• Title/Summary/Keyword: Hospital infections

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Lemierre Syndrome with Septic Pulmonary Embolism - A case report - (패혈성 폐색전증을 동반한 Lemierre 증후군 - 1예 보고 -)

  • Yoo, Dong-Gon;Kim, Chong-Wook;Lee, Geun-Dong;Ahn, Jae-Hong;Park, Chong-Bin
    • Journal of Chest Surgery
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    • v.40 no.11
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    • pp.782-785
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    • 2007
  • Lemierre syndrome is caused by an acute oropharyngeal infection with secondary septic thrombophlebitis of the internal jugular vein and frequent metastatic infections. The usual etiologic agent is Fusobacterium necrophorum. Lemierre syndrome was a common disease with a high mortality rate in the pre-antibiotic era. Since the advent of antibiotics and their widespread use for the treatment of pharyngeal infections, there has been a substantial decrease in the incidence of this malady and it has become a "forgotten disease". Prompt diagnosis and antibiotic therapy for lemierre syndrome is essential to avoid morbidity and mortality. We describe here a case of Lemierre syndrome with multiple septic pulmonary emboli.

HPV Genotyping Linear Assay Test Comparison in Cervical Cancer Patients: Implications for HPV Prevalence and Molecular Epidemiology in a Limited-resource Area in Bandung, Indonesia

  • Panigoro, Ramdan;Susanto, Herman;Novel, Sinta Sasika;Hartini, Sri;Sahiratmadja, Edhyana
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.10
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    • pp.5843-5847
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    • 2013
  • Background: Persistent infection with high risk human papillomavirus (hrHPV) is strongly associated with cervical cancer. Normal cervical cells may also harbor hrHPV, and detection of early hrHPV infection may minimize risk of cervical cancer development. This study aimed to compare two commercial HPV genotyping assays that may affordable for early screening in a limited-resource setting in Bandung, Indonesia. Materials and Methods: DNA from cervical biopsies with histologically confirmed as squamous cell cervical cacinoma were HPV genotyped by Linear Assay 1 (Roche Diagnostics, Mannheim, Germany) or Linear Assay 2 (Digene HPV Genotyping RH Test, Qiagen Gaithersburg, MD). In a subset of samples of each group, HPV genotype results were then compared. Results: Of 28 samples genotyped by linear assay 1, 22 (78.6%) demonstrated multiple infections with HPV-16 and other hrHPV types 18, 45 and/or 52. In another set of 38 samples genotyped by linear assay 2, 28 (68.4%) were mostly single infections by hrHPV type 16 or 18. Interestingly, 4 samples that had been tested by both kits showed discordant results. Conclusions: In a limited-resource area such as in Indonesia, country with a high prevalence of HPV infection a reliable cervical screening test in general population for early hrHPV detection is needed. Geographical variation in HPV genotyping result might have impacts for HPV prevalence and molecular epidemiology as the distribution in HPV genotypes should give clear information to assess the impact of HPV prophylactic vaccines.

A Feasibility Study of Hand Hygiene Status in Korea Hospitals (국내병원의 유형별 손위생 수행실태 조사분석)

  • Lee, Yongkyoon;Shin, Hyunhee
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.23 no.3
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    • pp.9-17
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    • 2017
  • Purpose : The easiest and most cost-effective way to prevent medical-related infections is known as proper hand washing of health care workers. The experience of MERS in domestic medical institutions has increased the importance of hand hygiene for medical workers to prevent infections in hospitals. It is necessary to investigate the level of hand hygiene practice by type of medical institutions and the factors influencing the infection prevention. Methods : Domestic and overseas hand hygiene related business cases and literature data were collected and analyzed in order to investigate the hand hygiene status of medical institutions in Korea. Result : As a result of hand hygiene monitoring of all hospital-level medical institutions in 2016, the total number of observations was 24,328 and the hand hygiene performance rate was 75.9%. The hand hygiene performance rate of hospitals was 71.5% for general hospitals, 75% for general hospitals, and 81.3% for hospitals. Implications : In general hospitals and hospitals, the HR(Hand Rubbing) method is preferred as a way of performing hand hygiene, whereas the HW(Hand Washing) method is relatively high in the small hospitals. It is estimated that the HW system is preferred because of the cost burden at the hospital medical institution. Therefore, it is necessary to compensate the related expenses to improve the hand hygiene performance of the physicians who are engaged in the hospitals.

Evaluation of Airborne Bacteria and Fungi in Surgical Areas at the Animal Hospital

  • Jeong, Seongsoo;Kang, Yuntae;Hwang, Yawon;Yoo, Seungwon;Jang, Hyejin;Oh, Hyejong;Kang, Jihoon;Chang, Dongwoo;Na, Kijeong;Kim, Gonhyung
    • Journal of Veterinary Clinics
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    • v.34 no.2
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    • pp.76-81
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    • 2017
  • Studies on the concentration of airborne microorganisms in human medicine as a part of a study on the nosocomial infections have been conducted properly, but in veterinary medicine, there has been rarely performed in Korea to the best of study's knowledge. The purpose of this study was to evaluate the distribution of airborne microorganisms and to identify their species in different places in the animal hospital to alert the necessity of thorough cleanliness management. This study evaluated the concentrations of airborne bacteria and fungi in hospital areas, such as patient waiting room, internal medicine ward, surgical ward and radiological diagnostic ward. The concentration of bacteria and fungi was significantly lower (p < 0.05) in two operating rooms and higher in the patient waiting room. The dominant species of bacteria were Micrococcus spp., Staphylococcus spp., and fungi were Penicillium spp., Dermatophyte mold. Animal hospitals need to perform proper procedures for disinfection, sterilization, and environmental cleaning as well as appropriate employee training and monitoring in order to the maximum prevention of the risk of nosocomial and surgical infections.

Comparing the "pre-COVID-19 period" and the "COVID-19 early-stage period" for emergency medical services (COVID-19 발현 초기 119 구급대를 경유해 응급실로 내원하는 환자들의 이송 시간과 호소하는 증상의 변화 : 부산지역 일개 응급의료센터로 이송된 환자의 구급활동일지를 중심으로)

  • Kang, Ji-Hun;Ji, Jae-Gu;Jang, Yun-Deok;Lee, Si-Won;Kim, Seong-Ju
    • The Korean Journal of Emergency Medical Services
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    • v.24 no.3
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    • pp.161-169
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    • 2020
  • Purpose: This study aims to identify changes in patients' transport time and chief complaints visiting the emergency room via emergency medical services from the "pre-COVID-19 period" compared to the "COVID-19 early-stage period". Methods: This retrospective observational study analyzed the emergency medical services reports at two time periods defined by the COVID-19 virus outbreak in Korea. The study was conducted in Busan, the Republic of Korea, from January 19 through May 6, 2019. Results: The transfer time of patients transported during the "COVID-19 early-stage period" was significantly delayed compared to the "pre-COVID-19 period" (p<.05). We found a significant increase in transport time for patients complaining of respiratory infections compared to patients without symptoms (p<.05). During the "COVID-19 early-stage period", there was a significant increase in the number of patients with respiratory infections and patients complaining of general symptoms compared to the "COVID-19early-stage period" (p<.05). Conclusion: The spread of the COVID-19 virus infection delayed patient transport and increased the number of patients reporting respiratory infection symptoms. Emergency medical services will need administrative and economic support to transport the increased number of patients requiring services.

Long Term Result of Four Cases without a Staged Reconstruction of an Infected Achilles Tendon Following Repair (아킬레스건 봉합술 후 발생한 감염에서 이차적 건 재건을 시행하지 않고 치료한 4예의 장기 추시 결과)

  • Lee, Jaeyoung;Jeong, Changhoon;Jung, Sehoon;Park, Il-Jung
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.5
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    • pp.436-443
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    • 2020
  • The main treatment of infections following the repair of a ruptured Achilles tendon is debridement of the infected tissue and reconstruction of the Achilles tendon after controlling the infection. On the other hand, some studies recently reported excellent clinical results after the debridement of the infected Achilles tendon without a reconstruction of the tendon. This paper reports four cases of a competent result after the debridement of an infected Achilles tendon without reconstructing the tendon with a review of the relevant literature.

Transaxillary Capsulorrhaphy with Reimplantation to Correct Bottoming-Out Deformity in Breast Mycobacterial Periprosthetic Infection: A Case Report with Literature Review

  • Tsung-Chun Huang;Jian-Jr Lee;Kuo-Hui Yang;Chia-Huei Chou;Yu-Chen Chang
    • Archives of Plastic Surgery
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    • v.50 no.6
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    • pp.557-562
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    • 2023
  • Augmentation mammoplasty is one of the most popular cosmetic surgeries, but there is a high reoperation rate (29.7%) commonly due to capsular contracture, implant malpositioning, infection, and unsatisfactory size. Although infection only accounts for 2% of cases, its management is very challenging, especially with nontuberculous mycobacteria (NTM) infection. Breast prosthetic NTM infection is a rare but is a disastrous condition with an incidence of approximately 0.013%. Immediate salvage reimplantation is usually not suggested, and most studies recommend a gap of 3 to 6 months after combination antibiotics therapy before reimplantation. However, delayed reimplantation often leads to great psychological stress and struggle between the doctor and patient. We present the case report of successful reimplantation in treating prosthetic NTM infections in a 28-year-old female. We discuss a novel technique "transaxillary capsulorrhaphy" to correct the bottoming-out deformity. One year after the combination of antibiotics and surgery, the follow-up computed tomography scan showed complete remission of NTM without recurrence. We discuss the surgical technique in detail. The 1-year follow-up assessment (photos and dynamic video) revealed good cosmesis and reliable correction using the new technique. This report is the first formal description and discussion of one-stage reimplantation following NTM infections. Transaxillary capsulorrhaphy allows for a successful salvage operation when an implant is displaced. This approach provides highly favorable result in eastern women undergoing revision augmentation mammoplasty. This study reflects level of evidence V, considering opinions of respected authorities based on clinical experience, descriptive studies, or reports of expert committees.

Role of the Gastrocnemius Musculocutaneous with a Propeller Style Skin Flap in Knee Region Reconstruction: Indications and Pitfalls

  • Gianluca Sapino;Rik Osinga;Michele Maruccia;Martino Guiotto;Martin Clauss;Olivier Borens;David Guillier;Pietro Giovanni di Summa
    • Archives of Plastic Surgery
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    • v.50 no.6
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    • pp.593-600
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    • 2023
  • Background Soft tissue reconstruction around the knee area is still an open question, particularly in persistent infections and multiple reoperations scenario. Flap coverage should guarantee jointmobility and protection, even when foreign materials are implanted. The chimeric harvesting of the musculocutaneous gastrocnemius flap, based on the sural artery perforators, can extend its applicability in soft tissue reconstruction of the upper leg, overcoming the drawbacks of the alternative pedicled flaps. Methods A multicenter retrospective study was conducted enrolling patients who underwent to a pedicled, chimeric gastrocnemius musculocutaneous-medial sural artery perforator (GM-MSAP) or lateral sural artery perforator (GM-LSAP) flap for knee coverage in total knee arthroplasty (TKA) recurrent infections and oncological or traumatic defects of the upper leg from 2018 to 2021. Outcomes evaluated were the successful soft tissue reconstruction and flap complications. Surgical timing, reconstruction planning, technique, and rehabilitation protocols were discussed. Results Twenty-one patients were included in the study. Nineteen GM-MSAPs and 2 GM-LSAPs were performed (soft tissue reconstruction in infected TKA [12], in infected hardware [4], and in oncological patients [5]). Donor site was closed primarily in 9 cases, whereas a skin graft was required in 12. Flap wound dehiscence (1), distal flap necrosis (1), distal necrosis of the skin paddle (1), and donor site infection (1) were the encountered complications. Flap reraise associated to implant exchange or extensive debridement was successful without requiring any further flap surgery. Conclusion The propeller-perforator GM-MSAP offers qualitative defect coverage and easiness of multiple flap reraise due to skin availability and its laxity.

A Case of Metapneumovirus Pneumonia-Related Acute Respiratory Distress Syndrome in a Young Adult Patient (젊은 성인 환자에서 인간 메타뉴모바이러스 폐렴에 의한 급성 호흡곤란증후군)

  • Tae Wan Kim;Won-Young Kim
    • The Korean Journal of Medicine
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    • v.99 no.2
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    • pp.111-115
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    • 2024
  • Human metapneumovirus (hMPV) infections commonly present as mild upper respiratory tract infections in healthy adults, although severe respiratory complications have been observed, particularly in elderly and immunocompromised patients. We report a case in whom pneumonia caused by hMPV progressed to acute respiratory distress syndrome (ARDS) in a healthy adult without underlying diseases. A 31-year-old female presented with fever and dyspnea, prompting transfer to our hospital for mechanical ventilation 3 days after symptom onset. Auscultation revealed coarse breath sounds and crackles in both lung fields, and chest X-ray showed non-specific infiltrative nodules with poorly defined borders throughout both lungs. ARDS caused by community-acquired pneumonia was diagnosed. hMPV was identified via rapid testing of respiratory samples for genes that encode pneumonia pathogens and drug resistance markers; we employed reverse transcription polymerase chain reactions to these ends. Six days later, the patient was weaned off the mechanical ventilator, and discharged from the hospital in good clinical condition.

Risk factors for cytological progression in HPV 16 infected women with ASC-US or LSIL: The Korean HPV cohort

  • So, Kyeong A;Kim, Seon Ah;Lee, Yoo Kyung;Lee, In Ho;Lee, Ki Heon;Rhee, Jee Eun;Kee, Mee Kyung;Cho, Chi Heum;Hong, Sung Ran;Hwang, Chang Sun;Jeong, Mi Seon;Kim, Ki Tae;Ki, Moran;Hur, Soo Young;Park, Jong Sup;Kim, Tae Jin
    • Obstetrics & gynecology science
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    • v.61 no.6
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    • pp.662-668
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    • 2018
  • Objective This study was to identify the risk factors for cytological progression in women with atypical squamous cells of undetermined significance (ASC-US) or low-grade squamous intraepithelial lesions (LSIL). Methods We analyzed data from women infected with the human papillomavirus (HPV) who participated in the Korean HPV cohort study. The cohort recruited women aged 20-60 years with abnormal cervical cytology (ASC-US or LSIL) from April 2010. All women were followed-up at every 6-month intervals with cervical cytology and HPV DNA testing. Results Of the 1,158 women included, 654 (56.5%) and 504 (43.5%) women showed ASC-US and LSIL, respectively. At the time of enrollment, 143 women tested positive for HPV 16 (85 single and 58 multiple infections). Cervical cytology performed in the HPV 16-positive women showed progression in 27%, no change in 23%, and regression in 50% of the women at the six-month follow-up. The progression rate associated with HPV 16 infection was higher than that with infection caused by other HPV types (relative risk [RR], 1.75; 95% confidence interval [CI], 1.08-2.84; P=0.028). The cytological progression rate in women with persistent HPV 16 infection was higher than that in women with incidental or cleared infections (P<0.001). Logistic regression analysis showed a significant relationship between cigarette smoking and cytological progression (RR, 4.15; 95% CI, 1.01-17.00). Conclusion The cytological progression rate in HPV 16-positive women with ASC-US or LSIL is higher than that in women infected with other HPV types. Additionally, cigarette smoking may play a role in cytological progression.