• Korean Journal of Clinical Laboratory Science
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• v.48 no.4
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• pp.348-354
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• 2016

Data stored in hospital information systems has a great potential to improve adequacy assessment and quality management. Moreover, an establishment of a data warehouse has been known to improve quality management and to offer help to clinicians. This study constructed a data mart that can be used to analyze antibiotic usage as a part of systematic and effective data analysis of infection control information. Metadata was designed by using the XML DTD method after selecting components and evaluation measures for infection control. OLAP-a multidimensional analysis tool-for antibiotic usage analysis was developed by building a data mart through modeling. Experimental data were obtained from data on antibiotic usage at a university hospital in Cheonan area for one month in July of 1997. The major components of infection control metadata were antibiotic resistance information, antibiotic usage information, infection information, laboratory test information, patient information, and infection related costs. Among them, a data mart was constructed by designing a database to apply antibiotic usage information to a star schema. In addition, OLAP was demonstrated by calculating the statistics of antibiotic usage for one month. This study reports the development of a data mart on antibiotic usage for infection control through the implementation of XML and OLAP techniques. Building a conceptual, structured data mart would allow for a rapid delivery and diverse analysis of infection control information.

• The Journal of the Korean Society for Microbiology
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• v.21 no.2
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• pp.211-226
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• 1986

To understand the pathogenesis of anicteric leptospirosis with severe pulmonary hemorrhage occured in Korea, the microbiological and pathological features were observed in the experimentally induced leptospirosis in guinea pigs infected with a virulent strain of Leptospira interrogans isolated from the patient at Wonju, Korea, and the results are summarized as follows. 1. The main pathological features were widespread hemorrhages, especially affecting lung, skeletal muscles, retroperitoneal and perirenal adipose tissues. The hemorrhages accompanied inflammatory process especially of vasculitic pattern as well as occasional coagulation necrosis in the liver, skeletal muscle, and myocardium. The main inflammatory cells were of plasma cell even in the fairly early stage of the infection. 2. Those pathologic changes were more exaggerated in the inoculation site. 3. Within 144 hours of infection, the longer the infection time, the more antigens were observed in the tissues, and the severer the pathologic changes. 4. Leptospiral antigens were detected at first by indirect immunofluorescent and immunoperoxidase technics. As the infection time extended, the antigens were observed in all of the tissues examined except in the skeletal muscle. The shape of the antigens was spiral or thread-like within 72 hours of infection. As the infection progressed, they became fragmented and granular. 5. Leptospires were detected in the blood within 144 hours of infection by darkfield microscopic examination. Thereafter, none was observed. 6. Antibody to leptospires were detected as early as 72 hours of infection. In summary, the virulent strain of L. interrogans used in this experiment induced widespread hemorrhages with inflammatory reaction especially in lung, skeletal muscles, and retroperitoneal adipose tissue. With these findings, it is suggested that the direct toxic effect of leptospires might playa great role in the pathogenesis of this infection.

• Parasites, Hosts and Diseases
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• v.23 no.1
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• pp.156-164
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• 1985

To elucidate the effect of splenectomy on the development of experimental primary amoebic meningoencephalitis in mice, the death rate and survival time of mice infected intranasally with Naegleria fowleri trophozoites $5{\times}10^4$ cultivated in CGVS medium were compared according to the mouse age when splenectomy was done, and post-operation until experimental infection. Immunodigusion was undergone to detect the presence of serum antibod). due to N, fowleri infecttion in mice. Polyacrylamide gel electrophoresis was done to compare the protein fractions of mouse serum in each experimental groups. In experiment I, splenectomy was done 3 weeks and infection 4 weeks after birth, the death rate of control, sham operated and splenectomized group were 100%, 85% and 95%, and the mean survival time after infection 7.3 days, 7.5 days and 7.8 days, respectively. In experiment II, splenectomy was undergone 3 weeks and infection 6 weeks after birth, the death rate of of control, sham operated and splenectomized group were 95%, 95% and 95%, and the mean survival time after infection 12.1 days, 11.5 days and 11.5 days, respectively. In experiment III, splenectomy was done 5 weeks and infection 6 weeks after birth, the death rate of control, sham operated and splenectomized group were 95%, 90% and 95%, and the mean survival time after infection 8.1 days, 8.3 days and 8.5 days, respectively. By Ouchterlony immunodigusion, anti-JV. fowleri antibody in the serum of mouse with primary amoebic meningoencephalitis was detected against a N. fowleri antigen, which was prepared by ultrasonication of N, fowleri trophozoites, each reacting two lines of precipitation. The patterns of serum fractions by polyacrylamide gel electrophoresis were different between control and sham operated groups from splenectomized group in fraction II, III and V, the sera of which were collected after N. fowleri infection. This results may be summarized as that splenectomy has no effect on the development of primary amoebic meningoencephalitis in mice.

• Clinical and Experimental Pediatrics
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• v.45 no.6
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• pp.719-726
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• 2002

Purpose : Neonates in neonatal intensive care units(NICU) have a high risk of acquiring nosocomial infection because of their impaired host defence mechanism and invasive procedures. Nosocomial infection result in considerable morbidity and mortality among neonates. This study was carried out to survey both the epidemiology of nosocomial infection in our NICU and the annual trends of pathogens. Methods : We retrospectively reviewed culture proven nosocomial infection which occurred in our NICU from January 1995 to December 1999. The data included clinical characteristics, site of infection, pathogens, and mortality. Results : Nosocomial infection rates was 9.0 per 100 NICU admissions during the five-year period. Major sites of infection were bloodstream(32.3%), skin(18.4%), endotracheal tube(17.2%), and catheter(10.6%). The most common pathogen was S. aureus(29.9%). and the others were coagulase- negative staphylococci(CONS)(14.8%), Enterobacter(12.4%), and Candida(9.0%). During the five-year period, nosocomial infection rates increased from 9.5 to 11.6 per 100 admissions with the increase of CONS, Candida, Klebsiella, and Acinetobacter baumannii. The infection rate of S. aureus decreased. Multiple episodes of nosocomial infection occurred in 26.1% of all nosocomial infections. Overall bloodstream infection rates were 3.6 per 100 NICU admissions during five years. CONS(29.1%) and S. aureus(27.1%) were the two most common pathogens. Increasing rates of bloodstream infection by CONS, Candida, Klebsiella, and Acinetobacter baumannii were observed. Bloodstream infection related mortality was 11.9%. Conclusion : The predominant pathogens of nosocomial infection in NICU were S. aureus and CONS. Bloodstream infection, the most frequent nosocomial infection, should be a major focus of surveillance and prevention efforts in NICU.

• Clinical and Experimental Pediatrics
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• v.57 no.10
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• pp.451-456
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• 2014

Purpose: We evaluated serum procalcitonin (PCT) as a diagnostic marker of neonatal sepsis, and compared PCT levels with C-reactive protein (CRP) levels. Methods: We retrospectively reviewed the medical records of 269 neonates with a suspected infection, admitted to Wonkwang University School of Medicine & Hospital between January 2011 and December 2012, for whom PCT and CRP values had been obtained. Neonates were categorized into 4 groups according to infection severity. CRP and PCT values were analyzed and compared, and their effectiveness as diagnostic markers was determined by using receiver operating characteristic (ROC) curve analysis. We also calculated the sensitivity, specificity, and positive, and negative predictive values. Results: The mean PCT and CRP concentrations were respectively $56.27{\pm}81.89$ and $71.14{\pm}37.17mg/L$ in the "confirmed sepsis" group; $15.64{\pm}32.64$ and $39.23{\pm}41.41mg/L$ in the "suspected sepsis" group; $9.49{\pm}4.30$ and $0.97{\pm}1.16mg/L$ in the "mild infection" group; and $0.21{\pm}0.12$ and $0.72{\pm}0.7mg/L$ in the control group. High concentrations indicated greater severity of infection (P<0.001). Five of 18 patients with confirmed sepsis had low PCT levels (<1.0 mg/L) despite high CRP levels. In the ROC analysis, the area under the curve was 0.951 for CRP and 0.803 for PCT. The cutoff concentrations of 0.5 mg/L for PCT and 1.0 mg/L for CRP were optimal for diagnosing neonatal sepsis (sensitivity, 88.29% vs. 100%; specificity, 58.17% vs. 85.66%; positive predictive value, 13.2% vs. 33.3%; negative predictive value, 98.6% vs. 100%, respectively). Conclusion: PCT is a highly effective early diagnostic marker of neonatal infection. However, it may not be as reliable as CRP.

• The Korean Journal of Nuclear Medicine
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• v.25 no.2
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• pp.259-265
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• 1991

The purpose of this study is to investigate the ability of I-131 labeled polyclonal human immunoglobulin to localize an infection. In our country, indium-111 labeled leukocyte or Tc-99m labeled IgG are not readily available because of compex, time-consuming procedure and cost. So we tried to localize infection with I-131 labeled IgG which could be easily prepared. Six rats, infected with staphylococcus aureus in a thigh muscle, received I-131 labeled IgG intravenously and I-131 labeled bovine serum albumin (BSA) were injected to other 5 infected rats. Scintigrams were made at 1, 4, 24, 48, 72 hour later. The radiopharmaceutical demonstrated significant accumulation at the site of infection. The accumulation of I-131 labeled IgG at the site of infection was significantly (P<0.05) higher than that of I-131 labeled BSA at 48, 72 hour. Similar finding could be found at 24 hour imaging, but it was not significant statistically. Therefore it was found that vascular permeability alone could not account for the mode of action of I-131 labeled IgG and it was considered that specific binding played a role. In conclusion, focal sites of inflammation can be detected with I-131 labeled nonspecific human polyclonal IgG and it seems that this method can also be applied to localization of human infection.

• Clinical and Experimental Pediatrics
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• v.61 no.1
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• pp.12-16
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• 2018

Purpose: To differentiate adenoviral pharyngoconjunctival fever (PCF) from acute Kawasaki disease (KD) using laboratory tests before results of virus-real time polymerase chain reaction and ophthalmologic examination are obtained. Methods: Baseline patient characteristics and laboratory measurements were compared between 40 patients with adenovirus infection and 123 patients with KD. Results: The patients with adenovirus infection were generally older than those with KD (median: 3.9 years vs. 2 years, P=0.000). White blood cell and, platelet count, and aspartate aminotransferase, alanine aminotransferase, and N-terminal pro-brain natriuretic peptide (NT-proBNP) levels showed significant differences between the 2 groups, but the C-reactive protein (CRP) levels did not ($6.8{\pm}3.0mg/dL$ vs. $8.3{\pm}5.8mg/dL$, P=0.126). In the adenovirus infection group, the CRP levels were <1, <3, <10, and ${\geq}10mg/dL$ in 2 (5%), 3 (7.5%), 30 (75%), and 5 patients (12.5%), respectively. The cutoff NT-proBNP level was 265 pg/mL. Discrepancy was defined as CRP and NT-proBNP levels of ${\geq}3$ or <3 mg/dL, and <265 or ${\geq}265pg/mL$, respectively. Among the 35 patients with adenovirus infection whose CRP levels were ${\geq}3mg/dL$, 29 (82.9%) showed a discrepancy. Conversely, of the 103 patients with KD whose CRP levels were ${\geq}3mg/dL$, 83 (80.6%) showed no discrepancy. Between the groups, a significant difference in discrepancy rate was observed (P=0.000). None of the patients with adenovirus infection had CRP and NT-proBNP levels of <3 mg/dL and ${\geq}265pg/mL$, respectively. Conclusion: With a sensitivity of 82.9% and a specificity of 80.6%, CRP and NT-proBNP levels may differentiate between adenoviral PCF and acute KD.

• Quality Improvement in Health Care
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• v.19 no.1
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• pp.30-42
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• 2013

Objectives: This study was intended to check if the "Creating Clean Wards" project, which is an innovative reinforced campaign activity targeting infection control strategies and active surveillance cultures for VRE (vancomycin resistant enterococci) high-risk patients to be admitted in the NS (neuro-surgery) wards, would be reduced the incidence rates of VRE acquisition, transmission rates. Methods: 75 subjects of the VRE high-risk patients were surveyed by carrying out active surveillance cultures of VRE colonization 11 times from January to March, 2012. And the retrospective study was conducted dividing them into two groups. Results: The incidence rates of VRE acquisition was reduced to 3.67 cases per 1,000 patients day in the control group and to 2.88 cases in experimental group, which was not statistically significant (p = .753). VRE transmission rates of 0.0015 per day before the project tended to increase to 0.0019, although not statistically significant (p = .650). As a result of multivariate analysis with regard to using glycopeptide antibiotics in order to find out risk factors of VRE colonization, the patients who had been treated with glycopeptide until VRE colonization showed 274.41 times higher rate. Conclusion : For effective VRE infection control in NS wards, We should carry out active surveillance culture regularly, especially patient of using glycopeptide. And block the spread of VRE by strengthening infection control through the strict isolation and the changed mind-set of members motivated by the "Creating Clean Wards" campaign.

• Asian-Australasian Journal of Animal Sciences
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• v.10 no.4
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• pp.435-438
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• 1997

Twelve newborn goat kids born of philippine does (3.5 and 5 years old) were used in this study. Four mother (candidate) doe goats were randomly allocated to each group. The mother does were infected orally with three levels (0, 15,000 and 30,000 larvae) of infective Haemonchus contortus larvae. Before infection all animals were housed in individual pens with concrete floors. They were provided with a uniform management. Estrus of does were synchronized using PGF2 alpha. All the animals were bred naturally by the same buck. Baby goat born of infected mother goats were divided into three groups. $T_1$, $T_2$ and $T_3$), respectively, from mother treatment groups. Birth weight and growth of goat kids born from H. contortus infected mother goats were determined. Birth weights of kids of $T_1$, $T_2$ and $T_3$ were 1.9, 1.5 and 1.2 kg, respectively. No significant (p > 0.05) differences in birth weight of kids for the 3 treatment groups were found. However, significant (p < 0.05) effects of stomach worm infection and duration of infection on liveweight gain of kids were observed. After second and third week of birth, respectively, the kids of groups 3 and 2 registered lover liveweight gains than the kids in control group. However, no significant (p > 0.05) difference in liveweight gain was found between the kids of infected mother does. Fecal egg counts of the infected mother does showed patent infections which also indicated by postmortem worm counts. However, no worm egg was found in the feces of the test kids.

• Clinical and Experimental Pediatrics
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• v.55 no.2
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• pp.42-47
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• 2012

$Mycoplasma$ $pneumoniae$ (MP), the smallest self-replicating biological system, is a common cause of upper and lower respiratory tract infections, leading to a wide range of pulmonary and extra-pulmonary manifestations. MP pneumonia has been reported in 10 to 40% of cases of community-acquired pneumonia and shows an even higher proportion during epidemics. MP infection is endemic in larger communities of the world with cyclic epidemics every 3 to 7 years. In Korea, 3 to 4-year cycles have been observed from the mid-1980s to present. Although a variety of serologic assays and polymerase chain reaction (PCR) techniques are available for the diagnosis of MP infections, early diagnosis of MP pneumonia is limited by the lack of immunoglobulin (Ig) M antibodies and variable PCR results in the early stages of the infection. Thus, short-term paired IgM serologic tests may be mandatory for an early and definitive diagnosis. MP infection is usually a mild and self-limiting disease without specific treatment, and if needed, macrolides are generally used as a first-choice drug for children. Recently, macrolide-resistant MP strains have been reported worldwide. However, there are few reports of apparent treatment failure, such as progression of pneumonia to acute respiratory distress syndrome despite macrolide treatment. The immunopathogenesis of MP pneumonia is believed to be a hyperimmune reaction of the host to the insults from MP infection, including cytokine overproduction and immune cell activation (T cells). In this context, immunomodulatory treatment (corticosteroids or/and intravenous Ig), in addition to antibiotic treatment, might be considered for patients with severe infection.