• Title/Summary/Keyword: 도관감염

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The Effects of Catheter Revision and Mupirocin on Exit Site Infection/Peritonitis in CAPD Patients (복막 투석 환자에서 도관 관련 감염 및 복막염에 대한 Mupirocin과 도관 전환술(Catheter revision)의 효과)

  • Park, Jun-Beom;Kim, Jung-Mee;Choi, Jun-Hyuk;Jo, Kyu-Hyang;Jung, Hang-Jae;Kim, Yeung-Jin;Do, Jun-Yeung;Yoon, Kyung-Woo
    • Journal of Yeungnam Medical Science
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    • v.16 no.2
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    • pp.347-356
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    • 1999
  • Background: Exit site/tunnel infection causes considerable morbidity and technique failure in CAPD patients. We presently use a unique revision method for the treatment of refractory ESI/TI in CAPD patients and mupirocin prophylaxis for high risk patients. Materials and Methods: We reviewed 139 CAPD patients about the ESI/TI from October 1993 to February 1999 at Yeungnam University Hospital. At the beginning of the ESI. we usually started medications with rifampicin and ciprofloxacin and then changed the antibiotics according to the sensitivity test. If the ESI had persisted and there were TI symptoms (purulent discharge, abscess lesion around exit site). we performed catheter revision(external cuff shaving, disinfection around tunnel and new exit site on opposit direction) with a combination of proper antibiotics. We applied local mupirocin ointment at the exit site three times per week to the 34 patients who had the risk of ESI starting from October 1998. Results: The total follow-up was 2401 patient months(pt. mon). ESI occurred on 105 occasions in 36 out of 139 patients, and peritonitis occurred on 112 occasions in 67 out of 139 patients. The total number of incidences of ESI and peritonitis was 1 per 23.0 pt. mon and 1 per 2l.6 pt.mon. The most common organism responsible for ESI was Staphylococcus aureus (26 of 54 isolated cases, 48%), followed by the Methicillin resistant S. aureus(MRSA) (13 cases, 24%). Seven patients(5: MRSA. 2: Pseudomonas) had to be treated with a revision to control infection. Three patients experienced ESI relapse after revision. One of them improved with antibiotics, while another needed a second revision and the remaining required catheter removal due to persistent MRSA infection with re-insertion at the same time. But, there was no more ESI in these 3 patients who were received management to relapse (The mean duration: 14.0 months). The rates of ESI were significantly reduced after using mupirocin than before(1 per 12.7 vs 34.0 pt.mon, P<0.01). Conclusions: In summary, revision technique can be regarded as an effective method for refractory ESI/TI before catheter removal. Also local mupirocin ointment can play a significant role in the prevention of ESI.

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Deep Vein as a Graft Conduit (도관으로 사용된 심부정맥)

  • Yie, Kil-Soo;Cheon, Sung-Bin;Oh, Won-Sub;Ryu, Se-Min;Lee, Bong-Ki;Kim, Hyung-Rae;Kim, Keun-Woo
    • Journal of Chest Surgery
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    • v.43 no.4
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    • pp.441-446
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    • 2010
  • The ideal graft requires acceptable size, less tissue toxicity, resistance to infection, and long-term durability. Great saphenous veins are gaining popularity as acceptable graft conduits, but they require time to grow in caliber. We report 2 cases of graft bypass and reconstruction using superficial femoral veins to acheive immediate high-flow patency.

Histopathology of Strawberry Plant Infected with Fusarium oxysporum f. sp. fragariae (Fusarium oxysporum f. sp. fragariae에 감염된 딸기의 병태조직에 관한 연구)

  • Moon Byung Ju;Chung Hoo Sup
    • Korean Journal Plant Pathology
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    • v.2 no.3
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    • pp.158-164
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    • 1986
  • Histopathological changes of strawberry plants infected with Fusarium oxysporum f. sp. fragariae Winks & Williams were examined. In all sections of the plant parts including roots, crowns, petioles and runners naturally and artificially infected with the fungus, fungal hyphae and conidia, and their plugging were found in xylem vessels, and formation of cavities was noted in the vascular cylinders. The xylem vessels were not localized with pectic materials, tyloses were not formed, and xylem parenchyma cells were not hypertrophied. The results suggest that plugging or disconnection of xylem elements by the fungus may be an important factor in inducing characteristic symptoms associated with Fusarium wilt of strawberry.

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Epidemiology of central venous catheter related blood stream infections in pediatric patients (중심정맥 도관 관련 감염의 역학 고찰)

  • Kim, Jung Hyun;Eun, Ho Sun;Choi, Kyung Min;Kim, Dong Soo;Young, Dong Eun
    • Clinical and Experimental Pediatrics
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    • v.49 no.2
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    • pp.157-161
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    • 2006
  • Purpose : The purpose of this study is to investigate the pathogens of central venous catheter-related blood stream infections and search for the association among the insertion site, the duration and the underlying conditions with the prevalence of central venous catheter-related blood stream infections under 15 years old. Methods : A retrospective study was performed from Jan, 2003 to Dec, 2003 in Severance Hospital on 112 patients who undertook central venous catheter insertions. Results : We examined 112 patients who undertook central venous catheter insertion. The mean age of patients was $4.77{\pm}4.12$ years old. Coagulase negative Staphylococci was the most common organism of central venous catheter-related blood stream infections accounting for 33.9 percent, followed by Eenterococcus faecium(9.3 percent), and Staphylococcus aureus(7.5 percent), The most common insertion site was the right femoral vein, followed by the right jugular vein and the left femoral vein. The mean insertion period was $14.17{\pm}12.00$ days. Conclusion : Central venous catheter-related blood stream infections were not only related to the underlying conditions, but also to the insertion site. We need to study the clinical importance of coagulase negative Staphylococci as it is part of the normal flora of the skin. In future, more studies are needed to take preventive measures and improve treatment methods.

Fracture of an Implantable Central Catheter Due to Pinch Off Syndrome (Pinch off 증후군에 의한 피하매몰형 중심정맥도관의 절단)

  • Yun, Ju-Sik;Oh, Sang-Gi;Song, Sang-Yun
    • Journal of Chest Surgery
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    • v.41 no.4
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    • pp.504-507
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    • 2008
  • Implantable central venous catheters (Chemoport) are increasingly being used for vascular access, parenteral nutrition and administering chemotherapeutic agents. As with most invasive procedures, central venous catheterization is associated with numerous potential complications such as infection, thoromboembolism and occlusion. A rare but serous complication is the catheter fracture. We present here three cases of catheter fracture as a consequence of Pinch off syndrome, and we include a review of the relevant literature.

Endocarditis with Intracardiac Migration of Transvenous Permanent Pacing Lead - 1 Case Report - (영구 경정맥 심박조율도관의 심장내 이동과 동반된 심내막염 - 1례 보고 -)

  • Ku, Gwan-Woo;Kang, Shin-Kwang;Won, Tae-Hee;Kim, Si-Wook;Yu, Jae-Hyun;Na, Myung-Hoon;Lim, Seung-Pyung;Lee, Young
    • Journal of Chest Surgery
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    • v.35 no.11
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    • pp.831-834
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    • 2002
  • When any part of the pacemaker system is infected, all pacemaker hardware should be removed, because reinfection rates of 51% to 77% have been noted in patients whose infected pacemaker system has been only partially explanted. The removal of infected leads during cardiopulmonary bypass prevents mechanical injury as well as the spread of infection and vegetation. We report one case of endocarditis by staphylococcus aureus with infected transvenous pacing lead which was migrated into the heart from the left subclavian vein. We removed the migrated pacing lead and vegetation under cardiopulmonary bypass.

Comparison of Anatomical Characteristics for Wood Damaged by Oak Wilt and Sound Wood from Quercus mongolica (참나무시들음병 신갈나무 피해목과 건전목의 해부학적 특징 비교)

  • JEON, Woo-Seok;LEE, Hyun-Mi;PARK, Ji-Hyun
    • Journal of the Korean Wood Science and Technology
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    • v.48 no.6
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    • pp.807-819
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    • 2020
  • The aim of this study was to investigate the anatomical characteristics of Quercus mongolica infested by oak wilt disease. To analysis the anatomical characteristics of the wood specimens infested by the oak wilt, the anatomical structures of an infected wood, a dead wood, and sound wood were observed at 10-year-old intervals from 10 to 50 annual rings using both an optical and a scanning electron microscope. The fiber length was measured in units of 5 annual rings from the pith, and the diameter of the vessel element and the ratio of the vessel including the tyloses were measured for each 10 annual ring. In the cross section, on the infected and dead wood specimens, mycelium was also observed with the tyloses in the vessel. There was no signification difference between the wood specimens in the fiber length and the vessel diameter of the vessel element. The fiber length was not difference after 20-30 annual rings which is a part of juvenile wood. The average of the vessel ratio including tyloses in the infected wood was the highest. Especially, the ratio of tyloses was the highest 40-50 annual rings in the infected wood and the dead wood. Therefore, the large difference between the infested wood by oak wilt and the sound wood was the ratio of tyloses. This result can be used as a basic data to utilize the infested wood.

Comparison of Early Complications after Peritoneal Dialysis Catheter Implantation by Laparoscopic Surgery and Conventional Surgery in Children (소아에서 복막투석도관 삽입시 복강경을 이용한 방법과 기존의 수술법에 따른 초기 합병증 발생의 차이)

  • Jeong, Soo-In;Lee, Hyun-Young;Lee, Cheol-Gu;Seo, Jeong-Meen;Lee, Suk-Koo;Kim, Su-Jin;Kwak, Min-Jung;Jin, Dong-Kyu;Paik, Kyung-Hoon
    • Childhood Kidney Diseases
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    • v.11 no.1
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    • pp.51-58
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    • 2007
  • Purpose : To assess the early complication of laparoscopic peritoneal dialysis catheter implantation in children. Methods : Medical record review was carried out on 21 laparoscopic and 16 conventional peritoneal dialysis catheter implantations which were performed in 31 children under 18 years of age between 2002 and 2006. All medical records were retrospectively analyzed. The patients were followed until 2 months after catheter placement. Patient characteristics and catheterrelated complications, such as significant bleeding, leakage, obstruction, migration, insertion site infection and peritonitis during the first 60 days after implantation were recorded. Results : After conventional operation, dialysate leakage occurred in 2 of 16 cases and all cases improved after conservative management. In 1 case, significant bleeding occurred and re-operation was performed. Three cases of obstruction due to migration were reported, 2 cases underwent reoperation and 1 case improved without intervention. After laparoscopic surgery, outflow obstruction occurred in 1 out of 21 cases, which was caused by adhesion after several reinsertions of the catheter and recurrent peritonitis. No migration was noted after laparoscopic surgery. There was no significant difference in the complication rate between the two groups. Conclusion : Laparoscopic peritoneal dialysis catheter placement is feasible in children of all age groups, with at least equivalent functional results compared to conventional surgery. The additional advantage of laparoscopic catheter insertion is the option to identify and eliminate anatomical risk factors, such as intra-abdominal adhesions, and to perform partial omentectomy without additional incisions.

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Outbreak of Acinetobacter septicemia in a neonatal intensive care unit (신생아 집중치료실에서 집단 발생한 Acinetobacter septicemia)

  • Kim, Myo Jing;Lee, Hye Jin;Son, Sang Hee;Huh, Jae Won
    • Clinical and Experimental Pediatrics
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    • v.49 no.5
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    • pp.494-499
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    • 2006
  • Purpose : Acinetobacter baumannii is increasingly recognized as an important cause of nosocomial infection, especially in neonatal intensive care units. But little is known about the clinical significance and hospital epidemiology of Acinetobacter species other than A. baumannii. The objective of this study is to describe the clinical characteristics and epidemiology of septicemia due to Acinetobacter species other than A. baumannii. Methods : We retrospectively reviewed 11 cases of blood culture proven nosocomial infection which occured in our neonatal intensive care unit from $4^{th}$ to $24^{th}$, February, 2004. To establish epidemiological analysis, we performed environmental cultures and an antibiogram was obtained from susceptability tests of isolated Acinetobacter species. Results : Clinical manifestations including fever, poor feeding, abdominal distension, diarrhea, bloody stool passage, vomiting, tachypnea and apnea were similar to other infectious diseases. Benign clinical courses were compared with poor prognose, including a high mortality rate in septicemia due to A. baumannii. The major predisposing factor among our patients was the presence of a peripheral intravascular catheter. Antibiogram was similar, but surveillance cultures of environmental specimens failed to identify the source of infection. Conclusion : Acinetobacter species other than A. baumannii were often considered relatively avirulent bacteria, but could be pathologic organisms if cultured in patients with clinical symptoms.

Surgical Removal of Knotted Pulmonary Artery Catheter -A case report- (매듭지어진 폐동맥도관의 외과적 적출 -1례 보고-)

  • Kim, Byung-Il;Kim, Hyuk;Sohn, Sang-Tae;Jeong, Tae-Yeol;Chung, Won-Sang;Kim, Young-Hak;Kang, Jeong-Ho;Jee, Heng-Ok
    • Journal of Chest Surgery
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    • v.32 no.3
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    • pp.315-317
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    • 1999
  • The complications associated with the use of pulmonary artery catheter include dysrhythmias, heart block, pulmonary artery rupture, pulmonary infarction, endocardial damage, balloon rupture, arterial puncture, thromboembolism, air embolism, infection, pneumothorax, and knotting of the catheter. Knotting of the catheter is a rare complication and it should be anticipated if there is an excessive advancement of the pulmonary artery catheter beyond the normally expected distance. We report a successful surgical removal of knotted pulmonary artery catheter by sternotomy and cardiopulmonary bypass.

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