• 제목/요약/키워드: Infection management

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Management of Infections with Rapidly Growing Mycobacteria after Unexpected Complications of Skin and Subcutaneous Surgical Procedures

  • Lim, Jong-Min;Kim, Jong-Hwan;Yang, Ho-Jik
    • Archives of Plastic Surgery
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    • 제39권1호
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    • pp.18-24
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    • 2012
  • Background : Infection caused by rapidly growing mycobacteria (RGM) is not uncommon, and the prevalence of RGM infection has been increasing. Clinical diagnosis is difficult because there are no characteristic clinical features. There is also no standard antibiotic regimen for treating RGM infection. A small series of patients with RGM infections was studied to examine their treatments and outcomes. Methods : A total of 5 patients who had developed postoperative infections from January 2009 to December 2010 were retrospectively reviewed. Patients were initially screened using a mycobacteria rapid screening test (polymerase chain reaction [PCR]-reverse blot hybridization assay). To confirm mycobacterial infection, specimens were cultured for nontuberculous mycobacteria and analyzed by 16 S ribosomal RNA and rpoB gene PCR. Results : The patients were treated with intravenous antibiotics during hospitalization, and oral antibiotics were administered after discharge. The mean duration of follow-up was 9 months, and all patients were completely cured of infection with a regimen of a combination of antibiotics plus surgical treatment. Although none of the patients developed recurrence, there were complications at the site of infection, including hypertrophic scarring, pigmentation, and disfigurement. Conclusions : Combination antibiotic therapy plus drainage of surgical abscesses appeared to be effective for the RGM infections seen in our patients. Although neither the exact dosage nor a standardized regimen has been firmly established, we propose that our treatment can provide an option for the management of rapidly growing mycobacterial infection.

코로나-19 관련 감염률과 치명률의 결정요인: 95개국 사례연구 (Determinants of COVID-19 related infection rates and case mortality rates: 95 country cases)

  • 진기남;한지은;박현숙;한철주
    • 한국병원경영학회지
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    • 제25권4호
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    • pp.1-12
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    • 2020
  • During the COVID-19 pandemic, most of the western countries with advanced medical technology failed to contain coronavirus. This fact triggered our research question of what factors influence the clinical outcomes like infection rates and case mortality rates. This study aims to identify the determinants of COVID-19 related infection rates and case mortality rates. We considered three sets of independent variables: 1) socio-demographic characteristics; 2) cultural characteristics; 3) healthcare system characteristics. For the analysis, we created an international dataset from diverse sources like World Bank, Worldometers, Hofstede Insight, GHS index etc. The COVID-19 related statistics were retrieved from Aug. 1. Total cases are from 95 countries. We used hierarchical regression method to examine the linear relationship among variables. We found that obesity, uncertainty avoidance, hospital beds per 1,000 made a significant influence on the standardized COVID-19 infection rates. The countries with higher BMI score or higher uncertainty avoidance showed higher infection rates. The standardized COVID-19 infection rates were inversely related to hospital beds per 1,000. In the analysis on the standardized COVID-19 case mortality rates, we found that two cultural characteristics(e.g., individualism, uncertainty avoidance) showed statistically significant influence on the case mortality rates. The healthcare system characteristics did not show any statistically significant relationship with the case mortality rates. The cultural characteristics turn out to be significant factors influencing the clinical outcomes during COVID-19 pandemic. The results imply that the persuasive communication is important to trigger the public commitment to follow preventive measures. The strategy to keep the hospital surge capacity needs to be developed.

Factors associated with performance of infection control among some physical therapists

  • Seol, Yoon-Yee;Han, Mi Ah;Park, Jong;Ryu, So Yeon
    • The Journal of Korean Physical Therapy
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    • 제28권2호
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    • pp.155-163
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    • 2016
  • Purpose: Infection management is important for physical therapists in order to protect patients and themselves since they often provide patient care and have physical contact with patients. This study examined the performance of infection control and associated factors among physical therapists. Methods: The study subjects were 174 physical therapists working in the G metropolitan city. The performance of infection control according to general characteristics, job-related characteristics, and infection-related characteristics were compared using t-test and ANOVA. Associations between awareness and performance of infection control were tested by correlation. Finally, multiple linear regression analyses were performed to examine the factors associated with performance of infection control. Results: Overall performance scores for personal and therapy room were $87.47{\pm}11.70$ and $70.08{\pm}13.68$, respectively. Both personal and therapy room infection control were lower for the degree of performance than the degree of awareness. In multiple linear regression analysis, the degree of performance at a personal level was related to current smoking status, type of charge therapy, supply of protection equipment, and awareness of personal infection control. The degree of performance of therapy room was related to injury experience in the workplace, supply of protection equipment, and awareness of therapy room infection control. Conclusion: Performance of therapy room infection control was lower than that of personal infection control. The performance was associated with the supply of protection equipment and awareness. Therefore, the degree of performance for infection control will be increased with proper supply of protection equipment in the hospital and increase the degree of awareness with adequate prevention education.

The association between COVID-19 Knowledge, perception of infection control and infection control practice among dental hygienists

  • Seon-Rye, Kim
    • 한국컴퓨터정보학회논문지
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    • 제28권2호
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    • pp.171-179
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    • 2023
  • 이 연구는 코로나19 팬데믹 상황이후 치과감염관리실태를 알아보고자 시행하였다. 치과위생사들을 대상으로 코로나19에 관한 지식과 감염관리인식, 감염관리실행정도를 파악하고, 이들 사이의 연관성을 측정하였다. 일반적 질문 9개, 코로나19 지식 10개, 감염관리에 대한 인식과 실행에 관한 36개 문항으로 이루어진 설문지를 이용하여, 2021년 5월 1일부터 31일까지 조사된 120부를 분석하였다. 분석을 위하여 T검정, 분산분석, 피어슨의 상관관계를 이용하였다. 연구결과, 코로나19 지식은 10점 중 6.59점, 감염관리 인식은 4점 중 3.57점, 감염관리 실행은 4점중 3.55점이었다. 코로나19 지식과 감염관리 실행은 0.485 양의 상관관계, 감염관리 인식과 감염관리 실행은 0.614 양의 상관관계로 코로나19 지식보다 상관관계가 유의미하게 높았다. 코로나19와 같은 감염병을 차단하기 위해서는, 치과에서 치과위생사들에게 감염관리에 대한 교육을 의무화하고, 치과감염관리 매뉴얼에 따라 감염관리 실행을 의무화해야 할 것이다.

부산지역 초음파실 근무인원의 병원감염관리 인식 분석 (Analysis of Hospital Infection Control Awareness of Ultrasound Room Office Personnel in Busan)

  • 김정훈;강세식;김창수
    • 대한방사선기술학회지:방사선기술과학
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    • 제38권2호
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    • pp.135-143
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    • 2015
  • 부산지역 초음파실 근무인원 146명을 대상으로 설문조사를 실시하여 병원감염에 대한 인식을 분석하였다. 그 결과, 개인 위생관리와 손씻기 관리인식도, 수행도는 학력이 높을수록 그 수치는 높았으며, 초음파 장비 위생관리에 관한 인식도에서는 감염교육 경험이 있는 집단이, 수행도에서는 대졸미만의 집단이 가장 높은 수치와 통계적으로 차이가 있는 것으로 분석 되었다. 본 연구 결과를 토대로 전체적인 인식도에 비해 수행도는 낮게 분석되었다. 이러한 결과는 수행하는 정도가 미흡하다는 것으로 해석할 수 있다. 그러므로 이를 해결하기 위해 감염교육을 통한 각자 개인위생에 대한 인식의 전환과 관심이 필요하다고 판단된다.

Management of complex surgical wounds of the back: identifying an evidence-based approach

  • Zolper, Elizabeth G.;Saleem, Meher A.;Kim, Kevin G.;Mishu, Mark D.;Sher, Sarah R.;Attinger, Christopher E.;Fan, Kenneth L.;Evans, Karen K.
    • Archives of Plastic Surgery
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    • 제48권6호
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    • pp.599-606
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    • 2021
  • Background Postoperative dehiscence and surgical site infection after spinal surgery can carry serious morbidity. Multidisciplinary involvement of plastic surgery is essential to minimizing morbidity and achieving definitive closure. However, a standardized approach is lacking. The aim of this study was to identify effective reconstructive interventions for the basis of an evidence-based management protocol. Methods A retrospective review was performed at a single tertiary institution for 45 patients who required 53 reconstruction procedures with plastic surgery for wounds secondary to spinal surgery from 2010 to 2019. Statistical analysis was performed for demographics, comorbidities, and treatment methods. Primary outcomes were postoperative complications, including dehiscence, seroma, and infection. The secondary outcome was time to healing. Results The overall complication rate was 32%, with dehiscence occurring in 17%, seroma in 15% and infection in 11% of cases. Median follow-up was 10 months (interquartile range, 4-23). Use of antibiotic beads did not affect rate of infection occurrence after wound closure (P=0.146). Use of incisional negative pressure wound therapy (iNPWT) was significant for reduced time to healing (P=0.001). Patients treated without iNPWT healed at median of 67.5 days while the patients who received iNPWT healed in 33 days. Demographics and comorbidities between these two groups were similar. Conclusions This data provides groundwork for an evidence-based approach to soft tissue reconstruction and management of dehiscence after spinal surgery. Timely involvement of plastic surgery in high-risk patients and utilization of evidence-based interventions such as iNPWT are essential for improving outcomes in this population.

Absorbable Plate-Related Infection after Facial Bone Fracture Reduction

  • Choi, Seung Hyup;Lee, Jang Hyun
    • 대한두개안면성형외과학회지
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    • 제17권1호
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    • pp.1-4
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    • 2016
  • Absorbable plates are used widely for fixation of facial bone fractures. Compared to conventional titanium plating systems, absorbable plates have many favorable traits. They are not palpable after plate absorption, which obviates the need for plate removal. Absorbable plate-related infections are relatively uncommon at less than 5% of patients undergoing fixation of facial bone fractures. The plates are made from a mixture of poly-L-lactic acid and poly-DL-lactic acid or poly-DL-lactic acid and polyglycolic acid, and the ratio of these biodegradable polymers is used to control the longevity of the plates. Degradation rate of absorbable plate is closely related to the chance of infection. Low degradation is associated with increased accumulation of plate debris, which in turn can increase the chance of infection. Predisposing factors for absorbable plate-related infection include the presence of maxillary sinusitis, plate proximity to incision site, and use of tobacco and significant amount of alcohol. Using short screws in fixating maxillary fracture accompanied maxillary sinusitis will increase the rate of infection. Avoiding fixating plates near the incision site will also minimize infection. Close observation until complete absorption of the plate is crucial, especially those who are smokers or heavy alcoholics. The management of plate infection is varied depending on the clinical situation. Severe infections require plate removal. Wound culture and radiologic exam are essential in treatment planning.

간호사의 중동호흡기증후군 감염 실태와 감염관리 인식 (Infection Control of Hospital Nurses: Cases of Middle East Respiratory Syndrome)

  • 전경자;최은숙
    • 한국직업건강간호학회지
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    • 제25권1호
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    • pp.1-8
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    • 2016
  • Purpose: The 2015 Korean Middle East Respiratory Syndrome Coronavirus (MERS-CoV) outbreaks resulted in 186 cases, with 8% (15 persons) of these being nurses. This study aimed to examine MERS-CoV infection status of clinical nurses and to evaluate perception for infection control. Methods: We investigated the MERS-CoV infection status of nurses using MERS-CoV press release data. We examined and analysed perception for Infection control of 121 nurses of the three MERS intensive therapeutic hospitals in July 2015. Results: One to six nurses per hospital in total 8 health care facilities were infected with MERS-CoV. They mainly had short clinical careers and were unaware of infection possibility. The personal and organizational infection control levels that nurses perceive were low and the relationship between two levels was statistically significant. Conclusion: For promoting health protection and infectious disease management competency of nurses, it is necessary to prepare institutional system for controlling infectious disease.

의료기관 종사자의 잠복결핵감염 유병률과 위험요인 분석 (Analysis of Prevalence and Risk Factors for Latent Tuberculosis Infection among Healthcare Workers)

  • 이재백;최정실
    • Journal of Korean Biological Nursing Science
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    • 제21권4호
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    • pp.300-307
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    • 2019
  • Purpose: The purpose of this study was to provide basic data on the infection prevention management program, which is one of the infectious disease control program by identifying the prevalence and risk factors of latent tuberculosis infection (LTBI) in healthcare workers. Methods: We surveyed a total of 3,046 LTBI test results, including those of 2,269 existing staff and 777 new employees. An interferon-gamma release assay (IGRA) for the diagnosis of LTBI was performed using QuantiFERON®-TB Gold In-Tube (QFT-IT). The risk factors of LTBI were analyzed using logistic regression analysis. Results: The overall prevalence of LTBI was 16.0% (487/3,046). The prevalence of LTBI in the existing staff was 17.9% (406/2,269) and the prevalence of LTBI in new employees was 10.4% (81/777). Multivariate logistic regression analysis revealed that the risk factors of latent tuberculosis infection among the existing staff were gender, age and work period wheres, the risk factor amongst the new employees depended on their age. Conclusion: The LTBI was not related to the type of occupation and work unit. Therefore, while establishing an infection control program for the prevention of tuberculosis infection at medical institurions, institutional heads and infection control experts should encompass a policy for all the employees.

Clostridium difficile in Children: To Treat or Not to Treat?

  • Shim, Jung Ok
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제17권2호
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    • pp.80-84
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    • 2014
  • Clostridium difficile infection has been increasing since 2000 in children and in adults. Frequent antibiotics use, comorbidity, and the development of hypervirulent strains have increased the risk of infection. Despite the high carriage rates of C. difficile, infants rarely develop clinical infection. Discontinuing antibiotics and supportive management usually leads to resolution of disease. Antibiotics use should be stratified depending on the patient's age and severity of the disease.