Osteomyelitis of the jaw infected with Coagulase-Negative Staphylococci (CNS) is rarely reported in the Oral and Maxillofacial Region. Staphylococcus is a part of the normal body flora, but it may be cause severe infections and CNS are often described as the important pathogens in nosocomial infections. Although many studies on prevalence and antibiotics of Staphylococcus aureus have been done, but many of these studies focus only on Methicillin-resistant S. aureus and not on methicillin-resistant coagulase-negative Staphylococci (MRCNS). There was a less study about CNS or MRCNS infections in the Oral and Maxillofacial Region. This report describes a case of a 41-year-old male patient who developed osteomyelitis caused by MRCNS on condyle after open reduction and internal fixation and suggests guideline for the prevention of postoperative infection and appropriate recommendation for treatment and control.
Methicillin-Resistant Staphylococcus aureus (MRSA) strains are resistant to a wide range of antibiotics and are a major cause of nosocomial infections. Accurate and rapid typing of MRSA is needed to implement effective infection control measures. Arbitrarily Primed PCR (AP-PCR) is a very useful method in rapid typing. AP-PCR is not necessary information about target DNA sequence because this is basically DNA amplification and could be useful in epidemiological typing by classified band pattern. In this study, MRSA were isolated and identified from ICU, Neu, IM and Ped environments and investigated molecular typing by AP-PCR. Ped, the MRSA pattern determines the la, IIa type, 1M is Ib type, Neu is IIa type and ICU determines the IIa, lIb types. All MRSA in this study were typeable by AP-PCR, which was easy to perform and reproduce with evidence of MRSA for purposes of nosocomial infection control.
Objectives: To evaluate the occurrence of patient adverse events in Korean hospitals as perceived by nurses and examine the correlation between patient adverse events with the nurse practice environment at nurse and hospital level. Methods: In total, 3096 nurses working in 60 general inpatient hospital units were included. A two-level logistic regression analysis was performed. Results: At the hospital level, patient adverse events included patient falls (60.5%), nosocomial infections (51.7%), pressure sores (42.6%) and medication errors (33.3%). Among the hospital-level explanatory variables associated with the nursing practice environment, 'physician-nurse relationship' correlated with medication errors while 'education for improving quality of care' affected patient falls. Conclusions: The doctor-nurse relationship and access to education that can improve the quality of care at the hospital level may help decrease the occurrence of patient adverse events.
Background: Nosocomial infection control is one of important means to assure the quality of medical care in the hospital, however, it has been neglected by most of the hospital personnels. Of nosocomial infections, urinary tract infection is the highest incidence, which is related to the indwelling catheter. It is, therefore, necessary to pay primary attention to the patients with the indwelling catheter in intensive care unit in order to control nosocomial Infection and to improve the quality of medical care in the hospital. Methods : The subjects of this study were patients with indwelling catheter who were admitted to the ICU of Pusan Paik Hospital from March 1994 to May 1995. The author calculated UTI rate among the subjects through the cultivation of the urine, identified the related factors of the UTI through brain storming of study team and head nurses working at ICU, and analized the effectiveness of the proposed approaches through comparing the infection rates of before and after activities. Results : The major activities carried out by the study team were to conduct in-service education programs for the staffs working at ICU about the importance of the nosocomial infection control in QA, and nursing intervention to reduce the UTI rate among the patients with indwelling catether. 1. The major nursing interventions that the study team had implemented were as follows ; 1) Drainage system was changed from partial open system to completely closed system. 2) Bladder irrigation which was routinely practised in all patients stopped among the noninfected patients. 3) Bladder irrigation set was changed to the disposable one. 4) Catheter was inserted under the anesthesia for patients to be operated. 5) Male patient receiving wrapped with gauze after perineal care was not wrapped. 6) Clamp which had not been before was newly attached to drainage tube. 7) Urine bag which had been packed into a lot of pieces was done into each piece. 8) The interval of change of indwelling catheter had regularly been four weeks, however it was used continously until it worked well. 9) Catheter was attached well at the defined site. 10) Paper towel was used instead of cotton towel. 11) Mats at the entrance were removed and cleansing of wards was enhanced. 2. The UTI rate by month was 34.4% in maximum and 9.8% in minimum during the period of this study, however it had gradually decreased. After 6 months from initiating infection control activities, the trend of rates was relatively stable. It was identified that UTI rate was different by season 12.5% in winter and 27.2% in summer. 3. Utilization rate of indwelling catheter was maintained at under 50%, but it was increased above 57% from April 1995. 4. The number of bladder irrigation sets used per day was 33.3 sets in maximum and 2.8 sets in minimum. The number used per day were also remarkably deceased. Conclusion : It was found that a program to control UTI could contribute to nosocomial infection control, and it was, in turn, a mean to assure the quality of medical care in the hospital. The nursing interventions which this study team had implemented were effective in the reduce of UTI rates.
Journal of the Korea Academia-Industrial cooperation Society
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v.20
no.6
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pp.370-378
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2019
The aim of this study was conducted to investigate the awareness and practice of personal hygiene and clinic hygiene of infection among physical therapist and to analyze the factors affecting it to provide basic data for the establishment of nosocomial infection management programs and policies in the physical therapist unit. In this study, 320 physical therapists were collected and analyzed. The study tool used a self-administered questionnaire to investigate general characteristics and awareness and practice of nosocomial infections. Responses were determined as 5-Likert scales and data were analysed using percentage, independent t-test, ANOVA. As a result of this study, 17.8% of infectious disease management departments were not found, and 41.6% of physical therapists were not educated about nosocomial infection. In addition, physical therapists with sufficient protective equipment for treatment were very low at 25.3%. Thus, in order to increase awareness and practice of nosocomial infection in the future, it is necessary to provide enough protective equipment for the treatment within the hospital, and it is considered that the nosocomial infection education of the physical therapist should be carried out regularly in the hospital itself.
In this study, microorganisms were isolated from nosocomial environment and are identified by biochemical analysis as the part of biochemical and technical convergence. Microorganisms were collected at intense care unit of general hospital located in Pyeongtak (2014.11.28. - 2014. 11. 30). Using a VITEK2 equipment of biochemical approaches, eleven microorganisms e.g., Micrococcus luteus (or M. lylae), Granulicatella adiacens (M. luteus or M. lylae), Staphylococcus caprae, Sphingomonas paucimobilis, Kocuria kristinae, G elegans, Aerococcus viridans (or Staphylococcus arlettae), Methylobacterium spp., Dermacoccus nishinomiyaensis (or Kytococcus sedentarius), Kocuria kristinae (or M. luteus, M. lylae), Pseudomonas oryzihabitans were identified. And then identified bacteria plates were applied with a plastic stick, so called with "FarmeTok (medistick/Puristic) to produce ClO2. ClO2-releasing plastic stick showed the very strong inhibition of bacterial growth with about 99.9%. There were no bacterial colonies on the ClO2-incubated plate. Taken together, it is suggested that chlorine dioxide should be very strong inhibitor to microorganisms of nosocomial infections.
Newborn infants, including premature infants, are high-risk patients susceptible to various microorganisms. Catheter-related bloodstream infections are the most common type of nosocomial infections in this population. Regular education and training of medical staffs are most important as a preventive strategy for central line-associated bloodstream infections (CLABSIs). Bundle approaches and the use of checklists during the insertion and maintenance of central catheters are effective measures to reduce the incidence of CLABSIs. Chlorhexidine, commonly used as a skin disinfectant before catheter insertion and dressing replacement, is not approved for infants <2 months of age, but is usually used in many neonatal intensive care units due to the lack of alternatives. Chlorhexidine-impregnated dressing and bathing, recommended for adults, cannot be applied to newborns. Appropriate replacement intervals for dressing and care sets are similar to those recommended for adults. Umbilical catheters should not be used longer than 5 days for the umbilical arterial catheter and 14 days for the umbilical venous catheter. It is most important to regularly educate, train and give feedback to the medical staffs about the various preventive measures required at each stage from before insertion to removal of the catheter. Continuous efforts are needed to develop effective and safe infection control strategies for neonates and young infants.
Purpose: Multi-drug resistant (MR) infections among intensive care unit (ICU) patients with oral intubation and a ventilator are serious nosocomial infections. This study was done to compare the effects of oral care and ventilator circuit on reduction of MR infections. Methods: A total of 92 participants were recruited from an ICU at C University Hospital in G-city, Korea, assigned to one of 4 groups and evaluated: group I received oral care with sponge and reusable circuit; group II received oral care with tooth brush and reusable circuit; group III received oral care with sponge and disposable circuit; group IV received oral care with tooth brush and disposable circuit. Results: Prevalence rate of MR infections was highest in group I (47.8%), followed by group II (30.4%), group IV (19.0%), and group III (13.6%). Of the four groups, group III showed a significantly decreased MR infections (p=.035) and higher possibility of survival rate as time passes according to survival analysis (p=.019). Conclusion: Results of this study indicate that using disposable ventilator circuit significantly decreases MR infections and raises the possibility of a higher survival rate as time passes. According to this study, the use of disposable ventilator circuit is useful in prevention of MR infections.
Purpose: Most cases of oral and maxillofacial infections are usually easily treated by proper diagnosis, elimination of causative factors, and antibiotic therapy. However, the emergence and the increase of multidrug-resistant bacteria make treatment challenging. "ESKAPE" pathogens are the most common opportunistic organisms in nosocomial infections and have resistant to commonly used antibiotics. There are many medical reviews of ESKAPE pathogens, but few in dentistry. This study focuses on oral and maxillofacial infection especially with ESKAPE pathogens. The purpose of this study is to prepare feasible data about tracing and treatment of infection related to pathogens that may be beneficial to clinicians. Methods: A total of 154 patients with oral and maxillofacial infections were reviewed by analyzing retrospectively hospitalized data in the Department of Oral and Maxillofacial surgery, Chosun University Hospital, Korea, past 5 years from January 2014 to December 2018. Based on the medical records and microbiological tests, the results were divided into two groups: infections with ESKAPE pathogens and other bacteria. Results: A total of 22 species were isolated from 154 patients. The proportion of ESKAPE pathogens among all bacterial isolates collected from infected patients was 39.6%. Causative factors, especially in post-operative infection, showed a statistically significant correlation to ESKAPE infections (29 cases). And average of treatment period in ESKAPE group was longer than non-ESKAPE groups. Overall, Klebsiella pneumoniae (60.7%) was the most frequently isolated ESKAPE pathogen. And high antibiotic resistance rates had been detected in the ESKAPE during the five-year period. Conclusions: Infections with ESKAPE pathogens are now a problem that can no longer be overlooked in Dentistry. Based on results of this study, ESKAPE pathogens were highly associated with post-operative or opportunistic infections. Clinicians should be careful about these antibiotic resistant pathogens and use appropriate antibiotics to patients while having dental treatments.
Kwon, Hye Jung;Kim, So Youn;Cho, Chang Yee;Choi, Young Youn;Shin, Jong Hee;Suh, Soon Pal
Clinical and Experimental Pediatrics
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v.45
no.6
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pp.719-726
/
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.
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