• Tuberculosis and Respiratory Diseases
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• 제61권1호
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• pp.13-19
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• 2006

연구 배경: A. baumannii는 전 세계적으로 중요한 병원 내 병원균으로 부각되고 있고 이들 균에 의한 감염 또한 빠르게 증가하고 있다. 이들 감염에 연관된 사망률(균혈증:52%, 폐렴:23-73%)은 매우 높고 다제 내성은 비교적 흔하게 발생하고 있는 실정이다. 그러므로 다제 내성 A. baumannii 감염에 대한 효과적인 치료를 위해서 이들의 임상 특징과 결과를 분석하고 이해하는 것이 필요하다. 이에 본 연구는 A. baumannii 병원내 폐렴 중 다제 내성군과 약제 감수성군 간의 임상적 특징, 사망률, 이환율을 비교하였다. 방 법: 2002년 1월 1일부터 2004년 11월 1일까지 춘천성심병원에 입원했던 환자 중 Acinetobacter 병원 내 폐렴으로 판단되는 47명의 환자를 연구 대상으로 하였고 이들의 의무기록을 후향적으로 분석하였다. 본 연구에서는 다제 내성 A. baumannii를 실험 환경에서 A. baumannii에 효과적이며 상업적으로 이용할 수 있는 모든 항생제에 내성을 보이는 것으로 정의하였다. 결 과: 47명의 A. baumannii 병원내 폐렴 환자 중 17명이 다제 내성군, 30명이 약제 감수성군으로 분류되었다. 이들의 평균 연령은 다제 내성군은 $69{\pm}11$세, 약제 감수성군 $70{\pm}13$세이었고 APACHE II 점수, 중환자실 입원기간, 사망률에 있어서 두 군간에 유의한 차이는 없었다($16.1{\pm}5.4$ vs $14.9{\pm}4.8$, P=0.43, $25.1{\pm}13.6$ vs $39.1{\pm}31.0$, P=0.2, 58.8% vs 40%, P=0.21). 결 론: Acinetobacter baumannii 다제 내성군과 약제 감수성군 간의 사망률과 임상적 특징 사이에서 유의한 차이는 보이지 않았다. 그러나 양군 모두 사망률과 이환율은 높게 나타나 A. baumannii 감염의 효과적인 감시 및 조절이 지속적으로 필요하겠다.

• 대한간호학회지
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• 제33권6호
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• pp.686-692
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• 2003

Purpose: To assess the effect of handwashing improving program and MRSA carrier detection program on MRSA(methicillin resistant Staphylococcus aureus) infection rate in a intensive care unit. Method: The intervention was Nosocomial Infection(NI) control program consisted of hand washing improving program and identification and treatment of MRSA carrier. Data on the NI and MRSA infections were collected by an infection control nurse based on the definition of CDC. MRSA infection rates were calculated by the number of MRSA infection per 100 admissions or 1,000 patients-days. The difference of MRSA infection rates between pre and post intervention was tested by Chi-square at =.05. Result: MRSA infection rates 3.0% or 3.2 per 1,000 patient-days at the pre, 4.6% or 3.7 per 1,000 patient-days at the post, and the differences were not statistically significant (p=.411, p=.769 respectively). Conclusion: The handwashing improving program and MRSA carrier detection program was not effective in reducing the Nosocomial Infection(NI) or MRSA infection rates. It is recommended further studies with a longer intervention and follow-up period.

• 대한치과의사협회지
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• 제58권10호
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• pp.615-626
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• 2020

The outbreak of COVID-19, caused by SARS-CoV-2 infection, has spread worldwide and resulted in a pandemic for health systems. The disease is transmitted via respiration as droplets or aerosol. Due to the nature of dental treatment, aerosols, including body fluid, blood, and saliva, are frequently produced in dental hospitals. The present study investigated the potential risk of nosocomial infection of COVID-19 in dental hospitals to provide recommendations in clinical situations. The Seoul National University Dental Hospital in Korea established a countermeasure to cope with the clinical situation based on The Guidelines of Korean Centers for Disease Control & Prevention (KCDC) for dental practitioners and the available literature. Notably, numerous considerations for patient reservation and schedule management are required for space separation in the hospital, including infection control. Experiences in dental hospitals in Korea would be referable for other dental hospitals facing this infectious respiratory disease.

• Pediatric Infection and Vaccine
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• 제8권2호
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• pp.241-246
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• 2001

저자들은 급성 림프구성 백혈병으로 진단받고 항암 약물 치료 중인 10세 남아와 선천성 수신증으로 진단받고 도뇨관 유치 후 배뇨성 방광 요도 조영술을 촬영한 신생아에서 발생된 Burkholderia cepacia 패혈증을 혈액 배양 검사로 진단하고 이에 감수성이 있는 항생제 투여 후 임상적으로 호전을 보였기에 문헌고찰과 함께 보고하는 바이다.

• Journal of Korean Neurosurgical Society
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• 제48권2호
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• pp.99-104
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• 2010

Objective : We conducted this study to evaluate the clinical impact of early enteral nutrition (EN) on in-hospital mortality and outcome in patients with critical hypertensive intracerebral hemorrhage (ICH). Methods : We retrospectively analyzed 123 ICH patients with Glasgow Coma Scale (GCS) score of 3-12. We divided the subjects into two groups : early EN group (< 48 hours, n = 89) and delayed EN group ($\geq$ 48 hours, n = 34). Body weight, total intake and output, serum albumin, Creactive protein, infectious complications, morbidity at discharge and in-hospital mortality were compared with statistical analysis. Results : The incidence of nosocomial pneumonia and length of intensive care unit stay were significantly lower in the early EN group than in the delayed EN group (p < 0.05). In-hospital mortality was less in the early EN group than in the delayed EN group (10.1% vs. 35.3%, respectively; p = 0.001). By multivariate analysis, early EN [odds ratio (OR) 0.229, 95% CI : 0.066-0.793], nosocomial pneumonia (OR = 5.381, 95% CI : 1.621-17.865) and initial GCS score (OR = 1.482 95% CI : 1.160-1.893) were independent predictors of in-hospital mortality in patients with critical hypertensive ICH. Conclusion : These findings indicate that early EN is an important predictor of outcome in patients with critical hypertensive ICH.

• International Journal of Oral Biology
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• 제35권1호
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• pp.7-12
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• 2010

The aims of this study were to investigate the nosocomial infection route of methicillin-resistant Staphylococcus aureus (MRSA) and explore preventative methods for this pathogen that involve blocking its dispersion. We cultured MRSA from nasal cavity swabs collected between June and July 2008 that we obtained from eight dental healthcare providers, 32 nurses and the sputum specimens of two patients from our hospital. In addition, we used VITEK 2 equipment to measure drug sensitivity, and we further performed biochemical testing and pulse-field gel electrophoresis (PFGE) to isolate MRSA colonies. The incidence of these bacteria on the nasal swabs was 25.0% from dental clinic healthcare providers, 13.6% from the internal medicine ward nurses and 30.0% from intensive care unit nurses. Moreover, MRSA was detectable in sputum specimens of ward patients. The antimicrobial agents resistance and partial PFGE types of MRSA showed a similar pattern. We suggest from these analyses that nasal cavity infection by MRSA could occur by cross contamination between healthcare providers and patients which underscores the importance of stringent MRSA management practices.

• Journal of Korean Biological Nursing Science
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• 제10권2호
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• pp.147-153
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• 2008

Purpose: Methicillin Resistant Staphylococcus aureus (MRSA) has become a major clinical problem and one of the major nosocomial pathogen worldwide. The aim of the study was to investigate the epidemiological characteristics of genotypes of MRSA isolated in the A-hospital ICU. Methods: In the period between December 2007 and May 2008, MRSA was isolated from ICU patients and its surrounding environment. Polymerase Chain Reaction (PCR) was conducted for the detection of MRSA gene. The incidence of MRSA in the clinical isolates of Staphylococcus aureus was examined by using a multiplex PCR. The spa gene of Staphylococcus aureus encodes protein A and is used for typing of MRSA. We used sequence typing of the spa gene repeat region to study the epidemiology of MRSA at a hospital. Results: Two different genotypes of MRSA were identified with 90 isolated from the patients and its surrounding environments in the ICU. Conclusion: This study may contribute to the development of effective strategies for preventing nosocomial infections. Genotyping may have more general application for the study of MRSA epidemic outbreak in hospital and community infection.

• Asian Pacific Journal of Cancer Prevention
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• 제15권7호
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• pp.3071-3074
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• 2014

Background: To investigate the related risk factors of postoperative nosocomial pneumonia (POP) in patients withI-IIIa lung cancer. Methods: Medical records of 511 patients who underwent resection for lung cancer between January 2012 to December 2012 were retrospectively reviewed. Risk factors of postoperative pneumonia were identified and evaluated by univariate and multivariate analyses. Results: The incidence of postoperative pneumonia in these lung cancer patients was 2.9% (15 cases). Compared with 496 patients who had no pneumonia infection after operation, older age (>60), histopathological type of squamous cell carcinoma and longer surgery time (>3h) were significant risk factors by univariate analysis. Other potential risk factors such as alcohol consumption, history of smoking, hypersensitivity, hypertension, diabetes mellitus and so on were not showed such significance in this study. Further, the multivariate analysis revealed that old age (>60 years) (OR 5.813, p=0.018) and histopathological type of squamous cell carcinoma (OR 5.831, p<0.001) were also statistically significant independent risk factors for postoperative pneumonia. Conclusions: This study demonstrated that being old aged (>60 years) and having squamous cell carcinoma histopathological type might be important factors in determining the risk of postoperative pneumonia in lung cancer patients after surgery.

• 한국임상수의학회지
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• 제22권1호
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• pp.50-55
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• 2005

We investigated the contamination of animal hospital floor, beauty table, computer keyboard, exam table, operation table and forcep handle by isolations of aerobic bacteria in small animal hospitals in Gwangju. The total number of aerobic bacteria was 52 isolates and Staphylococcus spp. (38 isolates) were the predominant isolates (69.71 %) of them. The prevalent contaminated areas were floor (17 isolates), beauty table (13 isolates) and computer keyboard (9 isolates). The detection of methicillin-resistant (mecA) gene, determined by PCR, showed that 3 of the 17 coagulase-negative Staphylococcus spp. (CNS) isolates possessed the mecA gene. For evaluating the antibiotic susceptibility patterns of the isolates, disk diffusion method was used. The majority of isolates showed high susceptibility to amoxicillin (92.1 %), ceftiofur (84.2%) and polymixin B (73.7%). Also they showed the high resistant to ampicilline (66.7%), penicillin (65%) and kanamycin (56.5%). These results suggest extensive contamination of aerobic bacteria in animal hospital environment.

• 기본간호학회지
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• 제12권3호
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• pp.395-403
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• 2005

Purpose: Methicillin-resistant Staphylococcus aureus (MRSA) is a major nosocomial pathogen in the intensive care units (ICUS). The purpose of this case-control study is to identify risk factors for acquisition of MRSA during ICU stays in patients with and without MRSA. Method: The study was conducted in a 16 beds-neurosurgical intensive care unit of a 2200-bed tertiary care university hospital in Seoul, Korea. Medical record and Critical Classification Scoring System were reviewed retrospectively in patients who were admitted more than 3 days from August 1, 2003 to May 30, 2004. Cases and controls were matched for age and gender. The obtained specimens were nasal swab and sputum. Result: There were 950 patients' admissions during the period. Among them, MRSA was isolated from twenty-three patients who were considered as hospital acquired. Artificial airway (p=.045), frequency of suction (p=.002), nasogastric tube (p=.004), wound drain (p=.045), and vancomycin (p=.019) were risk factors for MRSA acquisition in univariate analysis. Frequency of suction (p=.012, OR 3.5) was revealed as the only risk factor in multivariate conditional logistic regression. Conclusion: Our findings give support to recent studies that suggest that frequent physical contact maγ increase the nosocomial acquisition of MRSA in a neurosurgical ICU.