• 디지털융복합연구
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• 제15권10호
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• pp.315-326
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• 2017

본 연구는 호흡기감염에 대한 어린이집교사의 감염관리수행에 영향을 미치는 요인을 알아보기 위한 서술적 조사연구이다. 연구대상은 어린이집교사 432명으로, 자료수집은 2016년 7월 2일부터 8월 20일까지 진행되었다. 수집된 자료의 분석은 SPSS/WIN 18.0 프로그램을 이용하여, 기술통계, t-검정, 일원분산분석, 피어슨 상관관계분석, 다중회귀분석을 하였다. 연구결과, 호흡기감염의 원인과 증상에 관한 지식, 간호지식, 감염관리수행과 유의한 상관관계를 보였으며, 어린이집교사의 감염관리수행에 유의하게 영향을 미치는 요인은 간호지식(${\beta}=-.371$, p<.001), 양육경험(${\beta}=-1.993$, p<.001), 호흡기감염의 원인 및 증상에 관한 지식(${\beta}=.096$, p<.001)이었으며, 이들 변수가 감염관리수행 변인의 43.4%를 설명하였다. 이들 변수 중 감염관리수행에 가장 영향을 많이 미치는 변수는 간호지식이었다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제23권3호
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• pp.251-258
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• 2020

Purpose: Proton-pump inhibitors (PPIs) are frequently used to treat gastroesophageal reflux disease (GERD) in children, but recent evidence suggests a potential association between PPI treatment and some types of infections. The aim of this study was to assess the effectiveness of Lactobacillus rhamnosus GG (LGG) for the prevention of gastrointestinal and respiratory tract infections in children with GERD treated with PPI (omeprazol). Methods: Children younger than 5 years with GERD were assigned by a computer-generated list to receive LGG (10⁹ colony-forming units) or placebo, twice daily, concomitantly with PPI treatment for 4-6 weeks; they were followed up for 12 weeks after therapy. The primary outcome measures were the percentage of children with a minimum of one episode of respiratory tract infection and the percentage of children with a minimum of one episode of gastrointestinal infection during the study. Results: Of 61 randomized children, 59 patients (LGG n=30; placebo n=29, mean age 11.3 months) were analyzed. There was no significant difference found between the LGG and placebo groups, either for the proportion of children with at least one respiratory tract infection (22/30 vs. 25/29, respectively; relative risk [RR] 0.85, 95% confidence interval [CI] 0.66-1.10) or for the proportion of children with at least one gastrointestinal infection (9/30 vs. 9/29, respectively; RR 0.97, 95% CI 0.45-2.09). Conclusion: LGG was not effective in the prevention of infectious complications in children with GERD receiving PPI. Caution is needed in interpreting these results, as the study was terminated early due to slow subject recruitment.

• 보건행정학회지
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• 제28권4호
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• pp.402-410
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• 2018

Background: Monitoring appropriate medication categories can provide early warning of certain disease outbreaks. This study aimed to present a methodology for selecting and monitoring medications relevant to the surveillance of acute respiratory tract infections, such as influenza. Methods: To estimate correlations between acute febrile respiratory tract infection and some medication categories, the cross-correlation coefficient (CCC) was used and established. Two databases were used: real-time prescription trend of antivirals, anti-inflammatory drugs, antibiotics using Drug Utilization Review Program between 2012 and 2015 and physicians' number of encounters with acute febrile respiratory tract infections such as influenza outbreaks using the national level health insurance claims data. The seasonality was also evaluated using the CCC. Results: After selecting six candidate diseases that require extensive monitoring, influenza with highly specific medical treatment according to the health insurance claims data and its medications were chosen as final candidates based on a data-driven approach. Antiviral medications and influenza were significantly correlated. Conclusion: An annual correlation was observed between influenza and antiviral medications, anti-inflammatory drugs. Suitable models should be established for syndromic surveillance of influenza.

• Clinical and Experimental Pediatrics
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• 제64권11호
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• pp.543-551
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• 2021

The human microbiome, which consists of a collective cluster of commensal, symbiotic, and pathogenic microorganisms living in the human body, plays a key role in host health and immunity. The human nasal cavity harbors commensal bacteria that suppress the colonization of opportunistic pathogens. However, dysbiosis of the nasal microbial community is associated with many diseases, such as acute respiratory infections including otitis media, sinusitis and bronchitis and allergic respiratory diseases including asthma. The nasopharyngeal acquisition of pneumococcus, which exists as a pathobiont in the nasal cavity, is the initial step in virtually all pneumococcal diseases. Although the factors influencing nasal colonization and elimination are not fully understood, the adhesion of opportunistic pathogens to nasopharyngeal mucosa receptors and the eliciting of immune responses in the host are implicated in addition to bacterial microbiota properties and colonization resistance dynamics. Probiotics or synbiotic interventions may show promising and effective roles in the adjunctive treatment of dysbiosis; however, more studies are needed to characterize how these interventions can be applied in clinical practice in the future.

• Tuberculosis and Respiratory Diseases
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• 제74권2호
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• pp.63-69
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• 2013

Background: Aiming to improve outcome of lung transplantation (LTx) patients, we reviewed risk factors and treatment practices for the LTx recipients who experienced respiratory infection in the late post-LTx period (>1 month after LTx). Methods: We analyzed the clinical data of 48 recipients and donors from 61 LTx, who experienced late respiratory infections. Late respiratory infections were classified according to the etiology, time of occurrence, and frequency of donor-to-host transmission or colonization of the recipient prior to transplantation. Results: During the period of observation, 42 episodes of respiratory infections occurred. The organisms most frequently involved were gram (-) bacteria: Acinetobacter baumannii (n=13, 31.0%), Pseudomonas aeruginosa (n=7, 16.7%), and Klebsiella pneumoniae (n=4, 10.0%). Among the 42 episodes recorded, 14 occurred in the late post-LTx period. These were bacterial (n=6, 42.9%), fungal (n=2, 14.3%), viral (n=4, 28.5%), and mycobacterial (n=2, 14.3%) infections. Of 6 bacterial infections, 2 were from multidrug-resistant (MDR) A. baumannii and one from each of MDR P. aeruginosa, extended spectrum ${\beta}$-lactamase (+) K. pneumoniae, methicillin-resistant Staphylococcus aureus and Streptococcus pneumoniae. Infection-related death occurred in 6 of the 14 episodes (43%). Conclusion: Although the frequency of respiratory infection decreased sharply in the late post-LTx period, respiratory infection was still a major cause of mortality. Gram (-) MDR bacteria were the agents most commonly identified in these infections.

• Child Health Nursing Research
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• 제21권3호
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• pp.227-235
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• 2015

Purpose: The purpose of this study was to investigate disease prevalence, parent's educational needs, and disease management according to severity of respiratory infections in early childhood. Methods: Participants for this study were 173 mothers whose child was admitted to I university hospital in Seoul and whose child was an infant or toddler. Data were collected from December, 17, 2014 to February, 15, 2015 using self-report structured questionnaires. Data were analyzed using IBM/SPSS 21.0 program. Results: There were significant differences in the severity of respiratory infection according to neonatal admission due to dyspnea, feeding type, atopic dermatitis in the infant or allergic disease in father and siblings. Parent's educational needs for the severe respiratory infection group were higher than for the non-severe group. Parent's disease management for the severe respiratory infection group was lower than the non-severe group. Conclusion: As important care factors in neonatal admissions include dyspnea, cow milk feeding, eczema, family history of allergies, parent's educational needs and disease management, they should be considered when caring for young children with respiratory infections and their parents.

• Child Health Nursing Research
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• 제17권1호
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• pp.1-9
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• 2011

Purpose: The purpose of this study was to investigate the knowledge and practice level of infection managements in child guardians with respiratory infections after H1N1 diffusion of 2009. Methods: The data were collected during February and March 2010 using a self-report questionnaire. The participants were 228 child guardians. Data were analyzed using frequency, percentage, means, SD, t-test, F-test, Pearson correlation coefficients, and Cronbach's alpha with the SPSS 17.0 program. Results: Mean age of the guardians and children were 37.8 years, 4.1 years respectively. For knowledge level of respiratory infections, hand washing method had the highest score and snuffles prevention method, the lowest. For practice level for respiratory infections, environmental hygiene management had the highest score and symptom management, the lowest. Infection management knowledge and practice level had a positively significant correlation in every area. Conclusion: The results indicate the necessity of continual education on infection management, and that the most efficient timing for the education appears be for participants during their first pregnancy or after the woman has delivered her child.

• 보건행정학회지
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• 제25권4호
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• pp.323-332
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• 2015

Background: Antibiotic resistance has been becoming serious challenge to human beings. Overuse of antibiotics, especially, for infants is concerned, but studies are very few for the prescribing pattern of antibiotic use for infants. This study analyzes prescribing patterns of antibiotics in outpatients of preschool children with acute respiratory tract infections in South Korea. Methods: Data are used from 2011 Health Insurance Review & Assessment Services-pediatric patients sample. Inclusion criteria is outpatient children (0 to 5 years) with top five frequent diseases. Prescription rates are analyzed by types of disease, provider, specialty, region, and ages. Binary or multinomial logit models are used to analyze determinants of providers' prescription pattern. Results: The main findings are as follows. First, distributions of prescription rates are shown as L-shape or M-shape depending on the types of disease. Second, the prescription variation is so large among providers, where providers are polarized as a group with low prescription rates and the other group with high prescription rates, though the shapes are shown diversified across types of disease. Third, prescription rates appear to be lower in pediatrics and higher in ENT (ear-nose-throat). Fourth, broad spectrum antibiotics are widely used among children. Finally, the logit analysis shows similar results with descriptive statistics, but partly different results across types of disease. Conclusion: Antibiotics for respiratory tract infections of infants are used excessively with a large variation among providers, and especially broad spectrum antibiotics are used. The prescription guideline for antibiotics should be provided for each specific disease to reduce antibiotic resistance in the future.

• 한국임상약학회지
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• 제22권4호
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• pp.291-303
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• 2012

As respiratory tract infections (RTI) account for about 60% of all antibiotic prescriptions in outpatient care setting, there are significant concerns about emerging resistance that are largely due to the excessive or inappropriate use of antibacterial agents for viral respiratory infections. This study was aimed to develop retrospective drug utilization review (DUR) program of antibiotics for RTIs using Delphi methods. Retrospective DUR criteria of antibiotics for RTIs were identified based on clinical practice guidelines and opinion of experts. Expert panel members were clinical doctors and pharmacists and Delphi method was applied by survey on 16 members of panels. The claim data from Korean Health Insurance Review & Assessment (HIRA) were used to examine trends in outpatient antibiotic prescription between Janunary to December of 2008. As results, Quality index for RTI was assessed for the claim type, antibiotics use of quantity, duration, number and cost. Antibiotic prescription rate for RTIs, Defined Daily Dose (DDD), and duration of antibiotics use were more recognized as significant quality index by experts' opinion. Use of first line agents suggested by guidelines was low and duration of antibiotics use was shorter compared to the recommendations. Antibiotics were over prescribed for RITs. However, dose and duration of antibiotics were under-used.

• Pediatric Infection and Vaccine
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• 제6권1호
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• pp.131-135
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• 1999

신생아 시기에 호흡기 바이러스 감염은 증상이 다양하게 나타나 진단하기가 힘든 면이 있으나 본 증례와 같이 뚜렷한 호흡기 증상이 있는 경우 적극적인 진단과 치료가 필요하다고 사료되며 고위험군 환자에게 RSV 유행 시기에 앞서 예방이 중요하다고 생각한다.