• Title/Summary/Keyword: Effectiveness Score

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Importance-Satisfaction Analysis of Meditation Forest in Schools - Focusing on Middle Schools in Gwang-Ju City - (명상숲의 중요도-만족도 평가 - 광주광역시 중학교를 대상으로 -)

  • Kang, Taesun;Jeong, Moonsun
    • Journal of the Korean Institute of Landscape Architecture
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    • v.47 no.4
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    • pp.68-80
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    • 2019
  • This study is to provide basic data for the user-oriented design for a middle school meditation forest in the future by analyzing the physical environment characteristics of existing middle school meditation forests, the users' utilization behavior, and the degree of the importance satisfaction. For this purpose, 24 evaluation indices based on site characteristics, naturalness, functionality, and the effectiveness of meditation forest sites were selected for analysis of importance satisfaction. We surveyed and analyzed the students and teachers of two middle schools 'A' and 'B' in Gwangju Metropolitan City. The results of this study are as follows. First, the perception and utilization rates of the meditation forests by students was significantly lower than teachers at both schools. 'A' school has a better use and recognition rate than the 'B' school. Second, the purposes of using meditation forests were rest (49.6%), weekday lunchtime (63.6%), with friends (65.0%) or colleagues (60%), and short (less than 10 minutes) rests (68.6%). They preferred flowers (30.0%) and shading plants (28.9%), mainly using shelters (57.9%) and walking trails (37.1%). Third, as a result of the importance of satisfaction analysis, the average score of the 24 items importance (3.81), higher than the satisfaction (3.62). The 24 items positioned in 4 quadrants are as follows: Nine items are in the I quadrant for 'persistent maintenance'. Three items are in the II quadrant for 'priority correction'. Seven items are in the quadrant III for 'low priority in the management and operation'. Five items are in the quadrant IV for 'avoid over effort'. For the comparison of two middle schools' satisfaction, 'A' school satisfaction was higher than 'B' school for 16 items, which showed a statistically significant difference. It is believed that the users in 'A' school are more satisfied than 'B' school because it has more forests and trails, better accessibility, and a variety of plant types and planting areas in the A school meditation forest. The results of the overall satisfaction analysis showed a significant difference between 'A' school (68.0%) and 'B' school (47.2%) as 'A' school has better shelters and trails. The rankings of the most satisfying space are walking trails (1st place) and shelters (2nd place). The reason for the highest satisfaction was for rest (stress relief and emotional support) in both 'A' and 'B' schools.

Diagnostic Evaluation of the BioFire® Meningitis/Encephalitis Panel: A Pilot Study Including Febrile Infants Younger than 90 Days (BioFire® Meningitis/Encephalitis Panel의 진단적 유용성 평가: 90일 미만 발열영아에서의 예비 연구)

  • Kim, Kyung Min;Park, Ji Young;Park, Kyoung Un;Sohn, Young Joo;Choi, Youn Young;Han, Mi Seon;Choi, Eun Hwa
    • Pediatric Infection and Vaccine
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    • v.28 no.2
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    • pp.92-100
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    • 2021
  • Purpose: Rapid detection of etiologic organisms is crucial for initiating appropriate therapy in patients with central nervous system (CNS) infection. This study aimed to evaluate the diagnostic value of the BioFire® Meningitis/Encephalitis (ME) panel in detecting etiologic organisms in cerebrospinal fluid (CSF) samples from febrile infants. Methods: CSF samples from infants aged <90 days who were evaluated for fever were collected between January 2016 and July 2019 at the Seoul National University Children's Hospital. We performed BioFire® ME panel testing of CSF samples that had been used for CSF analysis and conventional tests (bacterial culture, Xpert® enterovirus assay, and herpes simplex virus-1 and -2 polymerase chain reaction) and stored at -70℃ until further use. Results: In total, 72 (24 pathogen-identified and 48 pathogen-unidentified) CSF samples were included. Using BioFire® ME panel testing, 41 (85.4%) of the 48 pathogen-unidentified CSF samples yielded negative results and 22 (91.7%) of the 24 pathogen-identified CSF samples yielded the same results (enterovirus in 19, Streptococcus agalactiae in 2, and Streptococcus pneumoniae in 1) as those obtained using the conventional tests, thereby resulting in an overall agreement of 87.5% (63/72). Six of the 7 pathogen-unidentified samples were positive for human parechovirus (HPeV) via BioFire® ME panel testing. Conclusions: Compared with the currently available etiologic tests for CNS infection, BioFire® ME panel testing demonstrated a high agreement score for pathogen-identified samples and enabled HPeV detection in young infants. The clinical utility and cost-effectiveness of BioFire® ME panel testing in children must be evaluated for its wider application.

Investigating Data Preprocessing Algorithms of a Deep Learning Postprocessing Model for the Improvement of Sub-Seasonal to Seasonal Climate Predictions (계절내-계절 기후예측의 딥러닝 기반 후보정을 위한 입력자료 전처리 기법 평가)

  • Uran Chung;Jinyoung Rhee;Miae Kim;Soo-Jin Sohn
    • Korean Journal of Agricultural and Forest Meteorology
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    • v.25 no.2
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    • pp.80-98
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    • 2023
  • This study explores the effectiveness of various data preprocessing algorithms for improving subseasonal to seasonal (S2S) climate predictions from six climate forecast models and their Multi-Model Ensemble (MME) using a deep learning-based postprocessing model. A pipeline of data transformation algorithms was constructed to convert raw S2S prediction data into the training data processed with several statistical distribution. A dimensionality reduction algorithm for selecting features through rankings of correlation coefficients between the observed and the input data. The training model in the study was designed with TimeDistributed wrapper applied to all convolutional layers of U-Net: The TimeDistributed wrapper allows a U-Net convolutional layer to be directly applied to 5-dimensional time series data while maintaining the time axis of data, but every input should be at least 3D in U-Net. We found that Robust and Standard transformation algorithms are most suitable for improving S2S predictions. The dimensionality reduction based on feature selections did not significantly improve predictions of daily precipitation for six climate models and even worsened predictions of daily maximum and minimum temperatures. While deep learning-based postprocessing was also improved MME S2S precipitation predictions, it did not have a significant effect on temperature predictions, particularly for the lead time of weeks 1 and 2. Further research is needed to develop an optimal deep learning model for improving S2S temperature predictions by testing various models and parameters.

Incorporating Social Relationship discovered from User's Behavior into Collaborative Filtering (사용자 행동 기반의 사회적 관계를 결합한 사용자 협업적 여과 방법)

  • Thay, Setha;Ha, Inay;Jo, Geun-Sik
    • Journal of Intelligence and Information Systems
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    • v.19 no.2
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    • pp.1-20
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    • 2013
  • Nowadays, social network is a huge communication platform for providing people to connect with one another and to bring users together to share common interests, experiences, and their daily activities. Users spend hours per day in maintaining personal information and interacting with other people via posting, commenting, messaging, games, social events, and applications. Due to the growth of user's distributed information in social network, there is a great potential to utilize the social data to enhance the quality of recommender system. There are some researches focusing on social network analysis that investigate how social network can be used in recommendation domain. Among these researches, we are interested in taking advantages of the interaction between a user and others in social network that can be determined and known as social relationship. Furthermore, mostly user's decisions before purchasing some products depend on suggestion of people who have either the same preferences or closer relationship. For this reason, we believe that user's relationship in social network can provide an effective way to increase the quality in prediction user's interests of recommender system. Therefore, social relationship between users encountered from social network is a common factor to improve the way of predicting user's preferences in the conventional approach. Recommender system is dramatically increasing in popularity and currently being used by many e-commerce sites such as Amazon.com, Last.fm, eBay.com, etc. Collaborative filtering (CF) method is one of the essential and powerful techniques in recommender system for suggesting the appropriate items to user by learning user's preferences. CF method focuses on user data and generates automatic prediction about user's interests by gathering information from users who share similar background and preferences. Specifically, the intension of CF method is to find users who have similar preferences and to suggest target user items that were mostly preferred by those nearest neighbor users. There are two basic units that need to be considered by CF method, the user and the item. Each user needs to provide his rating value on items i.e. movies, products, books, etc to indicate their interests on those items. In addition, CF uses the user-rating matrix to find a group of users who have similar rating with target user. Then, it predicts unknown rating value for items that target user has not rated. Currently, CF has been successfully implemented in both information filtering and e-commerce applications. However, it remains some important challenges such as cold start, data sparsity, and scalability reflected on quality and accuracy of prediction. In order to overcome these challenges, many researchers have proposed various kinds of CF method such as hybrid CF, trust-based CF, social network-based CF, etc. In the purpose of improving the recommendation performance and prediction accuracy of standard CF, in this paper we propose a method which integrates traditional CF technique with social relationship between users discovered from user's behavior in social network i.e. Facebook. We identify user's relationship from behavior of user such as posts and comments interacted with friends in Facebook. We believe that social relationship implicitly inferred from user's behavior can be likely applied to compensate the limitation of conventional approach. Therefore, we extract posts and comments of each user by using Facebook Graph API and calculate feature score among each term to obtain feature vector for computing similarity of user. Then, we combine the result with similarity value computed using traditional CF technique. Finally, our system provides a list of recommended items according to neighbor users who have the biggest total similarity value to the target user. In order to verify and evaluate our proposed method we have performed an experiment on data collected from our Movies Rating System. Prediction accuracy evaluation is conducted to demonstrate how much our algorithm gives the correctness of recommendation to user in terms of MAE. Then, the evaluation of performance is made to show the effectiveness of our method in terms of precision, recall, and F1-measure. Evaluation on coverage is also included in our experiment to see the ability of generating recommendation. The experimental results show that our proposed method outperform and more accurate in suggesting items to users with better performance. The effectiveness of user's behavior in social network particularly shows the significant improvement by up to 6% on recommendation accuracy. Moreover, experiment of recommendation performance shows that incorporating social relationship observed from user's behavior into CF is beneficial and useful to generate recommendation with 7% improvement of performance compared with benchmark methods. Finally, we confirm that interaction between users in social network is able to enhance the accuracy and give better recommendation in conventional approach.

Accelerometer-based Gesture Recognition for Robot Interface (로봇 인터페이스 활용을 위한 가속도 센서 기반 제스처 인식)

  • Jang, Min-Su;Cho, Yong-Suk;Kim, Jae-Hong;Sohn, Joo-Chan
    • Journal of Intelligence and Information Systems
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    • v.17 no.1
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    • pp.53-69
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    • 2011
  • Vision and voice-based technologies are commonly utilized for human-robot interaction. But it is widely recognized that the performance of vision and voice-based interaction systems is deteriorated by a large margin in the real-world situations due to environmental and user variances. Human users need to be very cooperative to get reasonable performance, which significantly limits the usability of the vision and voice-based human-robot interaction technologies. As a result, touch screens are still the major medium of human-robot interaction for the real-world applications. To empower the usability of robots for various services, alternative interaction technologies should be developed to complement the problems of vision and voice-based technologies. In this paper, we propose the use of accelerometer-based gesture interface as one of the alternative technologies, because accelerometers are effective in detecting the movements of human body, while their performance is not limited by environmental contexts such as lighting conditions or camera's field-of-view. Moreover, accelerometers are widely available nowadays in many mobile devices. We tackle the problem of classifying acceleration signal patterns of 26 English alphabets, which is one of the essential repertoires for the realization of education services based on robots. Recognizing 26 English handwriting patterns based on accelerometers is a very difficult task to take over because of its large scale of pattern classes and the complexity of each pattern. The most difficult problem that has been undertaken which is similar to our problem was recognizing acceleration signal patterns of 10 handwritten digits. Most previous studies dealt with pattern sets of 8~10 simple and easily distinguishable gestures that are useful for controlling home appliances, computer applications, robots etc. Good features are essential for the success of pattern recognition. To promote the discriminative power upon complex English alphabet patterns, we extracted 'motion trajectories' out of input acceleration signal and used them as the main feature. Investigative experiments showed that classifiers based on trajectory performed 3%~5% better than those with raw features e.g. acceleration signal itself or statistical figures. To minimize the distortion of trajectories, we applied a simple but effective set of smoothing filters and band-pass filters. It is well known that acceleration patterns for the same gesture is very different among different performers. To tackle the problem, online incremental learning is applied for our system to make it adaptive to the users' distinctive motion properties. Our system is based on instance-based learning (IBL) where each training sample is memorized as a reference pattern. Brute-force incremental learning in IBL continuously accumulates reference patterns, which is a problem because it not only slows down the classification but also downgrades the recall performance. Regarding the latter phenomenon, we observed a tendency that as the number of reference patterns grows, some reference patterns contribute more to the false positive classification. Thus, we devised an algorithm for optimizing the reference pattern set based on the positive and negative contribution of each reference pattern. The algorithm is performed periodically to remove reference patterns that have a very low positive contribution or a high negative contribution. Experiments were performed on 6500 gesture patterns collected from 50 adults of 30~50 years old. Each alphabet was performed 5 times per participant using $Nintendo{(R)}$ $Wii^{TM}$ remote. Acceleration signal was sampled in 100hz on 3 axes. Mean recall rate for all the alphabets was 95.48%. Some alphabets recorded very low recall rate and exhibited very high pairwise confusion rate. Major confusion pairs are D(88%) and P(74%), I(81%) and U(75%), N(88%) and W(100%). Though W was recalled perfectly, it contributed much to the false positive classification of N. By comparison with major previous results from VTT (96% for 8 control gestures), CMU (97% for 10 control gestures) and Samsung Electronics(97% for 10 digits and a control gesture), we could find that the performance of our system is superior regarding the number of pattern classes and the complexity of patterns. Using our gesture interaction system, we conducted 2 case studies of robot-based edutainment services. The services were implemented on various robot platforms and mobile devices including $iPhone^{TM}$. The participating children exhibited improved concentration and active reaction on the service with our gesture interface. To prove the effectiveness of our gesture interface, a test was taken by the children after experiencing an English teaching service. The test result showed that those who played with the gesture interface-based robot content marked 10% better score than those with conventional teaching. We conclude that the accelerometer-based gesture interface is a promising technology for flourishing real-world robot-based services and content by complementing the limits of today's conventional interfaces e.g. touch screen, vision and voice.

The Market Segmentation of Coffee Shops and the Difference Analysis of Consumer Behavior: A Case based on Caffe Bene (커피전문점의 시장세분화와 소비자행동 차이 분석 : 카페베네 사례를 중심으로)

  • Yu, Jong-Pil;Yoon, Nam-Soo
    • Journal of Distribution Science
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    • v.9 no.4
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    • pp.5-13
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    • 2011
  • This study provides analysis of the effectiveness of domestic marketing strategies of the Korean coffee shop "Caffe Bene". It bases its evaluation on statistical outputs of 'choice attributes,' "market segmentation," demographic characteristics," and "satisfaction differences." The results are summarized in four points. First, five choice attributes were extracted from factor analysis: price, atmosphere, comfort, taste, and location; these are related to coffee shop selection behavior. Based on these five factors, cluster analysis was conducted, with statistical results classifying customers into three major groups: atmosphere oriented; comfort oriented; and taste oriented. Second, discriminant analysis tested cluster analysis and showed two discriminant functions: location and atmosphere. Third, cross-tabulation analysis based on demographic characteristics showed distinctive demographic characteristics within the three groups. Atmosphere oriented group, early-20s, as women of all ages was found to be 'walking down the street 'and 'through acquaintances' in many cases, as the cognitive path, and mostly found the store through 'outdoor advertising', and 'introduction'. Comfort oriented group was mainly women who are students in their early twenties or professionals, and appeared as a group to be very loyal because of high recommendation to other customers compared to other groups. Taste oriented group, unlike the other group, was mainly late-20s' college graduates, and was confirmed, as low loyalty, with lower recommendation activity. Fourth, to analyze satisfaction differences, one-way ANOVA was conducted. It shows that groups which show high satisfaction in the five main factors also show high menu satisfaction and high overall satisfaction. This results show that segmented marketing strategies are necessary because customers are considering price, atmosphere, comfort, taste, location when they choose coffee shop and demographics show different attributes based on segmented groups. For example, atmosphere oriented group is satisfied with shop interior and comfort while dissatisfied with price because most of the customers in this group are early 20s and do not have great financial capability. Thus, price discounting marketing strategies based on individual situations through CRM system is critical. Comfort oriented group shows high satisfaction level about location and shop comfort. Also, in this group, there are many early 20s female customers, students, and self-employed people. This group customers show high word of mouth tendency, hence providing positive brand image to the customers would be important. In case of taste oriented group, while the scores of taste and location are high, word of mouth score is low. This group is mainly composed of educated and professional many late 20s customers, therefore, menu differentiation, increasing quality of coffee taste and price discrimination is critical to increase customers' satisfaction. However, it is hard to generalize the results of study to other coffee shop brand, because this study have researched only one domestic coffee shop, Caffe Bene. Thus if future study expand the scope of locations, brands, and occupations, the results of the study would provide more generalizable results. Finally, research of customer satisfactions of menu, trust, loyalty, and switching cost would be critical in the future study.

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The Effect of Structured Information on the Sleep Amount of Patients Undergoing Open Heart Surgery (계획된 간호 정보가 수면량에 미치는 영향에 관한 연구 -개심술 환자를 중심으로-)

  • 이소우
    • Journal of Korean Academy of Nursing
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    • v.12 no.2
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    • pp.1-26
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    • 1982
  • The main purpose of this study was to test the effect of the structured information on the sleep amount of the patients undergoing open heart surgery. This study has specifically addressed to the Following two basic research questions: (1) Would the structed in formation influence in the reduction of sleep disturbance related to anxiety and Physical stress before and after the operation? and (2) that would be the effects of the structured information on the level of preoperative state anxiety, the hormonal change, and the degree of behavioral change in the patients undergoing an open heart surgery? A Quasi-experimental research was designed to answer these questions with one experimental group and one control group. Subjects in both groups were matched as closely as possible to avoid the effect of the differences inherent to the group characteristics, Baseline data were also. collected on both groups for 7 days prior to the experiment and found that subjects in both groups had comparable sleep patterns, trait anxiety, hormonal levels and behavioral level. A structured information as an experimental input was given to the subjects in the experimental group only. Data were collected and compared between the experimental group and the control group on the sleep amount of the consecutive pre and post operative days, on preoperative state anxiety level, and on hormonal and behavioral changes. To test the effectiveness of the structured information, two main hypotheses and three sub-hypotheses were formulated as follows; Main hypothesis 1: Experimental group which received structured information will have more sleep amount than control group without structured information in the night before the open heart surgery. Main hypothesis 2: Experimental group with structured information will have more sleep, amount than control group without structured information during the week following the open heart surgery Sub-hypothesis 1: Experimental group with structured information will be lower in the level of State anxiety than control group without structured information in the night before the open heart surgery. Sub-hypothesis 2 : Experimental group with structured information will have lower hormonal level than control group without stuctured information on the 5th day after the open heart surgery Sub-hypothesis 3: Experimental group with structured information will be lower in the behavioral change level than control group without structured information during the week after the open heart surgery. The research was conducted in a national university hospital in Seoul, Korea. The 53 Subjects who participated in the study were systematically divided into experimental group and control group which was decided by random sampling method. Among 53 subjects, 26 were placed in the experimental group and 27 in the control group. Instruments; (1) Structed information: Structured information as an independent variable was constructed by the researcher on the basis of Roy's adaptation model consisting of physiologic needs, self-concept, role function and interdependence needs as related to the sleep and of operational procedures. (2) Sleep amount measure: Sleep amount as main dependent variable was measured by trained nurses through observation on the basis of the established criteria, such as closed or open eyes, regular or irregular respiration, body movement, posture, responses to the light and question, facial expressions and self report after sleep. (3) State anxiety measure: State Anxiety as a sub-dependent variable was measured by Spi-elberger's STAI Anxiety scale, (4) Hormornal change measure: Hormone as a sub-dependent variable was measured by the cortisol level in plasma. (5) Behavior change measure: Behavior as a sub-dependent variable was measured by the Behavior and Mood Rating Scale by Wyatt. The data were collected over a period of four months, from June to October 1981, after the pretest period of two months. For the analysis of the data and test for the hypotheses, the t-test with mean differences and analysis of covariance was used. The result of the test for instruments show as follows: (1) STAI measurement for trait and state anxiety as analyzed by Cronbachs alpha coefficient analysis for item analysis and reliability showed the reliability level at r= .90 r= .91 respectively. (2) Behavior and Mood Rating Scale measurement was analyzed by means of Principal Component Analysis technique. Seven factors retained were anger, anxiety, hyperactivity, depression, bizarre behavior, suspicious behavior and emotional withdrawal. Cumulative percentage of each factor was 71.3%. The result of the test for hypotheses show as follows; (1) Main hypothesis, was not supported. The experimental group has 282 minutes of sleep as compared to the 255 minutes of sleep by the control group. Thus the sleep amount was higher in experimental group than in control group, however, the difference was not statistically significant at .05 level. (2) Main hypothesis 2 was not supported. The mean sleep amount of the experimental group and control group were 297 minutes and 278 minutes respectively Therefore, the experimental group had more sleep amount as compared to the control group, however, the difference was not statistically significant at .05 level. Thus, the main hypothesis 2 was not supported. (3) Sub-hypothesis 1 was not supported. The mean state anxiety of the experimental group and control group were 42.3, 43.9 in scores. Thus, the experimental group had slightly lower state anxiety level than control group, howe-ver, the difference was not statistically significant at .05 level. (4) Sub-hypothesis 2 was not supported. . The mean hormonal level of the experimental group and control group were 338 ㎍ and 440 ㎍ respectively. Thus, the experimental group showed decreased hormonal level than the control group, however, the difference was not statistically significant at .05 level. (5) Sub-hypothesis 3 was supported. The mean behavioral level of the experimental group and control group were 29.60 and 32.00 respectively in score. Thus, the experimental group showed lower behavioral change level than the control group. The difference was statistically significant at .05 level. In summary, the structured information did not influence the sleep amount, state anxiety or hormonal level of the subjects undergoing an open heart surgery at a statistically significant level, however, it showed a definite trends in their relationships, not least to mention its significant effect shown on behavioral change level. It can further be speculated that a great degree of individual differences in the variables such as sleep amount, state anxiety and fluctuation in hormonal level may partly be responsible for the statistical insensitivity to the experimentation.

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COMPLIANCE STUDY OF METHYLPHENIDATE IR IN THE TREATMENT OF ADHD (주의력결핍과잉행동장애 치료 약물 Methylphenidate IR의 순응도 연구)

  • Hwang, Jun-Wan;Cho, Soo-Churl;Kim, Boong-Nyun
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.15 no.2
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    • pp.160-167
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    • 2004
  • Objectives : There have been very few studies on the compliance of methylphenidate-immediate releasing form(MPH-IR), which is the most frequently used drug in Korea, in Attention Deficit Hyperactivity Disorder(ADHD). This study was conducted to investigate the compliance rate and the related factors in the one year pharmacotherapy process via OPD for children with ADHD. Method : Total 100 ADHD patients were selected randomly among patients who have been treated with MPH-IR from September in 2002 to December in 2002. All the selected patients were diagnosed with DSM-IV-ADHD criteria and fulfilled the inclusion criteria. In March, 2003(at the time of 6 month treatment), all the patients and parents received the questionnaire for the compliance and satisfaction for MPH-IR treatment. In October 2003(at time of 1 year treatment), we, investigators evaluated the socio-demographic variables, developmental data, medical data, family data, comorbid disorders, treatment variables, and compliance rate. Through these very comprehensive data, The compliance rate at the time of mean 1 year treatment and the related factors were investigated. Result : 1) In the questionnaire for compliance and satisfaction for MPND treatment, the 60% of respondents(parents) reported more than moderate degree of satisfaction in the effectiveness of MPND. Their compliance rate for the morning prescription was 81%, but the rate of afternoon prescription was 43%. 2) In the evaluation at the time of 1 year treatment(October 2003), the 38% of parents were dropped out from the OPD treatment. The mean compliance rate for the 1 year treatment was 62%. the 38% of parents were dropped out from the OPD treatment. The mean compliance rate for the 1year treatment was 62%. 3) Compared with the noncompliant group(drop-out group), compliant group showed higher total, verbal and performance IQ scores. In the treatment variables, higher reposponder rate(clinician rating), higher medication dosage and more compliance rate in afternoon prescription were found in the compliant group compared with the noncompliant group. There were no statistical differences in the demographic variables(age, sex, SES, parental education level), medical data, developmental profiles and academic function. Conclusion : To our knowledge, this is the first report about the compliance rate of the MPH-IR treatment for the children with ADHD. The compliance rate at the time of mean 1year treatment was 62%, which was comparable with other studies performed in foreign countries, especially States. In this study, the compliance related factors were IQ score, clinical treatment response, dosage of MPH-IR, and early compliance for the afternoon prescription. These results suggest that clinician plan the strategies for the promotion of the early compliance for the after prescription and enhancement of overall treatment response.

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The Central Venous Catheter-related Infection of Chlorhexidine-silver Sulfadiazine Coated Catheters in Medical ICU (내과계 중환자실 환자에서 Chlorhexidine-silver Sulfadiazine Coated Catheter의 중심정맥관 감염에 대한 연구)

  • Jung, Young Ju;Koh, Younsuck;Lim, Chae-Man;Lee, Jae Seung;Yu, Mi Hyun;Oh, Yeon Mok;Shim, Tae Sun;Lee, Sang Do;Kim, Woo Sung;Kim, Dong Soon;Kim, Won Dong;Hong, Sang-Bum
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.4
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    • pp.389-396
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    • 2005
  • Background : Central venous catheters(CVCs) area major source of nosocomial infection. Chlorhexidine-silver sulfadiazine coated catheters (CHSS) were developed to reduce the rate of CVC infection. However, the clinical effectiveness of CHSS in comparison wth non-coated catheter (NCC) remains to be evaluated. Methods : From January 2004 to December 2004 in medical intensive care unit (ICU) of Asan Medical Center, CVCs were inserted in 446 cases. We retrospectively analyzed characteristics of patients and catheterization,the catheter-related infection rate and colonization, microbiologic findings, and insertion sites (subclavian, jugular, femoral) according to the type of inserted CVCs (NCC: 187 cases, CHSS: 259 cases). Catheter related infection is defined as catheter related bacteremia and catheter related non-bacteremic sepsis. Results : 1) The mean age of the patients in each group was $62{\pm}16$ years, $63{\pm}15$ years (p=0.42), and sex ratio 94:50, 141:69 (p=0.9) in NCC and CHSS. Duration of ICU admission ($29{\pm}37$, $26{\pm}44$ p=0.42), duration of mechanical ventilation ($17{\pm}22$, $15{\pm}19$ p=0.17), and APACHE III score at the time of CVC insertion ($81{\pm}34$, $82{\pm}37$ p=0.61) were not different between both groups. 2) Mean duration of catheterization was 118 in NCC and 119 in CHSS (p=0.98). Number of catheter-days was 2176 days in NCC and 3035 days in CHSS. Catheter-related infection occurred in 9 (4.8%) cases receiving NCC and 4 cases (1.5%) receiving CHSS. Catheterrelated infection incidence per 1000 catheter-days was 4.1 and 1.3, respectively (p=0.04). CHSS was associated with a significant reduction of infection in jugular catheters regarding to insertion sites (p=0.01). 3) Microorganisms causing infection were Staphylococcus aureus (n=3), Candida (n=3), coagulase-negative Staphylococci (n=2), and Klebsiella (n=1) in NCC, and Candida species (n=2), coagulase-negative Staphylococci (n=2), Proteus (n=1) in CHSS. Conclusion : CHSS has significantly reduced the episodes of infection compared to NCC in jugular catheterization in medical ICU.