• Journal of Yeungnam Medical Science
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• v.34 no.2
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• pp.182-190
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• 2017

Background: Respiratory viruses play a significant role in the etiology of acute respiratory infections and exacerbation of chronic respiratory illnesses. This study was conducted to identify the epidemiological and clinical characteristics of children with acute viral lower respiratory infections. Methods: This study investigated 1,168 children diagnosed with acute viral lower respiratory tract infections (RTIs) between January 2012 and December 2014. Specimens of respiratory viruses were collected using a nasopharyngeal swab and analyzed by reverse transcriptase polymerase chain reaction. We retrospectively reviewed the medical records and analyzed the clinical features of children hospitalized for acute lower respiratory infections. Results: Respiratory syncytial virus (RSV), the main cause of infection in children aged <5 years, was the most commonly detected pathogen in children with bronchiolitis and pneumonia, and resulted in high proportions of children requiring oxygen treatment and intensive care unit admission. Rhinovirus was preceded by RSV as the second most common cause of bronchiolitis and pneumonia, and was detected most frequently in the children aged ${\geq}6$ years. In addition, asthma was predominantly caused by rhinovirus in children aged ${\geq}6$ years, whereas croup was mostly caused by parainfluenza virus in those aged <5 years. Rhinovirus infection (p<0.001) and history of asthma (p=0.049) were identified as significant risk factors for readmission within a month. Conclusion: We identified the epidemiological and clinical characteristics of respiratory viruses in children with acute lower respiratory infections during the last 3 years. Our findings may provide useful clinical insight to comprehend the acute viral lower RTIs in children.

• The Korean Journal of Health Service Management
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• v.14 no.1
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• pp.93-102
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• 2020

Objectives: This study analyzed the prescription characteristics of medication for acute respiratory diseases before and after pay-for-performance to provide basic data on effective medical quality management policies. Methods: The research data were collected from the 2013-2014 sample cohort of the National Health Insurance Corporation, from Internal Medicine, Pediatrics, Otorhinolaryngology, Family Medicine and General practitioner clinics (classification of disease codes: J00-J06, J20-J22, J40 outpatients). Results: The antibiotics prescription rates decreased from 43.9% in 2013 to 43.5% in 2014 when the major diagnosis was for upper respiratory infections and increased from 62.0% in 2013 to 62.5% in 2014 when the major diagnosis was for lower respiratory infections. Conclusions: There is a need to identify the correct antibiotic prescription method by expanding the current assessment standards. Such standards must include acute lower respiratory infections and minor diagnoses as the current evaluation techniques focus only on the major diagnosis of acute upper respiratory infections.

• Tuberculosis and Respiratory Diseases
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• v.74 no.2
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• pp.79-81
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• 2013

Few recent reports have indicated that Mycobacterium massiliense causes various infections including respiratory infection. However, there is scarce information on the clinical significance, natural history of the infection, and therapeutic strategy. This report describes a case of an immunocompetent old man infected by M. massiliense that causes acute respiratory failure. In light of the general courses of non-tuberculous mycobacterium infections, rapid progression and fatality are very rare and odd. In addition, we discuss the biological and pathological properties of M. massiliense with the review of cases reported previously including our fatal one.

• Journal of Environmental Health Sciences
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• v.39 no.3
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• pp.230-238
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• 2013

Objectives: For our survey of the incidence of influenza viruses among respiratory viral infections in Seoul, we evaluated their prevalence among infectious acute respiratory viral patients in Seoul from 2010 to 2012 through regular surveillance. Methods: For influenza virus detection, we conducted real-time PCR analyses on 2,544 throat specimens collected from patients with respiratory viral infections in Seoul between 2010 and 2012. They were collected and then tested for the presence of influenza viruses through reverse transcription (RT) - polymerase chain reaction (PCR). Results: 19.1% (486/2,544) of the throat specimens were determined to be positive for influenza viruses. The incidences of influenza viral infection in the case of respiratory viral infections through regular surveillance in Seoul were 23.0% (212/923) in 2010, 6.4% (47/738) in 2011, and 25.7% (227/883) in 2012, and 10.8% (275/2,544) of type A, and 8.3% (211/2,544) type B influenza viruses. In addition, the greatest prevalence was in the 20-49 age group (51.6% ), which shows that influenza viruses constituted a major causative agent of acute respiratory viral infections. Conclusions: The distributions of influenza viruses and the epidemiologic patterns of the viral pathogen in acute respiratory viral infectious patients may provide potentially effective data for epidemiological studies in Seoul, Korea.

• Pediatric Infection and Vaccine
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• v.19 no.2
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• pp.71-78
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• 2012

Purpose: Human bocavirus (hBoV), a recently discovered virus, has been detected in children with respiratory tract infections worldwide. The aim of this study was to analyze the frequency and molecular phylogeny of hBoV in the respiratory samples of children with acute respiratory tract infections in 2010. Methods: Nasopharyngeal samples were collected from 953 children with lower respiratory tract infections at Severance children's hospital in Korea from January 2010 to December 2010. We applied the multiplex PCR technique for the identification of 12 respiratory viruses from the samples. Among the total specimens, hBoV positive samples were subjected to phylogenetic analysis by sequencing a fragment of the VP1/VP2 gene junction. Results: hBoV was detected in 141 (14.8%) among 953 patients. The 61.7% of hBoV-positive samples were found to co-exist with other respiratory viruses. The results of phylogenetic analysis showed that all 141 hBoV-positive isolates were identified as hBoV 1, revealing a high similarity among the isolates (>98%). Conclusion: hBoV 1 with minimal sequence variations circulated in children with acute respiratory infections during 2010. More research is needed to determine the clinical severity and outcomes of the minimal sequence variations.

• Journal of Preventive Medicine and Public Health
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• v.53 no.2
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• pp.82-88
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• 2020

Objectives: The objective of this study was to identify individual and institutional factors associated with the prescription of systemic steroids in patients with acute respiratory infections and to investigate the role of a policy measure aimed to reduce inappropriate prescriptions. Methods: We used data from the National Health Insurance Service-National Sample Cohort from 2006 to 2015 and focused on episodes of acute respiratory infection. Descriptive analysis and multiple logistic regression analysis were performed to identify individual-level and institution-level factors associated with the prescription of systemic steroids. In addition, steroid prescription rates were compared with antibiotic prescription rates to assess their serial trends in relation to Health Insurance Review and Assessment Service (HIRA) Prescription Appropriateness Evaluation policy. Results: Among a total of 9 460 552 episodes of respiratory infection, the steroid prescription rate was 6.8%. Defined daily doses/1000 persons/d of steroid increased gradually until 2009, but rose sharply since 2010. The steroid prescription rate was higher among ear, nose and throat specialties (13.0%) than other specialties, and in hospitals (8.0%) than in tertiary hospitals (3.0%) and other types of institutions. Following a prolonged reduction in the steroid prescription rate, this rate increased since the HIRA Prescription Appropriateness Evaluation dropped steroids from its list of evaluation items in 2009. Such a trend reversal was not observed for the prescription rate of antibiotics, which continue to be on the HIRA Prescription Appropriateness Evaluation list. Conclusions: Specialty and type of institution are important correlates of steroid prescriptions in cases of acute respiratory infection. Steroid prescriptions can also be influenced by policy measures, such as the HIRA Prescription Appropriateness Evaluation policy.

• YAKHAK HOEJI
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• v.57 no.3
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• pp.199-204
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• 2013

This study aimed to quantify antibiotic consumption and expenditures for acute upper respiratory tract infections (URIs) (J00-J06) in outpatients from 2009 to 2011. We used WHO ATC classification and DDDs in measuring antibiotic consumption. National Health Insurance and Medical Aid claims data were analyzed. Antibiotic consumption has decreased from 4.44 DDD/1,000inhabitants/day in 2009, to 4.43 in 2010 and 3.74 in 2011. The estimated expenditures were 8,206 won/1,000inhabitants/day in 2009, 8,379 in 2010, and 7,004 in 2011. Clinics accounted for 89.8% and 86.0% of antibiotic consumption and expenditures respectively for the acute URIs in 2011. We need to monitor antibiotic consumption consistently, and promote judicious antibiotic use.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.25 no.3
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• pp.210-219
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• 2018

Purpose: The purpose of this study was to investigate the effects of emergency setting visitors' knowledge and behavior patterns in relation to prevention of respiratory tract infections. Methods: A descriptive survey was used. The participants were visitors to the emergency service in 'D' general hospital in 'D' city, and the data were collected from July 1 to September 1, 2016. The collected data were analyzed using frequency analysis, t-test, ANOVA, $Scheff{\acute{e}}$ test, Pearson correlation coefficients, and multiple regression analysis. Results: Factors influencing prevention of respiratory tract infections were visitors' education level, methods of dissemination of prevention information, and participants' knowledge with regard to preventive methods. The explanatory power was found to be 35% in the regression model. Conclusion: The findings indicate that visitors' education level, knowledge of infection prevention, and the dissemination of information regarding infection prevention by the hospital play an important role in the prevention of respiratory tract infections in emergency services in the hospital. These results highlight the need for a customized education program for prevention of respiratory tract infections in emergency settings. Programs should take into consideration the educational background of visitors, and provide them with appropriate information regarding infection prevention.

• Clinical and Experimental Pediatrics
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• v.64 no.11
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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.

• Journal of Yeungnam Medical Science
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• v.37 no.4
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• pp.286-295
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• 2020

Respiratory infections are very common and highly contagious. Respiratory infectious diseases affect not only the person infected but also the family members and the society. As medical sciences advance, several diseases have been conquered; however, the impact of novel infectious diseases on the society is enormous. As the clinical presentation of respiratory infections is similar regardless of the pathogen, the causative agent is not distinguishable by symptoms alone. Moreover, it is difficult to develop a cure because of the various viral mutations. Various respiratory infectious diseases ranging from influenza, which threaten the health of mankind globally, to the coronavirus disease 2019, which resulted in a pandemic, exist. Contrary to human expectations that development in health care and improvement in hygiene will conquer infectious diseases, humankind's health and social systems are threatened by novel infectious diseases. Owing to the development of transport and trading activity, the rate of spread of new infectious diseases is increasing. As respiratory infections can threaten the members of the global community at any time, investigations on preventing the transmission of these diseases as well as development of effective antivirals and vaccines are of utmost importance and require a worldwide effort.