• Title/Summary/Keyword: Hospital infections

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The Effects of a Mupirocin Smear in the Nasal Cavity Against Nosocomial Infections (비강 내 약물 도포가 병원 감염 예방에 미치는 효과)

  • Kil Suk-Young
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.6 no.2
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    • pp.255-266
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    • 1999
  • This study was done to analyze the effects of a smear in the nasal cavity against nosocomial Infection. The smear used was mupirocin, and the study centered on infection which constitutes the majority of nosocomial infections called MRSA. The data were collected between March 23 1998 and June 31 of the same year in a university hospital in the Kyongi Province, and is made up of a experimental group of 14 patients who were given nasal cavity smears and a control group of 16 patients who were not given nasal cavity smears. The data were analyzed through frequency and the Chi-square tests and gave forth these results. 1. Of the experimental group 28.6% developed nosocomial infections while 62.5% of the control group developed infections. This difference was significant. 2. In the experimental group, all of the patients developed infections within the first week in the ICU, while 80% of the control group developed infections in the first week and 20% in the second week. The difference was not as marked here. 3. In the experimental group the DM group 66.7% contracted MRSA while 18.2% developed it in the non-DM group showing that the DM group had infection rate was 3.7 times higher than the non-DM groups. In the control group the DM group had a 100% infection rate while 50% of the non-DM group developed it. Overall the DM group's rate infection was 2.4 times higher than the non-DM group. 4. In the experimental group, 37.55% of the patients who had a tracheostomy developed it while 16.7% of the patients who did not have a tracheostomy developed infections. In the control group, 62.5% of the patients who had tracheostomy, and 37.5% of the patients who did not have tracheostomies developed infections. Those who had tracheostomies, and the control group had double the rate contracting infections. From these results we can see that nasal cavity smears are effective against nosocomial infections. In spite of the smears, patients with the diabetes mellitus had a high MRSA infection rate, which requires new alternative treatments.

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Factors Related to Surgical Site Infections in Patients Undergoing General Surgery (일반외과 환자의 수술부위 감염 관련 요인 분석)

  • Ahn You-Jin;Sohng Kyeong-Yae
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.12 no.1
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    • pp.113-120
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    • 2005
  • Purpose: To identify risk factors for surgical site infections in patients undergoing general surgery, to analyze the prolonged hospital stay and extra cost for antibiotics, and to provide basic data for control of surgical site infections. Method: Surgical site infection was defined using the definition of the CDC and the data were analyzed by $x^2$-test and unpaired t-test. Results: The prevalence of surgical site infections was 9.7%, and it was related to wound class, duration of operation, number of operations, whether the operation was an emergency, trauma, drains, preoperative stays, presence of remote infection during operative period, and previous history of recent surgery. The mean duration for post-operative stay when a surgical site infection occurred was 9.5 days and in 56.9 % of the patients the surgical site infection appeared 7 days after the operation. Post-operative stays for infected patients were 20.3 days longer than that of uninfected patients. The mean cost of antibiotics for infected patients was higher than that for uninfected patients by 561,067 won per person. Conclusion: Surgical site infection results in an increased length of stay and extra-cost, thus, hospitals need to create strategies to reduce nosocomial infections through effective infection surveillance and by considering factors related to surgical site infections.

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Parasitic infections in HIV-infected patients who visited Seoul National University Hospital during the period 1995-2003

  • GUK Sang-Mee;SEO Min;PARK Yun-Kyu;OH Myoung-Don;CHOE Kang-Won;KIM Jae-Lip;CHOI Min-Ho;HONG Sung-Tae;CHAI Jong-Yil
    • Parasites, Hosts and Diseases
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    • v.43 no.1 s.133
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    • pp.1-5
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    • 2005
  • The prevalence of parasitic infections was investigated in human immunodeficiency virus (HIV)-infected patients (n = 105) who visited Seoul National University Hospital, Seoul, Korea, during the period from 1995 to 2003. Fecal samples were collected from 67 patients for intestinal parasite examinations, and sputum or bronchoalveolar lavage samples from 60 patients for examination of Pneumocystis carinii. Both samples were obtained from 22 patients. Thirty-three ($31.4\%$) of the 105 were found to have parasitic infections; Cryptosporidium parvum ($10.5\%$; 7/67), Isospora belli ($7.5\%$; 5/67), Clonorchis sinensis ($3.0\%$; 2/67), Giardia lamblia ($1.5\%$; 1/67), Gymnophalloides seoi ($1.5\%$; 1/67), and Pneumocystis carinii ($28.3\%$; 17/60). The hospital records of the 11 intestinal parasite-infected patients showed that all suffered from diarrhea. This study shows that parasitic infections are important clinical complications in HIV-infected patients in the Republic of Korea.

Clinical Characteristics of Spinal Epidural Abscess Accompanied by Bacteremia

  • Chae, Ho-jun;Kim, Jiha;Kim, Choonghyo
    • Journal of Korean Neurosurgical Society
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    • v.64 no.1
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    • pp.88-99
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    • 2021
  • Objective : The treatment of choice for spinal epidural abscess (SEA) generally is urgent surgery in combination with intravenous antibiotic treatment. However, the optimal duration of antibiotic treatment has not been established to date, although 4-8 weeks is generally advised. Moreover, some researchers have reported that bacteremia is a risk factor for failure of antibiotic treatment in SEA. In this study, we investigated the clinical characteristics of SEA accompanied by bacteremia and also determined whether the conventional 4-8 weeks of antibiotic treatment is sufficient. Methods : We retrospectively reviewed the medical records and radiological data of 23 patients with bacterial SEA who underwent open surgery from March 2010 to April 2020. All patients had bacteremia preoperatively and underwent weeks of perioperative antibiotic treatments based on their identified organisms until all symptoms of infection disappeared. All patients underwent microbiological studies of peripheral blood, specimens from SEA and concomitant infections. The mean follow-up duration was 35.2 months, excluding three patients who died. Results : The male : female ratio was 15 : 8, and the mean age was 68.9 years. The SEA most commonly involved the lumbar spinal segment (73.9%), and the mean size was 2.9 vertebral body lengths. Mean time periods of 8.4 days and 16.6 days were required from admission to diagnosis and from admission to surgery, respectively. Concomitant infections more frequently resulted in delayed diagnosis (p=0.032), masking the symptoms of SEA. Methicillin-sensitive Staphylococcus aureus was the most commonly identified pathogen in both blood and surgical specimens. Seventeen patients (73.9%) showed no deficits at the final follow-up. The overall antibiotic treatment duration was a mean of 66.6 days, excluding three patients who died. This duration was longer than the conventionally advised 4-8 weeks (p=0.010), and psoas or paraspinal abscess required prolonged duration of antibiotic treatment (p=0.038). Conclusion : SEA accompanied by bacteremia required a longer duration (>8 weeks) of antibiotic treatment. In addition, the diagnosis was more frequently delayed in patients with concomitant infections. The duration of antibiotic treatment should be extended for SEA with bacteremia, and a high index of suspicion is mandatory for early diagnosis, especially in patients with concomitant infections.

Travelers' malaria among foreigners at the Hospital for Tropical Diseases, Bangkok, Thailand - a 6-year review (2000-2005)

  • Piyaphanee Watcharapong;Krudsood Srivicha;Silachamroon Udomsak;Pornpininworakij Karnchana;Danwiwatdecha Phatcharee;Chamnachanan Supat;Wilairatana Polrat;Looareesuwan Sornchai
    • Parasites, Hosts and Diseases
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    • v.44 no.3
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    • pp.229-232
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    • 2006
  • We retrospectively examined the charts of travelers admitted to the Hospital for Tropical Diseases, Bangkok, Thailand, with malaria during the years 2000-2005. Twenty-one cases of malaria were identified, of which 12 (57%) were Plasmodium vivax infections and 9 (43%) were P. falciparum infections. There was one mixed case with vivax and falciparum infection. Only 1 P. falciparum case had complications. All cases were successfully treated with standard antimalarial drugs. Only 3 of the 21 cases were thought to be acquired in Thailand, the rest were regarded to be imported.

Microsurgical Debridement for Persistent Ulcers Due to Rare Fungus Infection: Case Report and Literature Review

  • Yu-Wen Tsui;Chia-Yu Tsai;Hung-Chi Chen
    • Archives of Plastic Surgery
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    • v.51 no.1
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    • pp.135-138
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    • 2024
  • A patient suffered from chronic ulcer due to recalcitrant fungal infection for 3.5 years. Five antifungal agents and 40 times of debridement—all failed. Finally, radical microscopic debridement was performed for eradication of fungal conidiospores. Since then, there was no recurrence at 2 years of follow-up. Scopulariopsis brevicaulis is one of the rarest pathogens of cutaneous fungal infections, for which multidrug resistance increased the complexity and difficulty of treatment. Radical excision, especially microscopic debridement, was the key for eradication of fungal conidiospores in this case.

Descending Necrotizing Mediastinitis from Odontogenic Infection: a Case Report (치성감염에 의한 하행 괴사성 종격동염: 증례보고)

  • Jeong, Yong-Seon;Chae, Byung-Moo;Jo, Hyun-Joo;Kim, So-Hyun;Jung, Tae-Young;Park, Sang-Jun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.32 no.6
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    • pp.577-581
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    • 2010
  • Descending necrotizing mediastinitis (DNM) is a complication of odontogenic or oropharyngeal infections that can spread to the mediastinum. Such infections is serious, leading to sepsis and frequently to death. Even in this era of antibiotics, the mortality rate associated with DNM is approximately 40%. It is difficult to diagnose early because clinical and radiologic findings appear in the late stage of the infection. Delayed diagnosis is the principal reason for the high mortality in DNM. Therefore, descending necrotizing mediastinitis requires an early and aggressive surgical approach to reduce the high morbidity and mortality associated with this disease. We experienced a case of odontogenic infection followed by acute mediastinitis, so present now with the review of literatures.

Differentiation between Viral and Urinary Tract Infections Using the Modified Rochester Criteria In Febrile Infants Younger than three Months

  • Kim, Tae Hee;Hwang, Ji Hye;Yi, Dae Yong;Yun, Ki Wook;Lim, In Seok
    • Childhood Kidney Diseases
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    • v.19 no.2
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    • pp.118-124
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    • 2015
  • Purpose: The symptoms and signs of urinary tract infection (UTI) in early infancy are non-specific. Prompt diagnosis of UTI is important, as untreated UTI results in renal damage. Especially, febrile UTI in young infants coexist with other serious bacterial infections. The purpose this study was to propose modified Rochester criteria to differentiate viral infection from urinary tract infection. Methods: We carried out a retrospective investigation of 168 infants less than three months old with a tympanic temperature $>38^{\circ}C$ who were admitted to Chung-Ang University Hospital between 2011 and 2014. We compared the symptoms, physical examination results, and laboratory data between viral infection and UTI groups. A modified Rochester criterion was composed of statistically significant factors. Results: A total of 76 and 92 infants with UTI and a viral infection, respectively, were included. Statistically significant differences in gender, previous admission history, neutrophil ratio, and urine WBC count were found between the two study groups. Using a cut off value of 3 points, the sensitivity and specificity of the modified Rochester criteria were 71.28% and 78.57%, respectively. Conclusion: The modified Rochester criteria may give an outline for identifying young infants with UTI.

Empyema caused by Clostridium perfringens

  • Park, Hyun-Sun;Jung, Chul-Min;Choi, Jang-Won;Hong, Yoonki;Kim, Woo Jin
    • Journal of Yeungnam Medical Science
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    • v.32 no.1
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    • pp.35-37
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    • 2015
  • Pleuropulmonary diseases caused by Clostridial species infections are rare, but have a mortality rate of up to 30%. Furthermore, older people are at greater risk of developing invasive clostridium infections, and the majority of reported cases of clostridium empyema have been attributed to iatrogenic trauma or aspiration. The authors report a case of spontaneous empyema caused by Clostridium perfringens. A 72-year-old woman was admitted to Kangwon National University Hospital for empyema. The patient had no history of trauma, a dental procedure, or aspiration, and was treated using empirical antibiotics and by drainage of pleural fluid. Bacteria species that cause empyema are usually not detected, but on the 4th day of admission, C. perfringens was isolated from the pleural space. The patient was continuously treated with antibiotics for C. perfringens and drainage, and was discharged 25 days after admission with almost a fully recovered status. Increased awareness of Clostrium species infection in the elderly is needed to ensure appropriate treatment.

Incidence and Clinical Manifestations of Rotaviral Infections in a Neonatal Intensive Care Unit (신생아중환자실 내 로타바이러스 감염의 발생 및 임상 양상)

  • Baek, Jae-Moon;Kim, Hee-Young;Lee, Jang-Hoon;Choi, Byung-Min;Lee, Jung-Hwa;Lee, Kwang-Chul;Hong, Young-Sook
    • Neonatal Medicine
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    • v.16 no.1
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    • pp.55-63
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    • 2009
  • Purpose: This study was conducted to investigate the incidence and clinical manifestations of rotaviral infections in the neonatal intensive care unit (NICU). We also investigated whether neonates referred from other hospitals cause outbreaks of rotaviral infections in the NICU. Methods: Neonates diagnosed wit rotaviral infections in the NICU at Korea University Ansan Hospital between January 2002 and December 2006 were evaluated retrospectively. Results: Of 1,501 neonates admitted to the NICU, the number of rotaviral infections was 94 (6.3%) and the prevalence was 4.9 cases per 1,000-hospital days. Of 223 neonates referred from other hospitals to our NICU, 24 (10.8%) were confirmed to have rotaviral infections at the time of referral. Common symptoms of rotaviral infections were jaundice diarrhea or loose stools, vomiting, fever, apnea, irritability, seizures, and moaning sounds. Necrotizing enterocolitis of stage II or more was diagnosed in 3 premature neonates, accounting for 3.2% of total infected neonates and 6.8% of premature infected patients. There were no statistically significant differences in the prevalence of symptoms between term and preterm neonates, except for jaundice that is more frequent in premature infants. In time series analysis, the admission of neonates who were born at other hospitals and diagnosed with rotaviral infections were associated 1 month later by increased cases of neonates with rotaviral infections who were born at our hospital, whereas new cases of rotaviral infections among inborn neonates were decreased 2 and 4 months later (P<0.05). Conclusion: Rotaviral infections in NICU were not rare and showed vague symptoms. Three cases (3.2%) were diagnosed with stage II or more necrotizing enterocolitis. The referred neonates with rotaviral infections may induce outbreaks in the NICU, therefore awareness and strict surveillance for rotaviral infections should be performed at the time of referral.