• Title/Summary/Keyword: 병원 감염 관리

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Molecular Subtyping of Methicillin-Resistant Staphylococcus aureus Isolated from Patients' Nasal Cavity (환자의 비강으로부터 분리된 메티실린 내성 황색 포도알균의 분자 아형 분석)

  • Kim, Sang-Ha;Park, Sung-Bae;Park, Heechul;Kim, Jun Seong;Kim, Jungho;Lee, Jiyoung;Lim, Jaewon;Kim, Young Kwon;Kim, Sunghyun
    • Korean Journal of Clinical Laboratory Science
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    • v.52 no.2
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    • pp.128-135
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    • 2020
  • Methicillin-resistant Staphylococcus aureus (MRSA) is a bacterium that causes infections in different parts of the body and causes skin and soft tissue infections (SSTI). The present study examined the antimicrobial resistance patterns and molecular epidemiological characteristics of MRSA isolated from nasal swabs in clinical patients. SCCmec type of MRSA isolates from clinical patients were analyzed: 24 cases were SCCmec type-II; two cases were type-II/IVa; one case was type-II/V; one case was type-IVa; 11 cases were not-typeable. The mec complex type of MRSA isolates from clinical patients were analyzed: 29 cases were mec complex type A, and 10 cases were not-typeable, but type B was not found in the present study. In conclusion, SCCmec type-II and mec complex type A were the most dominant MRSA subtypes among the MRSA isolates from a nasal swab of patients, and the results were similar to other studies on hospital-acquired MRSA (HA-MRSA). These results can not only provide basic data for hospital infection management but also be a good guideline for MRSA infections in the Republic of Korea.

Aquatic animal health management in stock enhancement (방류용 수산종묘의 질병 관리에 대한 고찰)

  • Seo, Jang-Woo;Cho, Mi-Young;Kim, Jin-Woo;Park, Gyeong-Hyun;Jee, Bo-Young;Choi, Dong-Lim;Park, Myoung-Ae;Oh, Myung-Joo
    • Journal of fish pathology
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    • v.23 no.1
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    • pp.85-98
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    • 2010
  • Ministry of Agriculture, Fisheries and Food (MAFF) and National Fisheries Research and Development Institute (NFRDI) have inspected the hatchery-reared seeds of 22 marine species and 11 freshwater species for aquatic animal diseases in stock enhancement program in 2009. Results showed that total 12 local selfgovernments have been restocking the sea with cultured juveniles. Gyeongsangnam-do, Jeollanam-do, Jejudo and Chungcheongnam-do have a preference for marine species seeds to freshwater species. On the contrary, freshwater species were released mostly in Gyeonggi-do, Jeollabuk-do and Chungcheongbuk-do. In the marine species group, abalone was the most abundant as 24.5%, and then sea cucumber (15.2%), olive flounder (11.5%), swimming crab (5.6%), black sea bream and rockfish (6.8%), rock bream (5.1%), black rockfish (4.6%) and scorpionfish (4.5%) were followed. Crucian carp was the most abundant as 19.4%, and then eel (17.0%), Korean bullhead (12.3%), melanian snail (12.0%), catfish (8.4%) were followed in the freshwater species group. The total number of inspection cases in this study were 1,080 and disqualification cases were 19 by detection of aquatic animals pathogens such as red sea bream iridovirus (RSIV), koi herpesvirus (KHV) or white spot syndrome virus (WSSV).

$CO_2$ Laser Application for Treatment of the Hairy Tongue (이산화탄소 레이저를 이용한 모설의 치료)

  • Jung, Da-Woon;Cho, Eunae;Ahn, Hyung-Joon
    • Journal of Oral Medicine and Pain
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    • v.38 no.2
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    • pp.97-101
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    • 2013
  • Hairy tongue is a disease caused by hypertrophy of filiform papillae on the tongue dorsum. Clinically, it occurs on the posterior 1/3 of the tongue dorsum and is rarely observed on the lateral and tip of the tongue. Several types of colored pigmentation from white to brown and black appear depending on the ingested food and the existing pigmentation inducing bacteria. Although clinically asymptomatic, patients will visit the clinic for esthetic problems and at rare intervals experience nausea, halitosis, dysgeusia and unpleasant sensation. The exact etiology is yet not known but causes such as inappropriate oral hygiene control, a shift in oral bacterium, infection, radiotherapy, use of antibacterial drugs or immunosuppressants, excessive smoking or alcohol drinking and decrease of salivary flow rate may be a factor of the disease. Clinical symptoms are quite typical and diagnosis may be made simply by observation, not necessarily biopsy. Treatment of hairy tongue is done by eliminating the etiology factors, brushing the tongue gently with a tongue cleaner and in some cases using keratolytic agent. Although it is rare to treat hairy tongue surgically, we will introduce a case successfully treated using carbondioxide laser($CO_2$ laser), after no sufficient improvement had been made by conservative treatment.

A study of the impacts of medical institution information on daily medical expenses and medical expense reduction rate in convergence age (융복합시대에 의료기관 정보가 일당진료비와 삭감율에 미치는 영향에 관한 연구)

  • Yang, Yu-Jeong;Lee, Hye-Seung
    • Journal of Digital Convergence
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    • v.13 no.7
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    • pp.259-268
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    • 2015
  • This research grasped the difference of between the daily medical expenses and the medical expenses reduction rate also the cause of change. In the centre, it was conducted in order to offer the necessary basic data to a recuperation pay management solution's establishment. This research surveyed across the country's urban region 50-general hospital's the infective enteritis disease for a year. Then it was conducted the average daily medical expenses and the average medical expenses reduction rate as a distinguishable survey that is a hospitalization and an outpatient the result is followed. The inpatient daily medical expenses correlated with the total number of medical institution personnel, and the outpatient daily medical expenses correlated with the number of beds.. Inpatient medical expense reduction rate was correlated with number of beds and the total number of medical institution personnel. The interaction between medical institution information and daily medical expenses was found to have a positive (+) effect on the total number of medical institution personnel, as well as the numbers of inpatients vs. outpatient. This research about the medical expense reduction rate and daily medical expense help medical institution's efficient, rational decision making and it will be an important basis of a priority recuperation pay's policy.

A Survey on the Performance of Surgical Hand Scrubs (의사와 간호사의 외과적 손씻기에 관한 지식, 태도 및 실천에 대한 조사 연구)

  • 윤혜상
    • Journal of Korean Academy of Nursing
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    • v.26 no.3
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    • pp.591-604
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    • 1996
  • The surgical hand scrub (SHS) is the single most important procedure in the prevention of post-operative wound infections and yet it remains the most violated of all infection control procedures. The purpose of this study was to gain an overview of SHS habits in operative th atre personnel and to determine knowledge and attitudes to identify whether there is a need for improvement. The subjects for this study included 79 doctors and 94 nurses working in the operative th atres of four hospitals in Incheon City and Kyungki Province. Related data were collected from July 25 to August 10, 1995 by the author. The data were analyzed using descriptive stat-istics and Chi-squre test. The results of the study are summarized as follows : 1. Nurses felt that they conducted SHS for a longer period of time than doctors did(X=20.1, P=.005). 2. Nurses and doctors had some knowledge of slip-ping rings off fingers and the length of nails, but they lacked knowledge on the duration of SHS, handwashing after an operation and on manicure. 3. There were many reasons given for insufficient SHS included : 1) because they were so busy (38%). 2) brushes were too harsh(19.7%). 3) operations were very simple(18.7%). 4) surgical latex gloves provide functional barrier(11.6%). 5) SHSs were troublesome(7.4%) 6) there were no clocks near the sinks(2.5%) and 7) the operative patients were administered antibiotics after operartion(2.1%). 4. Most of nurses and doctors considered SHS to be important in prevention against post operative infections. 5. Nurses were found to do a thorough SHS, but residents were found to neglect SHS. 6. Considering prevention against postoperative infections, most nurses and doctors considered aseptic techniques, environment-sanitary management and SHS more important than the use of antibiotics, the resistance of patients or the method of operation. 7. Half of the nurses and doctors(54.3%) considered surgical latex gloves to function well as a barrier. 8. Half of the nurses (56.4%) and doctors(51.9%) learned SHS as part of the curriculum in their school education and the rest(nurses : 95.7%, doctors : 74.7%) learned SHS as part of their In Service Education. In conclusion, these findings suggest a need to develop an educational program on surgical hand scrub and hospital infection control for surgical personnels, to install clocks near the hand scrub sinks, to consider a violation report for negligent surgical hand scrubs, and to develop a soft brush for hand scrubs in order to increase performance of the surgical hand scrub.

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Coronary Artery Bypass Surgery in Patients with End-Stage Renal Disease (말기 신부전 환자에서의 관상동맥 우회수술)

  • Kim, Kun-Il;Song, Hyun;Yu, Yang-Gi;Jo, Min-Seop;Matsuda, Naruto;Sorokin, Vitaly A.;Choo, Suk-Jung;Lee, Jae-Won;Song, Meung-Gun;Yi, Joon-Seung;Kim, Soon-Bae;Park, Su-Kil;Park, Jung-Sik
    • Journal of Chest Surgery
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    • v.34 no.4
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    • pp.338-344
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    • 2001
  • 배경: 말기 신부전 환자에서 심장병, 특히 관상 동맥 질환의 이환이 늘어나면서 관상동맥 우회수술의 대상 환자가 지속적으로 증가하고 있다. 이들 환자군은 수술후 유병률과 사망률이 매우 높고 고위험군으로 알려져 있다. 대상 및 방법: 1996년 3월부터 2000년 5우러까지 서울 중앙 병원 흉부외과에서 술전 말기 신부전증으로 진단 받은 후 관상 동맥 우회수술을 시행받은 환자 25명을 대상으로 의무 기록을 중심의 후향적 분석을 하였다. 술전 위험 인자 및 술전 신기능, 수술 결과, 술후 경과, 수술후 합병증, 사망률 및 생존률 등을 분석하였다. 결과: 술전 평균 크레아티닌 청소율은 12.7$\pm$5ml/mim였고 술전 평균 혈중 크레아티닌 치는 6.2$\pm$3mg/dl(1.7-14.4)였다. 술전 투석을 시행중인 환자는 11례(44%)였고 술전 투석을 시행하지 않았던 14례(56%)중 8례(8/14, 57.1%)는 수술전후로 새로이 투석이 필요하였다. 술전 혈액 투석 중이었던 9례중 2례에서 수술후 복막 투석으로 전환하였다. 수술 사망률은 2례(8%)로 흡인성 폐렴과 종격동염으로 1례, 그리고 수술후 출형과 종격도염으로 1례가 사망하였다. 수술후 합병증은 14명(56%)의 환자에서 발생하여 매우 높은 발생율을 보였다. 만기사항은 2례(8%)에서 발생하였으며 사망원인은 카테터에 의한 복막염이었다. 생존 환자의 4년 생존률은 82$\pm$13% 였다. 결론: 말기 신부전 환자에서의 관상동맥 우회수술을 비교적 만족스러운 범위의 수술 사망률(8%)을 보였으나 합병증 발생률이 매우 높고 합병증 발생 시 사망률이 매우 높아 수술주위 감염 예방과 세심한 환자 관리가 필요하다.

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Clinical Characteristics Associated with Blood Culture Contamination in Neonates (신생아에서 혈액 배양 오염과 관련된 임상적 특징)

  • Jung, Min Young;Son, Ok Sung;Hong, Yoo Rha;Oh, Chi Eun
    • Pediatric Infection and Vaccine
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    • v.22 no.3
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    • pp.147-153
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    • 2015
  • Purpose: This study was aimed to investigate the contamination rates of blood culture in a neonatal intensive care unit (NICU) and to examine the clinical characteristics related to the contamination. Methods: Eight hundred thirty cases of blood culture performed from March 2013 to February 2014 were analyzed. We evaluated the contamination rates of blood culture by blood sampling sites and compared the clinical characteristics such as real name system and body weights of the contaminated cases and those of non-contaminated ones. The clinical characteristics were retrospectively reviewed by medical records. Results: The overall contamination rate was 3.6% (30/830). The contamination rates by blood sampling sites were as follows: peripheral vein 15.6% (10/64), peripheral artery 2.6% (20/759), and umbilical arterial catheter 0% (0/7). There was no difference in the contamination rates between cases with and without real name system (P=0.484). However, there were significant differences in the contamination rates by the physicians who performed the culture (P=0.038) and body weight (<1,000 g vs. ${\geq}1,000g$) at the time of blood culture (P<0.001). Conclusions: These results suggest that neonates with a body weight less than 1,000 g have more risks of the contamination of blood culture. Furthermore, there is a necessity to provide blood culture performers with active feedbacks and individualized education plans that can help diminish blood culture contamination rates. Prospective studies in a systematic manner that can be applied in actual clinical settings are needed in order to figure out factors that can diminish the contamination rates of blood culture in NICU.

Mediating Effect of Attitude toward Advertisement on the Relationship between COVID-19 Involvement and Behavioral Intention of Social Distancing in Loss versus Gain Advertising Context (손실과 이득 메시지 프레이밍 광고상황에서 COVID-19에 대한 관여와 사회적 거리두기 실천의도와의 관계에 영향을 미치는 광고태도의 매개효과)

  • Choi, Ja In;Choi, Ja Yun
    • Journal of the Korea Convergence Society
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    • v.12 no.12
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    • pp.467-477
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    • 2021
  • Purposes of this study were to identify the relationship among involvement in COVID-19 (IiC), attitude toward advertisement (AtA), and behavioral Intention to social distancing (BItSD), and to investigate the mediating effect of AtA in a loss versus gain advertising context. The participants were 379 adults who have been consecutively living in Korea since January 2020. The participants were randomly assigned to one of two advertisements using an online survey system. We found that IiC affects BItSD since Korean adults recognize the risks and seriousness of COVID-19 infection or transmission through IiC. Induced positive attitudes or emotions through involvement in the COVID-19 preventive behaviors including social distancing and vaccination are helpful to increase the BItSD. Thus, health care and information providers should give an accurate message, which induces a positive attitude, to recognize that our world is a risk of the COVID-19.

The Role of Health Committee for Health Management of Rural Residents in the COVID-19 Epidemic (코로나19 유행 상황에서 농어촌지역 건강마을 건강위원의 역할)

  • Kim, Yunyoung;Kim, Keonyeop;Hong, Nam-Soo;Kang, Soo Jin;Kim, Eunhwi;Kim, Jong-Yeon;Park, Min-Ah
    • Journal of agricultural medicine and community health
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    • v.46 no.4
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    • pp.218-229
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    • 2021
  • Objectives: The purpose of this study was to suggest the direction of the Healthy Village project for rural residents in accordance with the prolonged COVID-19 by investigating the digital environment for major health problems, the role of a health leader, necessary projects, and non-face-to-face projects for Healthy Village members in the COVID-19 epidemic. Methods: Telephone interview surveys were conducted with 585 residents from November 30, 2020 to December 21, 2020. Results: Health problems perceived by residents were in the order of concerns about infection (48.5%), depression (32.5%), difficulties in using medical services (9.4%), and lack of exercise (7.7%). The role of the health committee in the COVID-19 situation was "encouraging people to follow quarantine rules" with 91.3%. As a necessary health village project, there was a high demand for the provision of health products and mental health projects. 17.9% said that there is a computer or smart device connected to the Internet in their home, and 42.2% said that there is someone in the village who can easily get help if there is a problem in accessing and using Internet information. 36.9% were able to watch videos, and 22.2% were able to use the Internet through public facilities. Conclusion: In a public health crisis, where the provision of public health and medical services to rural residents is not smooth, it is necessary to manage health and quarantine through health leaders in the village, and it is required to establish a digital environment infrastructure that can conduct community participatory health village projects in a non-face-to-face environment.

Epidemiological Study of KPC-2 Producing Klebsiella pneumoniae Isolated in Daejeon During a 4-Year Period (최근 4년간 대전지역에서 분리된 KPC-2 생성 Klebsiella pneumoniae의 역학적 연구)

  • Hye Hyun, Cho
    • Korean Journal of Clinical Laboratory Science
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    • v.54 no.4
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    • pp.265-272
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    • 2022
  • The emergence and dissemination of carbapenemase-producing Enterobacteriaceae (CPE), particularly the Klebsiella pneumoniae carbapenemase-2 (KPC-2) producing Klebsiella pneumoniae, has been rapidly increasing worldwide and is becoming a serious public health threat. Since the epidemiology and characteristics of these KPC-2-producing K. pneumoniae vary according to the region and period under consideration, this study investigated the prevalence of carbapenemases and the epidemiological relationship of 78 carbapenem-resistant K. pneumoniae (CRKP) isolated from a tertiary hospital in Daejeon, from March 2017 to December 2020. The antimicrobial susceptibility tests were identified using the disk-diffusion method. PCR and DNA sequencing were used to determine the carbapenemase genes. In addition, molecular epidemiology was performed by multilocus sequence typing (MLST). Among the 78 CRKP isolates, 35 isolates (44.9%) were carbapenemase-producing K. pneumoniae (CPKP) and the major carbapenemase type was KPC-2 (30 isolates, 85.7%). The New Delhi metallo-enzyme-1 (NDM-1) and NDM-5 were identified in 4 isolates (11.4%) and 1 isolate (2.9%), respectively. Multilocus sequence typing (MLST) analysis showed 10 sequence types (STs) and the most prevalent ST was ST307 (51.4%, 18/35). All the ST307 isolates were KPC-2-producing K. pneumoniae and were multidrug-resistant (MDR). In addition, ST307 has gradually emerged during a four-year period. These findings indicate that continuous monitoring and proper infection control are needed to prevent the spread of KPC-2-producing K. pneumoniae ST307.