resistance mechanisms, epidemiology, and approaches to screening for vancomycin-resistant Enterococcus in the health care setting" 54 : 2436-2447, 2016

      18 "Recommendations for preventing the spread of vancomycin resistance: recommendations of the Hospital Infection Control Practices Advisory Committee (HICPAC)" 23 : 87-94, 1995

      19 Cui L, "Novel mechanism of antibiotic resistance originating in vancomycin-intermediate Staphylococcus aureus" 50 : 428-438, 2006

      20 Martin EM, "Noninfectious hospital adverse events decline after elimination of contact precautions for MRSA and VRE" 39 : 788-796, 2018

      21 Bennett JE, "Mandell, Douglas, and Bennett’s principles and practice of infectious diseases" Elsevier 2495-2496, 2020

      22 Lemieux C, "Longitudinal multicenter analysis of outcomes after cessation of control measures for vancomycin-resistant enterococci" 38 : 24-30, 2017

      23 Leavis HL, "Insertion sequence-driven diversification creates a globally dispersed emerging multiresistant subspecies of E. faecium" 3 : e7-, 2007

      24 Korea Disease Control and Prevention Agency, "Infection control of healthcare-associated infections"

      25 Korea Centers for Disease Control and Prevention, "Infection control guidelines for multidrug resistant microorganisms in healthcare facilities"

      26 Korea Centers for Disease Control and Prevention, "Infection control guidelines for healthcare-associated infections in 2020"

      27 De Angelis G, "Infection control and prevention measures to reduce the spread of vancomycinresistant enterococci in hospitalized patients: a systematic review and meta-analysis" 69 : 1185-1192, 2014

      28 신수진, "Improvement Plan of Nurse Staffing Standards in Korea" 한국간호과학회 14 (14): 57-65, 2020

      29 Bearman G, "Impact of discontinuing contact precautions for methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococcus: an interrupted time series analysis" 39 : 676-682, 2018

      30 Werner G, "Host range of enterococcal vanA plasmids among Gram-positive intestinal bacteria" 66 : 273-282, 2011

      31 Shariati A, "Global prevalence and distribution of vancomycin resistant, vancomycin intermediate and heterogeneously vancomycin intermediate Staphylococcus aureus clinical isolates: a systematic review and meta-analysis" 10 : 12689-, 2020

      32 Melo-Cristino J, "First case of infection with vancomycin-resistant Staphylococcus aureus in Europe" 382 : 205-, 2013

      33 김현순, "Factors Associated with Vancomycin-Resistant Enterococcus Colonization in Patients Transferred to Emergency Departments in Korea" 대한의학회 33 (33): 1-7, 2018

      34 Wagenvoort JH, "Environmental survival of vancomycin-resistant Enterococcus faecium" 77 : 282-283, 2011

      35 Schwalbe RS, "Emergence of vancomycin resistance in coagulase-negative staphylococci" 316 : 927-931, 1987

      36 Yoonchang SW, "Efficacy of infection control strategies to reduce transmission of vancomycin-resistant enterococci in a tertiary care hospital in Korea: a 4-year follow-up study" 28 : 493-495, 2007

      37 Rupp ME, "Effect of cessation of contact isolation for endemic methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci" 38 : 1005-1007, 2017

      38 Banach DB, "Duration of contact precautions for acute-care settings" 39 : 127-144, 2018

      39 Zhu W, "Dissemination of an Enterococcus Inc18-Like vanA plasmid associated with vancomycin-resistant Staphylococcus aureus" 54 : 4314-4320, 2010

      40 Johnstone J, "Discontinuing contact precautions for vancomycin-resistant Enterococcus (VRE) is associated with rising VRE bloodstream infection rates in Ontario hospitals, 2009-2018: a quasi-experimental study" 71 : 1756-1759, 2020

      41 Marra AR, "Discontinuing contact precautions for multidrug-resistant organisms: a systematic literature review and meta-analysis" 46 : 333-340, 2018

      42 Yoon YK, "Determining the clinical significance of co-colonization of vancomycin-resistant enterococci and methicillinresistant Staphylococcus aureus in the intestinal tracts of patients in intensive care units: a case-control study" 18 : 28-, 2019

      43 Vergis EN, "Determinants of vancomycin resistance and mortality rates in enterococcal bacteremia: a prospective multicenter study" 135 : 484-492, 2001

      44 Kluytmans-van den Bergh MFQ, "Contact precautions in single-bed or multiple-bed rooms for patients with extended-spectrum β-lactamase-producing Enterobacteriaceae in Dutch hospitals: a cluster-randomised, crossover, non-inferiority study" 19 : 1069-1079, 2019

      45 Noble WC, "Co-transfer of vancomycin and other resistance genes from Enterococcus faecalis NCTC 12201 to Staphylococcus aureus" 93 : 195-198, 1992

      46 Centers for Disease Control and Prevention, "CDC reminds clinical laboratories and healthcare infection preventionists of their role in the search and containment of vancomycin-resistant Staphylococcus aureus (VRSA)"

      47 Walsh CT, "Bacterial resistance to vancomycin: five genes and one missing hydrogen bond tell the story" 3 : 21-28, 1996

      48 Kotkowski K, "Association of hospital contact precaution policies with emergency department admission time" 96 : 244-249, 2017

      49 Morgan DJ, "Adverse outcomes associated with Contact Precautions: a review of the literature" 37 : 85-93, 2009

      50 Hwang JH, "Active surveillance for carbapenem-resistant Enterobacteriaceae, vancomycin-resistant enterococci and toxigenic Clostridium difficile among patients transferred from long-term care facilities in Korea" 99 : 487-491, 2018

      51 Kim B, "A study of nurses’ perception of the comprehensive nursing service" 7 : 99-104, 2017

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      연월일 이력구분 이력상세 등재구분
      2023 평가예정 재인증평가 신청대상 (재인증)
      2020-01-01 평가 등재학술지 선정 (재인증) KCI등재
      2018-01-01 평가 등재후보학술지 선정 (신규평가) KCI등재후보
      2017-12-01 평가 등재후보 탈락 (계속평가)
      2016-12-31 학술지명변경 한글명 : 병원감염관리 -> 의료관련감염관리
      외국어명 : Korean Journal of Nosocomial Infection Control -> Korean Journal of Healthcare-Associated Infection Control and Prevention
      KCI등재후보
      2016-01-01 평가 등재후보학술지 유지 (계속평가) KCI등재후보
      2015-07-09 학회명변경 한글명 : 대한병원감염관리학회 -> 대한의료관련감염관리학회
      영문명 : Korean Society For Nosocomial Infection Control -> Korean Society for Healthcare-associated Infection Control
      KCI등재후보
      2014-01-01 평가 등재후보학술지 선정 (신규평가) KCI등재후보
      2013-01-01 평가 등재후보 탈락 (등재후보2차)
      2012-01-01 평가 등재후보 1차 FAIL (기타) KCI등재후보
      2010-01-01 평가 등재후보학술지 선정 (신규평가) KCI등재후보
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      기준연도 WOS-KCI 통합IF(2년) KCIF(2년) KCIF(3년)
      2016 0.83 0.83 0.57
      KCIF(4년) KCIF(5년) 중심성지수(3년) 즉시성지수
      0.57 0.58 1.335 0.11
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