• 기본간호학회지
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• 제20권4호
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• pp.359-371
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• 2013

Purpose: The purpose of this study was to determine the status of tuberculosis (TB) infection control in hospitals. Method: This study was a cross-sectional descriptive study in which self-administered questionnaires were used to survey 77 hospitals. Data were collected from August 12 to September 15, 2012. Results: Only 27 institutions (35.1%) were monitoring patients infected with or suspected of having TB. Most hospitals were conducting TB prevention education for patients' family and employees, and TB screening for employees along with follow-up examinations. However, private negative pressure rooms were more often available in wards and intensive care units than in outpatient departments, and in institutions with over 700 beds located in Seoul or GyeongGi Province. Most hospitals ensured that masks were placed on infected patients while transporting them. In addition, efforts to control TB infection such as placing respiratory etiquette posters in outpatient departments and airborne infection signs on the doors in the wards were also well established in most institutions. Conclusion: More efforts are needed to improve the status of TB infection control to ensure quality care, especially in terms of monitoring patients with TB infections and making private negative pressure rooms available in outpatient departments.

• Tuberculosis and Respiratory Diseases
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• 제83권2호
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• pp.132-140
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• 2020

In human immunodeficiency virus (HIV)-infected patients, Pneumocystis jirovecii pneumonia (PCP) is a well-known opportunistic infection and its management has been established. However, PCP is an emerging threat to immunocompromised patients without HIV infection, such as those receiving novel immunosuppressive therapeutics for malignancy, organ transplantation, or connective tissue diseases. Clinical manifestations of PCP are quite different between patients with and without HIV infections. In patients without HIV infection, PCP rapidly progresses, is difficult to diagnose correctly, and causes severe respiratory failure with a poor prognosis. High-resolution computed tomography findings are different between PCP patients with HIV infection and those without. These differences in clinical and radiological features are due to severe or dysregulated inflammatory responses that are evoked by a relatively small number of Pneumocystis organisms in patients without HIV infection. In recent years, the usefulness of polymerase chain reaction and serum β-D-glucan assay for rapid and non-invasive diagnosis of PCP has been revealed. Although corticosteroid adjunctive to anti-Pneumocystis agents has been shown to be beneficial in some populations, the optimal dose and duration remain to be determined. Recent investigations revealed that Pneumocystis colonization is prevalent and that asymptomatic carriers are at risk for developing PCP and can serve as the reservoir for the spread of Pneumocystis by airborne transmission. These findings suggest the need for chemoprophylaxis in immunocompromised patients as well as infection control measures, although the indications remain controversial. Because a variety of novel immunosuppressive therapeutics have been emerging in medical practice, further innovations in the diagnosis and treatment of PCP are needed.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제8권1호
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• pp.7-12
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• 2002

The air ventilation system of operation rooms has been studied to prevent the cross infection during the operation. Operation rooms and air ventilation systems of three University hospitals were investigated. The distribution of microbe was measured by cultivating air samples in the operation room. A two-dimensional model for the cross-section of an operation room was developed for the CFD(Computational Fluid Dynamics) analysis. The characteristics of air flow in the empty operation room and in occupied operation room were calculated by using a CFD program. The current diffuser location of an old hospital did not deliver the clean air to the operation part efficiently. A new method to locate diffusers that improve air venting with little increase of the cost of equipment was suggested.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제24권2호
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• pp.7-14
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• 2018

Purpose: The outbreak of Middle East Respiratory Syndrome(MERS) in KOREA has brought up the demands for ventilation guideline and regulations for healthcare facilities since most of the infection was spreaded inside healthcare facility. Currently KOREA has no ventilation guideline or regulations covering entire section of healthcare facility. The purpose of this study is to investigate current ventilation methods in KOREA healthcare facilities to in future, propose ventilation guideline. Methods: Research of foreign counties ventilation guideline and regulation for healthcare facilities were conducted for reference. Field investigation with survey of 21 healthcare were conducted to identify the ventilation system and operating methods. Additionally survey for healthcare workers were conducted to observe the recognition related to ventilation system in healthcare facility. Results: The result showed that most of foreign countries ventilation guideline and regulation suggests similar items to reduce the spread of infection and maintain good indoor air quality. The investigation results indicated that fixed guideline for ventilation in healthcare facility were required due to different ventilation operating methods. Survey result of healthcare workers has told us that ventilation guideline and regulation is needed to prevent further infection. Implications: Absence of ventilation guideline and regulations for healthcare facility in KOREA is an urgent issue.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제24권2호
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• pp.37-44
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• 2018

Purpose: This study investigates the influences of coughing direction and healthcare worker's location on the transport characteristics of coughed particles in airborne infection isolation room (AIIR), which is commonly called negative pressure isolation room, with a downward ventilation system. Methods: Computational Fluid Dynamics (CFD) was used to simulate the airflow and for tracing the behavior of particles. Results: The results show that the airflow pattern and coughing direction have a significant influence on the characteristics of particle dispersion and deposition. When healthcare workers are in the isolation room with the patient who is lying on the bed, it is recommended to be located far from the anteroom to reduce the exposures from infectious particles. And when the patient is lying, it is more effective in removing particles than when the patient is in Fowler's position. Although it is an isolation room that produces unidirectional flow, coughing particles can spread to the whole room and a large number of particles can be deposited onto patient, bed, side rails, healthcare worker, ceiling, floor, and sidewall. Implications: Following the patients' discharge or transfer, terminal cleaning of the vacated room, furniture, and all clinical equipment is essential. Also, it is necessary to establish detailed standard operating procedure (SOP) in order to reduce the risk of cross-contamination.

• The Plant Pathology Journal
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• 제15권4호
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• pp.158-161
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• 1999

We determined threshold environmental factros to initiate infection of pepper plants by Botrytis cinerea, a fungal pathogen of pepper gray mold, in two greenhouse conditions. A new efficient spore-trapping method was developed to estimate population density of airborne conidia in the greenhouses, and spore release was measured using a Kerssies' selective medium. At a given day, spores were released greater during daytime (mostly from 7:30 am to 10:30 am and at 4:30 pm) than nighttime. Diurnal and nocturnal temperatures in the greenhouse-1 were about $25^{\circ}$ and $17^{\circ}$,and relative humidity was 100% for prolonged 24 h due to rain on December 17, 1997. Population density of air-borne conidia was 3.0$\times$103 conidia/ $0.5\textrm{m}^3$ after two days, and the initial infection occurred in ten days. During the same period of time in the greenhouse-2, diurnal temperature was about $25^{\circ}$ and nocturnal temperature was below $15^{\circ}$, and population density of air-borne conidia was 104 conidia/ $0.5\textrm{m}^3$. Under these conditions, the initial infection started in three days. This indicates that the early infection occurs under which diurnal temperature is approximately $25^{\circ}$, nocturnal temperature is maintained below $15^{\circ}$, and population density of air-borne conidia is 104 conidia/ $0.5\textrm{m}^3$ at saturated relative humidity condition.

• 대한치과의료관리학회지
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• 제8권1호
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• pp.1-7
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• 2020

Dental settings have unique characteristics that warrant specific infection control considerations, including (1) prioritizing the most critical dental services and provide care in a way that minimizes harm to patients due to delayed care, or harm to personnel from potential exposure to persons infected with the COVID-19 disease, and (2) proactively communicate to both personnel and patients the need for them to stay at home if sick. For health care, an interim infection prevention and control recommendation (COVID-19) is recommended for patients suspected of having coronavirus or those whose status has been confirmed. SARS-CoV-2, which is the virus that causes COVID-19, is thought to be spread primarily between people who are in close contact with one another (within 6 feet) through respiratory droplets that are produced when an infected person coughs, sneezes, or talks. Airborne transmission from person-to-person over long distances is unlikely. However, COVID-19 is a new disease, and there remain uncertainties about its mode of spreads and the severity of illness it causes. The virus has been shown to persist in aerosols for several hours, and on some surfaces for days under laboratory conditions. COVID-19 may also be spread by people who are asymptomatic. The practice of dentistry involves the use of rotary dental and surgical instruments, such as handpieces or ultrasonic scalers, and air-water syringes. These instruments create a visible spray that can contain particle droplets of water, saliva, blood, microorganisms, and other debris. While KF 94 masks protect the mucous membranes of the mouth and nose from droplet spatter, they do not provide complete protection against the inhalation of airborne infectious agents. If the patient is afebrile (temperature <100.4°F)* and otherwise without symptoms consistent with COVID-19, then dental care may be provided using appropriate engineering and administrative controls, work practices, and infection control considerations. It is necessary to provide supplies for respiratory hygiene and cough etiquette, including alcohol-based hand rub (ABHR) with 60%~95% alcohol, tissues, and no-touch receptacles for disposal, at healthcare facility entrances, waiting rooms, and patient check-ins. There is also the need to install physical barriers (e.g., glass or plastic windows) in reception areas to limit close contact between triage personnel and potentially infectious patients. Ideally, dental treatment should be provided in individual rooms whenever possible, with a spacing of at least 6 feet between the patient chairs. Further, the use of easy-to-clean floor-to-ceiling barriers will enhance the effectiveness of portable HEPA air filtration systems. Before and after all patient contact, contact with potentially infectious material, and before putting on and after removing personal protective equipment, including gloves, hand hygiene after removal is particularly important to remove any pathogens that may have been transferred to the bare hands during the removal process. ABHR with 60~95% alcohol is to be used, or hands should be washed with soap and water for at least 20 s.

• 한국재난정보학회 논문집
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• 제18권3호
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• pp.566-573
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• 2022

연구목적: 본 연구는 중동호흡기증후군(MERS) 및 코로나바이러스 감염증-19(코로나19)의 국내 유행 이후 늘어난 신종 감염병에 대한 두려움을 해소하기 위하여, 감염취약계층의 집단감염 위험이 있는 초등학교에서 공기살균기 적용에 따른 공기살균효과를 검증하고자 하였다. 연구방법: 서울시 소재의 초등학교의 교실 및 급식실, 화장실에 공기살균기를 각 1대씩 설치하고 공기살균기와 2m 떨어진 거리에서 표면 및 공기 시료를 채취하여 미설치 대조군과 비교하여 세균저감 효과를 분석하였다. 연구결과: 표면에서의 살균효과는 대조군 및 시험군 모두 2log CFU/cm²미만의 결과가 나왔으며, 대조군에 비해 시험군이 54~87% 저감효과가 있는 것으로 나타났다. 또한 공기중에서의 살균효과는 공기살균기 설치 위치에 따라 살균능력이 차이 났으며, 벽면 설치는 대조군에 비해 최대 91%의 저감 효과를 보였으며, 중앙 설치는 최대 93%의 저감 효과를 보였다. 결론: 연구결과 상시적인 소독을 진행하는 초등학교에서 현재의 방역프로그램을 유지하는 한편 공기살균기의 적용하여 상시적인 공기살균을 병행하면 감염병 전파 방지에 상승효과를 볼 수 있을 것으로 보인다. 또한 공기살균기로의 공기유입이 원활할 수 있도록 하는 것이 바람직할 것으로 사료된다.

• 대한바이러스학회지
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• 제28권4호
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• pp.317-325
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• 1998

The primary culture of human nasal epithelial cells was performed using the inferior nasal turbinate tissues, and infected with Hantaan virus to examine the hypothesis of airborne transmission of Hantaan virus in humans. The primary culture cells were identified as epithelial cells by morphologic and immunologic analyses. The viral antigens were detected in the primary human nasal epithelial cells infected with Hantaan virus by immunofluorescence staining. The ICAM-1 induction by Hantaan virus or $IFN-{\gamma}$ was examined in the primary human nasal epithelial cells and human lung fibroblasts (WI-38). Hantaan virus induced the surface ICAM-1 in WI-38 cells in a time-dependent manner, and $IFN-{\gamma}$ induced the surface ICAM-1 in a dose-dependent manner in HNEC and WI-38 cells. These results revealed that the human nasal epithelial cells are susceptible to Hantaan viral infection supporting the hypothesis of airborne transmission of Hantaan virus in humans. The human lung fibroblasts also might have an important role in the pathogenesis of Hantaan virus through the induction of ICAM-1.

• 대한의생명과학회지
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• 제29권4호
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• pp.363-370
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• 2023

Human respiratory viral infections such as COVID-19 are highly contagious, so continuous management of airborne viruses is essential. In particular, indoor air monitoring is necessary because the risk of infection increases in poorly ventilated indoors. However, the current method of detecting airborne viruses requires a lot of time from sample collection to confirmation of results. In this study, we proposed a system that can monitor airborne viruses in real time to solve the deficiency of the present method. Air samples were collected in liquid form through a bio sampler, in which case the virus is present in low concentrations. To detect viruses from low-concentration samples, viral RNA was concentrated and extracted using silica-magnetic beads. RNA binds to silica under certain conditions, and by repeating this binding reaction, bulk samples collected from the air can be concentrated. After concentration and extraction, viral RNA is specifically detected through real-time qPCR (quantitative polymerase chain reaction). In addition, based on liquid handling technology, we have developed an automatic machine that automatically performs the entire testing process and can be easily used even by non-experts. To evaluate the system, we performed air sample collection and automated testing using bacteriophage MS2 as a model virus. As a result, the air-collected samples concentrated by 45 times then initial volume, and the detection sensitivity of PCR also confirmed a corresponding improvement.