• Title/Summary/Keyword: nosocomial infection

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A Study on the Measurement of Bacterial Contamination of MRI Examination Equipment and Disinfection Conditions (자기공명영상검사장비의 세균오염도 측정 및 소독에 관한 연구)

  • Jeung, Seung-Woon;Lim, Chung-Hwan;You, In-Gyu
    • Journal of Digital Convergence
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    • v.11 no.12
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    • pp.665-672
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    • 2013
  • In radiology department, where patients with a variety of diseases receive their tests, there is a large possibility of cross contamination of nosocomial infection. Magnetic resonance imaging (MRI) tests take particularly more time than other tests do, which increases the possibility of being exposed to cross contamination. Therefore, this research examines the status of MRI equipment sterilization and investigates the bacterial distribution on head coils, which have the most frequent contact with patients, patient fixation blocks, and bores, which are confined spaces. The status of MRI equipment disinfection was examined by a survey targeting 150 employees, and the distribution of bacteria was measured in ten medical facilities. The result of bacterial distribution tests on MRI equipment showed various bacteria, including Staphylococcus, Acinetobacter, Sphingomona, Pantoea agglomeranss, Micrococcus, Bacillus, Saprophyticus, Brevundimona, and Myroidesspecies. The result of examining the stat us of MRI room disinfection showed that the disinfections of the head coil, block, and bore were implemented well, and the largest proportion was carried out once a day in the morning. The time and implementation of disinfection by the disinfection manager showed that they were implemented well when the manager was the MRI room examiner. The disinfection after examining a patient using an appropriate disinfectant is mandatory to prevent cross contamination.

Risk Factors Associated with Gastrointestinal Tract Colonization by Enterobacteriaceae in Neonatal Intensive Care Unit Patients (신생아 집중 치료실에 입원한 신생아에서 장내 세균에 의한 장관 집락화와 관련된 위험 인자)

  • Kim, Min-Ji;Jung, Yu-Jin;Hong, Yoo-Rha;Bae, Il-Kwon
    • Neonatal Medicine
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    • v.18 no.2
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    • pp.272-279
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    • 2011
  • Purpose: The incidence of nosocomial infection caused by Gram-negative bacilli (GNB) has increased in neonatal intensive care units (NICU). This study identified the progression of sepsis caused by GNB colonization and analyzed the risk factors associated with using periodic stool culture surveillance. Methods: We included 86 newborns admitted to the NICU, Kosin University Gospel Hospital from October 2007 to May 2008. Three stool specimens were collected right after birth and two more were collected at 2 week intervals. The risk factors related to GNB colonization were established from each medical record and related references. Results: The incidence of colonization by GNB was 22 (25.6%) per 86 neonates but none had culture-proven sepsis. The three most commonly isolated GNB were Pseudomonas aeruginosa, Enterobacter cloacae, and Citrobacter freundii. Approximately 89% (32/36) of isolated GNB were susceptible to amikacin. The probability of GNB colonization increased in infants who were fed a small volume during enteral feeding. In contrast, delayed enteral feeding resulted in a decreased probability for GNB colonization. Conclusion: Colonized GNB in the intestine was confirmed by enteric surveillance culture of newborns admitted to the NICU. However, we found no evidence of culture-proven GNB sepsis. As lower feeding volume on the colonization day is a risk factor for GNB colonization, the chance for GNB colonization should be considered when feeding intolerance is present.

Effective Identification of Ochrobactrum anthropi Isolated from Clinical Specimens (임상검체에서 분리된 Ochrobactrum anthropi의 효과적인 동정)

  • Ko, Hyun-Mi;Jo, Jun-Hyeon;Baek, Hae-Gyeong
    • Korean Journal of Clinical Laboratory Science
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    • v.52 no.3
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    • pp.221-228
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    • 2020
  • Ochrobactrum anthropi is a non-fermentative oxidative gram-negative bacillus that produces oxidase. Distinguishing a mixed culture with non-fermenting bacteria having a similar appearance and oxidase-positive is difficult, and there is a limit to accurate identification with a biochemical identification system. This paper proposes that the Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry Platform (MALDI-TOF) method is useful for classifying bacteria that are difficult to identify using biochemical testing methods. As a result of analyzing five cases of O. anthropi examined using MicroScan, it took 6.5 days to the final report, which was 3.5 days more than the 3.0 days of E. coli. The pus sample in patient 5 was a mixed infection with Achromobacter xylosoxidans, and it took 11.3 days because of multiple subculture and retests. Four patients were over 60 years old with an underlying disease, and the possibility of opportunistic and nosocomial infections could not be excluded. Among them, samples collected after 92 days of hospitalization were resistant to imipenem and meropenem. Therefore, an examination using the MALDI-TOF method will be useful for the rapid and adequate treatment of patients with difficult identification, such as O. anthropi.

Clonal Dissemination of Multidrug Resistant Acinetobacter baumannii Isolates Harboring blaOXA-23 at One University Hospital in Daejeon, Korea (대전지역 소재 대학병원에 blaOXA-23 유전자를 가지고 있는 다제내성 Acinetobacter baumannii의 확산)

  • Sung, Ji Youn
    • Korean Journal of Clinical Laboratory Science
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    • v.48 no.2
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    • pp.94-101
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    • 2016
  • Acinetobacter species isolates are important opportunistic pathogens and commonly implicated in nosocomial infections. The therapeutic options for treatment of the bacterial infections are limited because the bacteria isolates are usually multidrug resistant (MDR). In the current study, we investigated various carbapenemase genes in 68 Acinetobacter species isolates. Antimicrobial susceptibilities were tested using the disk diffusion method. Screening of carbapenemase genes was performed via multiplex PCR. In addition, PCR and DNA sequencing were used to identify the carbapenemase genes. Repetitive extragenic palindromic-PCR (REP-PCR) was also performed to assess the clonality of isolates. In our study, A. baumannii isolates were highly resistant to all agents tested while all non-A. baumannii isolates were susceptible to all agents tested, with the exception of aztreonam and cefotaxime. All 51 A. baumannii isolates contained the $bla_{OXA-51}$ gene and 37 (72.5%) isolates also harbored the $bla_{OXA-23}$ gene. In addition, 39 MDR A. baumannii isolates were identified in our study and 37 isolates contained the $bla_{OXA-23}$ gene. The 37 MDR strains harboring $bla_{OXA-23}$ showed type I (n=22) or type II (n=15) banding patterns on their REP-PCR profiles. Our results suggest clonal relation and horizontal spreading of MDR A. baumannii isolates containing the $bla_{OXA-23}$ gene at the hospital located in Daejeon. Continuous investigation of antimicrobial resistant determinants and monitoring emergence and dissemination of MDR isolates is required to prevent and control infection and colonization of MDR A. baumannii isolates.

Antibiotic sensitivity of the bacterial strains isolated from operating wounds (수술창에서 분리된 균주의 항생제 감수성)

  • Oh, Yang-Hyo;Kim, Yung-Bu;Park, Young-Min;Kim, Min-Jung;Cha, Mi-Sun
    • Journal of Life Science
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    • v.8 no.1
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    • pp.40-50
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    • 1998
  • Staphylococuus aureus and Escherichia coli is increasingly responsible for outbreaks of nosocomial infection around the world. Because serious infections due to these organisms currently necessiate use of non-$\beta$-lactam antimicrobial therapy and because strains is ofen resistant to many antimicrobial agents, infections with this organism are difficult to treat. Isolated strains from post operaton wounds of PNU hospital patient were tested for the antimicrobial susceptibility, resistant pattern and combined action to the 6 antibiotics. The minimal inhibitory concentraction of each antibiotic anc antibiotics combining in various ratios were measured by checkerboard dilution method. the synergism was determined through calculating the fractional inhibitory concentraction index (FICI). In case of S. aureus, 15 strains was shown to be highly sensitive to streptomycin and 13 strains to cephalothin. In case of E. coli, it is excellent senstitive 16 strains, sensitive 4 strains on cefoperazone, as like S. aureus, and thus the sensitive is most to be 66%. As the result of gaining MIC from S. aureus upon agar dilution method, MIC$_{50}$ was 8$\mu$g/ml, MIC$_{90}$ was 16$\mu$g/ml and thus the streptomycine is shown to be lowest. In case of E, coli, S. MIC$_{50}$ was 4$\mu$g/ml, MIC$_{90}$ was 16$\mu$g/ml, in streptomycin and thus is shown to be lower than S. aureus. As the result of comparing the resistance aspect of combining the antibiotics on S. aureus and E. coli, the resistant strain can be known to be reduced to the large range more than each 40% than combining with only aminoglycoside-series or cephalosporine-series. As the result of combining aminoglycoside-series, streptomycin and cephalothin or cefuroxime sensitive to S. aureus and E. coli in the above mentioned results, the increase or imporovement of effect is over 73% and 80%, respectively, thus the case od combining 2 antibiotics is shown to be better in the effect. Isolated strains from operating wounds were for the antimicrobial susceptibility. In case of S. aureus 15 strains was shown to be sensitive very much on streptomycin. In case of E. coli it is excellent sensitive 16 strains. As the results of combining aminoglycosides-series, streptomycin and cephalosporine series, cephalothin and cefuroxime, the increase or improvement of effect is over 73%, thus case of combining 2 antibiotics is shown to be better in the effect.

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A study on the Participation Motivation of Clinical Nurses in Job Training (임상간호사의 융복합적 직무교육 참여동기에 관한 연구)

  • Park, Hyun Hee;Lee, Kwang-Ok;Kim, Soon-Ok
    • Journal of Digital Convergence
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    • v.14 no.8
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    • pp.319-329
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    • 2016
  • This study aimed to identify nurses' participation motivation, its influence factors, and their job training need. A survey was conducted on 345 nurses of general hospitals in Gyeonggi-do. Data was collected from October 5th to 18th, 2016 and was analyzed through t-test, ANOVA, Bonferroni post-test, and multiple regressions using SPSS 21.0. Participation motivation was high in 'expertise capability improvement and development' and low in personal gain and job stability. Job training need was the highest in nosocomial infection management and CPR and was the lowest in hospice and rehabilitation nursing. Participation motivation had significant differences depending on age, marital status, educational level, and clinical experience, and was influenced by the job training need of professional nursing and medical knowledge for disease treatment. Therefore, it is necessary to plan medical educational programs to enhance job training effectiveness, establish a strategy to increase participation motivation; and expand various job training support.

Detection for Methicillin Resistant Staphylococcus aureus in Using Bio-Chip Based Loop Mediated Isothermal Amplification Assay (칩 기반 등온증폭법을 이용한 약제 내성 포도상구균의 검출)

  • Cho, Min-Ho;Jang, Won-Cheoul;Choi, Jae-Gu
    • Journal of the Korean Chemical Society
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    • v.57 no.1
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    • pp.81-87
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    • 2013
  • Staphylococcus aureus is the most important pathogen in nosocomial infections, including bloodstream infections. Prompt identification of S. aureus from blood cultures and detection of methicillin resistance are essential in cases of suspected sepsis. We have studied a new method for the sequence-specific visual detection of minute amounts of nucleic acids using intercalating reaction by addition of SYBR Green to amplicons of LAMP, and it's a unique gene amplification method in which DNA can be isothermally amplified using only one enzyme. Staphylococcus-LAMP, which targets the spa gene, encoding S.aureus-specific protein A, and the mecA gene, encoding penicillin-binding protein-2' for methicillin resistance, detected MRSA and MRSE. In this study, by using LAMP assay, I detected for Staphylococcus aureus and Staphylococcus epidermidis concentration in the clinical sample. The detection of Staphylococcus aureus and Staphylococcus epidermidis was tested by using serial 10-fold dilutions standard solution. I have accurate detected the limit of detection, sensitity, specificity and reproducibility of the assay. The Bio-chip based LAMP assay allowed easy, rapid, accurate and sensitive detection of infection with Staphylococcus and especially applicable in a resource-limited situation.

Detection of blaKPC and blaNDM Genes from Gram-Negative Rod Bacteria Isolated from a General Hospital in Gyeongnam (경남지역 종합병원에서 분리된 그람음성막대균으로부터 blaKPC 및 blaNDM 유전자 검출)

  • Yang, Byoung Seon;Park, Ji Ae
    • Korean Journal of Clinical Laboratory Science
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    • v.53 no.1
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    • pp.49-59
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    • 2021
  • This study investigated the use of real-time PCR melting curves for the diagnosis of blaKPC and blaNDM genes among the most frequently detected carbapenemase-producing Enterobacteriaceae in Korea. As a means of addressing the shortcomings of phenotype tests and conventional PCR. The modified Hodge test confirmed positivity in 25 of 35 strains, and carbapenemase inhibition testing confirmed positivity in 14 strains by meropenem+PBA or meropenem+EDTA. PCR analysis showed amplification products in 25 strains of Klebsiella pneumoniae carbapenemases (KPC), 10 of K. pneumoniae, 5 of E. coli, 5 of A. baumannii, 4 of P. aeruginosa, and 1 of P. putida. New Delhi metallo β-lactamase (NDM) identified amplification products in 8 strains, that is, 2 K. pneumoniae, 3 E. coli, 1 P. aeruginosa, 1 E. cloacae, and 1 P. retgeri strains. Real-time PCR melting curve analysis confirmed amplification in 25 strains of KPC and 8 strains of NDM, and these results were 100% consistent with PCR results. In conclusion, our findings suggest early diagnosis of carbapenem resistant Enterobacteriaceae by real-time PCR offers a potential means of antibacterial management that can prevent and control nosocomial infection spread.

Contact Investigation for Twins With Congenital Tuberculosis in the Neonatal Intensive Care Unit

  • Myung Hwan Yoo;Kyoung Sim Kim;Yong Wook Kim;Eun Young Kim;Young Kim;Hae In Jang;Hyoung Min Cho
    • Pediatric Infection and Vaccine
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    • v.29 no.3
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    • pp.141-146
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    • 2022
  • Purpose: Congenital tuberculosis (TB) is difficult to diagnose owing to its non-specific symptoms. Delayed diagnosis increases the risk of nosocomial infections. We examined the TB status of infants and healthcare workers who were in proximity to preterm twins diagnosed with congenital TB 63 days after birth and 48 days after admission to the neonatal intensive care unit (NICU). Methods: Contact investigations were conducted on 24 staff members and 35 infants who had contact with the twins with congenital TB. Results: Two of the exposed infants, both of whom had received the Bacille Calmette-Guérin vaccine, had positive tuberculin skin test results. Four of the 24 exposed staff members had positive interferon-gamma release assay (IGRA) test results before exposure and were not re-tested after exposure; the remaining 20 had negative IGRA test results. All exposed staff members and infants had normal chest radiographic findings. Conclusions: Although transmission of TB in the NICU is unusual, it can occur. These results support the need for a systematic investigation of the TB status of exposed infants, their family members, and healthcare workers.

An Analysis of the Antibiotic Resistance Genes of Multi-Drug Resistant (MDR) Acinetobacter baumannii (다제내성 Acinetobacter baumannii 의 항생제 내성 유전자 분석)

  • Lim, Jina;Lee, Gyusang;Choi, Yeonim;Kim, Jongbae
    • Korean Journal of Clinical Laboratory Science
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    • v.48 no.3
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    • pp.217-224
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    • 2016
  • Acinetobacter baumannii (A. baumannii) is prevalent in hospital environments and is an important opportunistic pathogen of nosocomial infection. It is known that this pathogen cause herd infection in hospitals, and the mortality rate is remarkably higher for patients infected with this pathogen and already have other underlying diseases. Herein, we investigated the antibiotic resistance rate and the type of resistance genes in 85 isolates of multi-drug resistant A. baumannii from the samples commissioned to laboratory medicine in two university hospitals-in hospital A and hospital B-located in Cheonan and Chungcheong provinces, respectively, in Korea. As a result, $bla_{OXA-23-like}$ and $bla_{OXA-51-like}$ were detected in 82 stains (96.5%). These 82 strains of $bla_{OXA-23-like}$ producing A. baumannii were confirmed with the ISAba1 gene found at the top of the $bla_{OXA-23-like}$ genes by PCR, inducing the resistance against carbapenemase. The armA, AME gene that induces the resistance against aminoglycoside was detected in 34 strains out of 38 strains from Hospital A (89.5%), and in 40 strains out of 47 strains from Hospital B (85.1%), while AMEs were found in 33 strains out of 38 strains from Hospital A (70.2%) and in 44 strains out of 47 strains in Hospital B (93.6%). Therefore, it was found that most multi-drug resistant A. baumannii from the Cheonan area expressed both acethyltransferase and adenyltransferase. This study investigated the multi-drug resistant A. baumannii isolated from Cheonan and Chungcheong provinces in Korea, and it is thought that the results of the study can be utilized as the basic information to cure multi-drug resistant A. baumannii infections and to prevent the spread of drug resistance.