• Tuberculosis and Respiratory Diseases
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• v.67 no.5
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• pp.430-435
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• 2009

Background: Thus far, research studies on community-acquired pneumonia (CAP) have focused on its clinical severity. Recently, it has been determined that procalcitonin (PCT) level is correlated with severity of CAP. A retrospective study conducted at our hospital used risk predictability and PCT to determine whether or no PCT is useful in assessing the severity of CAP. Methods: This study covered 92 CAP cases that were admitted to the respiratory department at Changwon Fatima Hospital between July 1, 2008 and June 30, 2009. All enrolled subjects were measured for infection markers and risk predictability. Results: Based on hospital admission data, enrolled subjects had Pneumonia Severity Index (PSI) scores serving as risk predictors showed that both PCT and white blood cell (WBC) were statistically significant as infection markers (p=0.001, 0.037). Thus, this study used ROC curves in PSI for data analysis. As a result, it was determined that the area under curve (AUC) of PCT and WBC was 0.694 and 0.593 respectively, indicating that PCT has a higher test value for WBC, when PCT was higher than 0.745 ng/mL. In addition, it was found that PCT levels higher than 0.745 ng/mL had higher PSI scores than the group with PCT lower than 0.745 ng/mL (p=0.032). Conclusion: In order to predict risk of pneumonia cases admitted due to symptoms of CAP, it is important to consider PCT as well as PSI, and follow-up monitoring of PCT cases.

• Childhood Kidney Diseases
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• v.23 no.2
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• pp.121-123
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• 2019

Urinary tract infection is common in the pediatric population. The most common causative agents are bacteria, among which Escherichia coli is the most frequent uropathogen. Although fungal urinary tract infection is rare in the healthy pediatric population, it is relatively common among hospitalized patients. Fungus may be isolated from the urine of immunocompromised patients or that of patients with indwelling catheters. The most common cause of funguria is Candida albicans. Although more than 50% of Candida isolates belong to non-albicans Candida, the prevalence of non-albicans candiduria is increasing. Herein, we report a case of community-acquired candiduria in a 4-month-old immunocompetent male infant who had bilateral vesicoureteral reflux and was administered antibiotic prophylaxis. He was diagnosed with urinary tract infection caused by Candida lusitaniae and was managed with fluconazole.

• Childhood Kidney Diseases
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• v.8 no.2
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• pp.214-222
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• 2004

Purpose: Appropriate antibiotic therapy is important in childhood urinary tract infection and the selection of anibiotics is based on antimicrobial sensitivity of Escherichia coli. Extended-Spectrum ${\beta}-Lactamase(ESBL)$ is an enzyme produced by gram-negative bacilli that has the ability to hydrolyse penicillins, broad-spectrum cephalosporin and monobactam. There have been many reports of outbreaks of hospital infection by ESBL-producing organism. However, community-acquired infection with ESBL-producing organism are rare. This study was performed to retrospectively identify the incidence, characteristics and risk factors of ESBL (+) E. coli in community-acquired childhood UTI. Methods: In 288 children admitted in Ewha Womans University Hospital with E. coli UTI from Mar 2001 to February 2003, ESBL was isolated. ESBL was confirmed by the utilization of an automatized machine(Vitek GNS 433 card) using liquid medium dilution method according to National Committee for Clinical Laboratory Standard. The clinical characteristics, risk factors, antimicrobial resistance and treatment effectiveness were compared with ESBL(-) E. coli UTI. Results: Of 288 E. coli isolates, 31(10.8%) produced ESBL and 93.5%(29/31) occurred in infants younger than 6 month of age(P<0.01). No significant differences were noted in prior antibiotic use, prior admission history and underlying urogenital anomaly. Antimicrobial resistance was significantly higher in ESBL(+) E. coli compared with control patients (P<0.05). Although ceftriaxone showed 100% resistance in ESBL(+) E. coli, bacteriologic sterilization rate after ceftriaxone therapy was higher(96.8%). However, the recurrence rate of febrile UTI within 6 months was higher(25.8%) than control patients(6.6%). Conclusion: Epidemiologic study is required to find out any new risk factors of community-acquired ESBL(+) E. coli UTI and changes in selection of empirical antibiotics should be considered.

• Biomedical Science Letters
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• v.10 no.3
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• pp.309-315
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• 2004

Methicillin resistant Staphylococcus aureus (MRSA) is one of the most common nosocomial pathogens. Many hospitals are facing the problems which they have to use expensive antibiotics and suffer from long term hospital study of patients due to MRSA. This study is to survey MRSA nasal colonization of patients and doctors, and to investigate the mode of transmission of MRSA by pulsed field gel electrophoresis (PFGE) and then use these data to prevent further spread of cross infection and reduce nosocomial infection. Subjects of this study were 201 patients with MRSA infection at an university hospital in Busan from Sept. 1997 to Aug. 1998. Bacterial genotypes of MRSA strains isolated from nares and wound of patients (14 cases) and nares of doctors (8 cases) were analyzed by PFGE. Nasal cultures of 20 I patients for detecting nasal colonization of MRSA were performed and incidence rate of nasal colonization was 40％ (80/201). Among 201 patients MRSA were acquired from hospital in 140 (70％) patients and were acquired from community 61 (30％) patients. Among 14 pairs of MRSA from colonized or infected sites and anterior nares, DNA patterns of 10 pairs (71.4％) were equal. 86％ (12/14) MRSA strains isolated from patients and 12.5％ (1/8) MRSA strains isolated from doctors show same pattern. DNA patterns were changed in some doctors after nasal oint. Treatment. It could be inferred that the most sources of MRSA in hospital are the endemically existing MRSA. Therefore, we believe that it would be necessary to control MRSA nasal colonization of the patients and the related medical teams to reduce the medical cost and to improve the efficacy of medical cares.

• Journal of The Korea Institute of Healthcare Architecture
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• v.22 no.3
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• pp.45-56
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• 2016

Purpose: The MERS(Middle East Respiratory Syndrome) outbreaks in Korea highlighted dramatically the failings of traditional hospital environment for controlling or preventing infections among both patients and healthcare workers. MERS is transmitted by droplets that can be airborne over a limited area. The point should be emphasized that MERS in South Korea was predominantly a hospital-acquired (not a community-acquired) infection, because approximately 93% of MERS cases were resulted from exposure in hospital settings. This paper tries to suggest the design guidelines of negative pressured isolation ward for the sake of proper control of severe respiratory infectious diseases. Methods: Literature survey on the design guideline and regulations of airborne infection wards in Korea, Europe U.K. and CDC of U.S. have been carries out. 4 special infection wards in Hongkong, Germany, Japan and Korea have been surveyed in order to make the best use of the experiences related to facility design and operations. Results: Operating system influencing the facility design, space organizations of infectious ward including required space and zoning, and circulations of patients, staffs and materials are proposed. Implications: The results of this paper can be the basic data for the design of the airborne infection ward and relevant regulations. Afterwards in-depth study such as the development of space standards for the single bedroom, locker room and so on could be explored.

• Tuberculosis and Respiratory Diseases
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• v.69 no.6
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• pp.450-455
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• 2010

Background: High cortisol levels are frequently observed in patients with severe infections are of prognostic value in sepsis. The aim of this study was to evaluate the clinical usefulness of serum cortisol in assessment for the severity of community-acquired pneumonia (CAP). Methods: This study analyzed the results of 52 CAP subjects admitted in Changwon Fatima Hospital between July 2008 to May 2010. Total serum cortisol, infection markers such as C-reactive protein (CRP), procalcitonin (PCT) and CURB (Confusion, Uremia, Respiratory rate, Blood pressure)-65 were examined retrospectively. Results: In clinically unstable subjects on admission day 4, baseline serum cortisol, CURB-65, and CRP were elevated significantly compared to those of stable subjects. Area under curve (AUC) of cortisol, CRP, and CURB-65 from ROC curves were 0.847, 0.783, and 0.724 respectively. In the subjects with serum cortisol ${\geq}22.82{\mu}g/dL$, CRP, PCT, CURB-65 score, and mortality were significantly elevated. Conclusion: These findings suggest that measurement of serum cortisol in early stage may provide helpful information in the assessment of CAP severity.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.18 no.3
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• pp.209-215
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• 2015

Mycoplasma pneumoniae is responsible for approximately 20% to 30% of community-acquired pneumonia, and is well known for its diverse extrapulmonary manifestations. However, acute necrotizing pancreatits is an extremely rare extrapulmonary manifestation of M. pneumoniae infection. A 6-year-old girl was admitted due to abdominal pain, vomiting, fever, and confused mentality. Acute necrotizing pancreatitis was diagnosed according to symptoms, laboratory test results, and abdominal computed tomography scans. M. pneumoniae infection was diagnosed by a 4-fold increase in antibodies to M. pneumoniae between acute and convalescent sera by particle agglutination antibody assay. No other etiologic factors or pathogens were detected. Despite the occurrence of a large infected pseudocyst during the course, the patient was able to discharge without morbidity by early aggressive supportive care. This is the first case in Korea of a child with acute necrotizing pancreatitis associated with M. pneumoniae infection.

• Clinical and Experimental Pediatrics
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• v.48 no.7
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• pp.716-722
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• 2005

Purpose : A full view of the spectrum of all bacterial diseases in healthy children is essential to the establishment of public health priorities. Accurate information on the relative importance of the various pathogens in terms of the age of the affected patients, the site of infection and the case fatality rate are valuable to the clinician in choosing antimicrobial treatments. Methods : Fifty-nine episodes of bacteremia were analysed. Data were collected at Ilsan Paik Hospital from January 2000 to December 2003. Analysis of each collected episode included isolating pathogen from blood culture, diagnosis, hospital course, isolating pathogens from other tissue sites, and studying results of antimicrobial sensitivity tests. Results : Fifty-nine cases of community-acquired bacteremia were reviewed. The most common pathogen was Staphylococcus aureus(11 cases, 18.6 percent), followed by Salmonella(10 cases, 16.9 percent), E. coli(7 cases, 11.9 percent), Streptococcus pneumoniae(five cases, 8.5 percent), Streptococcus viridans(5 cases 8.5 percent). The most common diagnosis was bacteremia without an indentified focus(61 percent), followed by meningitis(12 percent), bacteremia with enteritis(10.2 percent) and bacteremia with urinary tract infection(8.5 percent). Salmonella was still an important causative agent of bacteremia. The relative importance of Haemophilus influenza and Streptococcus pneumoniae was lower than in other studies. The most common organism responsible for bacteremia without an identified focus was Staphylococcus aureus. The case-fatality was 3.4 percent for all cases of bacteremia. Conclusion : We reviewed the etiology of community-acquired bacteremia. These data may be useful in the establishment of public health priorities and serve as a reference for selection of antibiotics in the empirical therapy of suspected invasive bacterial infection.

• The Transactions of the Korean Institute of Electrical Engineers D
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• v.50 no.12
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• pp.597-603
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• 2001

In the mathematical model for the transmission dynamics of HIV infection described in previous papers, the population under consideration is assumed to be homogeneous community of homosexual males for which the parameter x represents the constant rate at which individual members of the population acquire new sexual partners. This is a gross oversimplification since it is well known that individuals vary widely in their levels of sexual activity and in this papers the heterogeneous model is modified to allow for this variation. The pattern on the epidemic character of HIV, the causative agent of AIDS, was analysed by heterogeneous-mixing model. The computer simulation was performed using real date.

• Journal of Preventive Medicine and Public Health
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• v.49 no.4
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• pp.240-248
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• 2016

Objectives: Human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) adversely impacts food security in households of people living with HIV/AIDS (PLWHA). Little research has focused on food insecurity among PLWHA in India. The purpose of this study was to identify the prevalence of and factors relating to food security in households of PLWHA in the Siliguri subdivision of Darjeeling, West Bengal, India. Methods: A cross-sectional community-based study was carried out among 173 PLWHA residing in Siliguri and registered at the Anti-retroviral Therapy Centre of North Bengal Medical College & Hospital. Data was collected at the household level with interviews of PLWHA using a food security survey instrument. We analyzed the associations using logistic regression. Results: The prevalence of household food security among the participants was 50.9% (88/173). Five years or more of schooling, higher socioeconomic class and males were found to be significantly associated with a higher likelihood of food security. A later stage of the disease and the presence of other family members with HIV/AIDS were significantly associated with a lower likelihood of food security. The major coping strategies to deal with food insecurity in the acute phase HIV infection included borrowing money (56.1%), followed by spousal support, loans from microfinance institutions, banks, or money lenders, borrowing food, or selling agricultural products. Conclusions: The present study revealed that only about half of households with PLWHA were food secure. Prior interventions relating to periods of food and economic crisis as well as strategies for sustaining food security and economic status are needed in this area.