Chun, Jaeyoung;Lee, Jaechun;Bae, Jaeseok;Kim, Miyeon;Lee, Jae-Geun;Shin, Sang-Yop;Kim, Young Ree;Lee, Keun-Hwa
Tuberculosis and Respiratory Diseases
/
v.67
no.3
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pp.239-243
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2009
Delftia acidovorans is a gram-negative motile rod found ubiquitously in soil and in water. Confirmed isolation from clinical infections is rare, and has been documented mostly in immunocompromised patients or those with indwelling catheters. A 53-year-old man was referred for the evaluation of a huge mass-like lesion found incidentally by chest X-ray. The lesion occupied more than half of the right lung and was diagnosed as a large loculated pleural effusion by CT scan. Bloody pus was drained through a percutaneous catheter, and D. acidovorans, identified by the Vitek GN card and confirmed by amplification of 16S ribosomal RNA and sequencing analysis, was isolated repeatedly from the drained pus. The patient was treated with imipenem/cilastatin to which the organism was sensitive. This is a rare report of chronic empyema associated with D. acidovorans in the respiratory system of an immunocompetent patient.
This study aimed to investigate the effect of Hwanglyeonhaedok-tang on the clearance of vancomycin-resistant Enterococcus (VRE) colonization in a patient with traumatic subarachnoid hemorrhage and subdural hematoma. A 73-year-old man who was diagnosed with traumatic subarachnoid hemorrhage and subdural hematoma with isolation of VRE colonization was administered Hwanglyeonhaedok-tang and followed up with a rectal swab VRE culture every week. After treatment with Hwanglyeonhaedok-tang, VRE colonization was no longer detected. This case report proved that Hwanglyeonhaedok-tang could be an effective treatment for clearance of VRE colonization in a patient with traumatic subarachnoid hemorrhage and subdural hematoma.
Telehealth is widely tested in the U.S.A and other developed countries. This system is expected to solve rural health problems reducing professional isolation. Some demonstration projects showed that the system can provide quality care in reasonable prices to rural residents. However, few study has been done on whether telehealth system can attract physicians by reducing professional isolation. The system is not available to most of the rural hospitals because the price for the equipment and telephone charges are not low enough. It is promising that the system cost and telephone charges are decreasing gradually. As time passes, rural hospitals will be more viable for the system. Satisfaction of the physicians and patients is a key factor for the implementation of the system. The physicians need to understand more about telecommunication and computer systems. After physicians are well-versed about the system, we can expect wide use of telehealth in rural areas. Effort for the confidentiality and standardization should be devoted to assure patient's privacy and compatibility of patient records and exam results. In Korea, two projects are being operated in Uljin and Kurye. A study evaluated the economic efficiency of the projects suggesting that increase of the number of patients up to three times of current number or decrease in hardware costs and telecommunication charges into two thirds of the current costs. The hardware and telecommunication charges are decreasing. Another area telehealth system can be applied is psychiatric accommodation facilities. Establishment of telehealth in the psychiatric facilities will increase the access of psychiatric care for patients and is expected to be economically efficient.
Background : Chlamydia pneumoniae is one of common causes in upper and lower respiratory infections. Isolating C. pneumoniae from clinical specimens is very difficult due to the characteristics of the organism. Recently, we succeeded in isolating C. pneumoniae from a Korean patient, who suffered from acute pharyngitis. This is the first isolate from a clinical specimen in Korea. Methods : We attained a nasopharyngeal swab from a 22-year-old female patient, and inoculated it on a monolayer of the Hep-2 cell line. After 8 passages, we found the inclusion bodies of C. pneumoniae by an immunofluorescence(IF) test. The species-specific monoclonal antibody IF staining and species-specific PCR were done to confirm the species of the isolate, and electron microscopy was used to characterize the morphology. Results : The isolated was confirmed to be C. pneumoniae by species-specific IF and PCR, and the strain was named LKK-1. The shape of the elementary body was round and with a narrow periplasmic space, as shown by electron microscopy, which is similar to the Japanese strain, but not the Western strain. Conclusion : We succeeded in isolating C. pneumoniae from a 22-year-old patient with acute pharyngitis, which is the first isolate in Korea. In the future, this Korean strain will be useful to the study of C. pneumoniae.
Purpose: This study was conducted to examine the effect of education on infection control for multidrug resistant organism (MDRO). Methods: One group pre-post time series design was used. Infection control education for MDRO infection was provided to nurses working in the Neonatal Intensive Care Unit (NICU). Knowledge and recognition were evaluated before and after education. Hand hygiene compliance, MDRO isolation rate and central line-associated bloodstream infection (CLABSI) rate were used as outcome variables. Data from 45 nurses was used for analysis. Results: General knowledge about MDRO increased (p=.011). Responses to questions about image of MDRO and MDRO management tended to change in a positive direction (p=.046). Hand hygiene compliance was 100% at pre-test, 79.5% during education period and 98.4% at post-education period. MDRO isolation rate was 6.83 per 1,000 patient days at pre-test, 10.24 during education period and 6.68 at post-education period. CLABSI rate was 3.76 per 1,000 central line days at pre-test, 6.84 during education period and 4.71 at post-education period. Conclusion: Findings indicate that the education program is effective in improving knowledge about MDRO in NICU nurses. However, more reliable indicators should be used to determine long-term effects.
The purpose of this study was to identify the level of HIV/AIDS related knowledge and attitudes of Korean childbering women. The subject were 1152 Korean women who were living in the Seoul area and whose age was between 17-50 years. Data was collected by self reporting with a questionnaire of 57 items developed by the researcher. The reliability of the instrument for the HIV/AIDS related knowledge and attitudes were Cronbach's alpha. .6954 and .7987 respectively. The results were as follows: The mean age of the subjects was 26 years and 46.8% of them were married. The mean score for HIV/AIDS related knowledge was 14.7 out of a possible maximum score of 22. The correct answer rate for HIV/AIDS related knowledge was between 87.0-94.1% for the risk factors. and 36.4-54.8% for the transmission mode. Even though 87% of the subjects knew that homosexuals are risk group for HIV/AIDS. only half(55.8%) of the subjects answered that anal sex is the transmission mode. And only 57% of the subjects knew that HIV/AIDS transmission is possible through heterosexual contact. Their agreement level for attitudes was in order of communal coping (95%). pregnant women protection (94%). Problem appraisal (82%). patients isolation(68%). and disclosure of infection(67%). It was shown that the group who had a pregnancy (t=2.07, p=.039), used contraceptives (t=2.57, p=.OO1). and the group of college level graduates(t=3.61, p=.000) had a higher level of HIV/AIDS related knowledge. The agreement level of pregnant women protection. patient isolation. and problem appraisal were higher in the group of having had a pregnancy, having used contraceptives. and the group over 30 years of age. It was concluded that Korean childbearing women were quite knowledgeable about the risk factors but confused about the transmission mode. especially heterosexual contact. and they showed responsive attitudes to the HIV/AIDS issues considering the 339 infected cases in Korea. They preferred isolation of patients and communal coping as behavioral attitudes. Therefore it can be suggested that a HIV/AIDS prevention program should be focused on transmission mode.
The Journal of the Korean Society for Microbiology
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v.20
no.1
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pp.35-44
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1985
Isolation and identification of anaerobic bacteria from blood cultures are still technically demanding procedures. Recently, with the use of gas liquid chromatography, the accuracy of identification is much improved. However, there has never been a satisfactory data analysis on anaerobic bacteremia in Korea. The authors evaluated both the clinical and the bacteriological data of 129 anaerobic bacteremias found at the Yonsei Medical Center during the period of 1973 to 1984. The most frequently isolated anaerobic bacteria were Bacteroides (52.7%), among which the major species was B. fragilis (38.7%). Incidence of anaerobic bacteremia by sex was 57% in male and 43% in female. Mortality was higg in groups below 1-year old and above 50-year old. The cause of death seemed closely correlated with the patient's age, general condition and the severity of the underlying disease. Various neoplasms were the most common (20%) underlying diseases predisposing the anaerobic bacteremia. Biliary tract was considered the most frequent route of infection in anaerobic bacteremia. The frequent clinical signs in anaerobic bacteremia were fever (65%), followed by liver function abnormality (29%), jaundice (20%) and hypotention(18%). When analysis of positive rate of blood culture was made on the patients from whom 4 cultures were done within 24 hours, it was found that 33% of the samples were positive. Isolation rate of anaerobic bacteria in thioglycollate medium was 83.8%, while it was 44% in Tryptic soy broth. Among the anaerobic bacteremia, 25.4% were polymicrobial infections with aerobic bacteria (92.5%), such as E. coli(33.3%). From these studies, it is concluded that B. fragilis is the most important causative organism in anaerobic bacteremia, with high fatality, particularly in those who have underlying diseases. The ports of entry are mainly biliary, gastrointestinal and female genital tract. Fever is the most frequent clinical sign. Single blood culture is not sufficient to detect all anaerobic bacteremia, therefore more cultures with optimal time interval are needed. The incidence of polymicrobial infection in anaerobic bacteremia is higher than that in overall bacteremia.
The Journal of the Korean Society for Microbiology
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v.15
no.1
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pp.3-8
/
1980
Yersinia enterocolitica has been known to be an important enteric pathogen especially in Scandinavian countries and Canada. In Korea, the authors reported the first case of Y. pseudotuberculosis septicemia in 1979. In 1980, three isolates of Y enterocolitica were obtained from 3 adult patients with enteritis, besides the already reported one in a 5-month-old child, during March to June 1980. Difficulty in the isolation was experienced; ie., the organism was isolated only from the SS primary isolation plate in one case and in the other two cases only from the SS plates inoculated with overnight culture of selenite broth. The isolates showed typical cultural and biochemical characteristics except for the nonmotility even at room temperature. Two isolates were indole negative possibly belonging to Wauter's biotype 3 and the other one was indole positive belonging to biotype 2. One patient was tested for the serum agglutinin titer on the 8th hospital day and it was found to be 1:128. All of the isolates were susceptible to chloramphenicol, colistin, gentamicin, kanamycin, tetracyclne, and tobramycin by the Kirby-Bauer disc diffusion method. All of the infections were controled by ampicillin, amoxicillin, amikacin, or gentamicin treatment. It is considered urgent to broaden our knowledge on yersiniosis in Korea not only by isolating, serotyping and biotyping of the organism, but also by surveying serum agglutinin titer of enteritis patients and normal individuals.
Purpose: This study aimed to derive the elements for effectively improving the management of emerging infectious diseases in the emergency room in large general hospitals. Methods: This research involved an analytic hierarchy process analysis of 10 experienced nurses working in a large general hospital located in the Seoul metropolitan area. The weighted values of the criteria for evaluating the importance of the management elements of patients with emerging infectious diseases in the emergency room of large general hospitals were derived using an analytic hierarchy process survey. Results: The results of the analytic hierarchy process analysis showed that experts considers responsiveness (0.291) as most important with respect to the criteria for the policy for isolation and control of infectious patients. The order of importance of the criteria for the policy for isolation and control of infectious patients were as follows: responsiveness (0.291), economical efficiency (0.257), feasibility (0.242), and sustainability (0.209). Subsequently, the weighted values of the management of the policy elements were determined based on the derived importance of the criteria mentioned above. These were, in order of priority, the construction of communication channels with the government authorities when dealing with emerging infectious diseases (15.9%), the equipment and provision of personal protective equipment to protect nurses from infection and dissemination of material (14.6%), and the operation of the isolation room and patient separation systems (14.1%). Conclusion: This study suggests critical strategies for infection control during a pandemic of emerging infectious disease.
Journal of The Korea Institute of Healthcare Architecture
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v.28
no.3
/
pp.7-16
/
2022
Purpose: This study aims to establish the basic directions of the modular airborne infection isolation(AII) ward. Considering a specific function and purposed use as a modular AII ward, it is a chance to derive an address of current modular technology by overview the limitation and improvement of the existing modular architecture. Methods: In addition to the literature analysis on the configuration system of mobile hospitals, research cases on the operational effectiveness of the domestic and foreign mobile construction systems are analyzed. Results: In order to meet the various and strict space guidelines of the AII ward and a chance to improve limitations of uniformed existing modulars, AII modular the negative pressurized care setting should be minimized a structural restriction for reflecting its system on a architectural plan. For this unique requirements, it could be possible to apply various space boxes called infill box which needs to secure a large-scale space. So, a rahmen structure system could be adaptable for this purpose. A dead space between beams of the rahmen structure is to be used for MEP installation. Partial separation, dismantling, and repair should be possible by separating the MEP and infill box from the structure. The infill box must keep 3.5m width under the current Road Traffic Act. Implications: It is necessary to utilize and develop an improved construction method that can reduce the problems of existing steel modular and PC modular.
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