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Nosocomial Infection in Neonatal Intensive Care Unit (신생아 중환자실의 원내 감염 추이)

  • Kwon, Hye Jung;Kim, So Youn;Cho, Chang Yee;Choi, Young Youn;Shin, Jong Hee;Suh, Soon Pal
    • Clinical and Experimental Pediatrics
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    • v.45 no.6
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    • pp.719-726
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    • 2002
  • Purpose : Neonates in neonatal intensive care units(NICU) have a high risk of acquiring nosocomial infection because of their impaired host defence mechanism and invasive procedures. Nosocomial infection result in considerable morbidity and mortality among neonates. This study was carried out to survey both the epidemiology of nosocomial infection in our NICU and the annual trends of pathogens. Methods : We retrospectively reviewed culture proven nosocomial infection which occurred in our NICU from January 1995 to December 1999. The data included clinical characteristics, site of infection, pathogens, and mortality. Results : Nosocomial infection rates was 9.0 per 100 NICU admissions during the five-year period. Major sites of infection were bloodstream(32.3%), skin(18.4%), endotracheal tube(17.2%), and catheter(10.6%). The most common pathogen was S. aureus(29.9%). and the others were coagulase- negative staphylococci(CONS)(14.8%), Enterobacter(12.4%), and Candida(9.0%). During the five-year period, nosocomial infection rates increased from 9.5 to 11.6 per 100 admissions with the increase of CONS, Candida, Klebsiella, and Acinetobacter baumannii. The infection rate of S. aureus decreased. Multiple episodes of nosocomial infection occurred in 26.1% of all nosocomial infections. Overall bloodstream infection rates were 3.6 per 100 NICU admissions during five years. CONS(29.1%) and S. aureus(27.1%) were the two most common pathogens. Increasing rates of bloodstream infection by CONS, Candida, Klebsiella, and Acinetobacter baumannii were observed. Bloodstream infection related mortality was 11.9%. Conclusion : The predominant pathogens of nosocomial infection in NICU were S. aureus and CONS. Bloodstream infection, the most frequent nosocomial infection, should be a major focus of surveillance and prevention efforts in NICU.

Growth Characteristics of Juvenile Abalone, Haliotis discus hannai by Commercial Artificial Diet Feeding rate during the Winter Season in Indoor Tank (동계기간 상업용 배합사료 공급비율에 따른 북방전복, Haliotis discus hannai 치패의 성장특성)

  • Kim, Byeong-Hak;Park, Jung Jun;Son, Maeng-Hyun;Kim, Tae-Ik;Lee, Si-Woo
    • The Korean Journal of Malacology
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    • v.32 no.2
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    • pp.95-102
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    • 2016
  • This study investigated the growth characteristics of juvenile abalone when has been rearing as other different feed rates by the commercial abalone formulated feed on indoor tank, during the winter period that was maintaining on the low water temperature. Experimental abalones were use to 1 year old (shell length $29.14{\pm}2.56mm$, wet weight $2.9{\pm}0.6g$), and it has cultured at six feeding rate groups (0.75 DFW, 1.50 DFW, 2.25 DFW, 3.00 DFW, 3.75 DFW, 4.5 DFW) that were set up the daily feeding rate about total weight (DFW), and two replicated. The average water temperature in the experiment period was $9.7{\pm}3.27^{\circ}C$. In the monthly change absolute growth rate (AGRSL) and specific growth (SGRSL) of shell length, at January, 3.00 DFW was significantly higher than all feeding rate groups (P < 0.05). And in the monthly change of weight change and weight gain (WG), at March, 3.75DFW was significantly higher than all feeing rate groups (P < 0.05). The growth coefficient of thermal units (TGC) was decreased rapid since January, and 3.75 DFW was show significantly higher than all feeding rate groups (P < 0.05). In monthly change of feed efficiency (FE), at December, the 0.75 DFW was significantly higher than all feeding rate groups (P < 0.05), and in February and March, there was no significant difference between all feeding period. Therefore, In this study, was show that juvenile abalones can do to maintain or increasing from weight to supply commercial artificial diet during winter period when rearing into the indoor tank.

1 year follow-up results of prenatally diagnosed unilateral hydronephrosis according to renal sonographic findings at 1 month of age (산전 초음파로 발견된 일측성 수신증의 생후 1개월 때의 초음파 소견에 따른 1년 추적 결과)

  • Yoon, Hoe-Soo;Yum, Mi Sun;Lee, Joo Hoon;Park, Young Seo;Kim, Kun Seok;Yoon, Chong Hyun;Moon, Dae Hyuk;Hahn, Hyewon
    • Clinical and Experimental Pediatrics
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    • v.49 no.1
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    • pp.64-70
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    • 2006
  • Purpose : The natural courses of prenatally diagnosed hydronephrosis(HN) are diverse. Our purpose was to determine if the findings of renal ultrasonography(USG) in patients with prenatal HN at 1 month of age can predict the 1 year follow-up results and determine the guideline of follow-up study. Methods : Among 462 hydronephrotic patients registered between 1996 and 2004, 153 unilateral hydronephrotic renal units were enrolled in this study, bilateral HN, vesicoureteral reflux and other associated anomaly were excluded. These were classified into four groups respectively, according to anterior posterior pelvic diameter(APPD) or Society for Fetal Urology(SFU) grading by USG findings at 1 month after birth. Renal USG and $Tc^{99m}$-mercaptoacetyl triglycerine(MAG3) scan were done according to a set protocol. Results : Most cases improved or remained stationary. No one underwent an operation SFU grade 1,2 groups and only one case of SFU grade 3 group was operated. Thirty two cases(64 percent) were operated on among the 50 cases of SFU grade 4 group. 0/2(0 percent), 5/11(45.5 percent), 11/17(64.7 percent) and 16/20(80 percent) were operated on in each group with APPD <10, 10-19, 20-29, >30 mm, and the operation risk is higher as the APPD is increased. Conclusion : In group with SFU grade below 3 and APPD below 10 mm, we can delay the follow-up study beyond existing set protocol. Operations are recommended immediately if diuretic renogram show the obstructive pattern or decreased renal function in SFU grade 4 group with APPD over 10 mm.

Urinary Tract Infections in Febrile Infants under Three Months of Age (3개월 이하 영아기 열성 요로감염증에 대한 임상적 관찰)

  • Eun, Byung Wook;Chung, Yoo Mi;Kang, Hee Gyung;Ha, Il Soo;Cheong, Hae Il;Lee, Hoan Jong;Choi, Yong
    • Clinical and Experimental Pediatrics
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    • v.46 no.3
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    • pp.265-270
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    • 2003
  • Purpose : To characterize the infants under 3 months of age with urinary tract infections(UTIs), and especially patients with bacteremia or meningitis Methods : Hospital records of all the infants under 3 months of age discharged from our hospital for 69 consecutive months with the diagnosis of initial episode of UTI were reviewed. UTI was defined when patients had fever with pyuria, and had urine culture results of ${\geq}10^5$ colony forming units/mL from a bag specimen. Patients with previously known urologic abnormality or immunodeficiency were excluded. Nosocomial infections were also excluded from the study. Results : The male:female ratio was 35 : 6. Of the urine cultures, 40(97.6%) yielded single pathogen, one yielded two pathogens. Escherichia coli was the predominant isolate from the urine. Five patients(12%) also had bacteremia. Pathogens isolated from the blood cultures were E. coli(4) and Enterococcus faecalis(1). No patient had culture-positive meningitis or cerebrospinal fluid pleocytosis. Clinical or laboratory findings between patients with and without bacteremia were not different significantly. The rate of vesicoureteral reflux(VUR) was 44%. The sensitivity of ultrasound for detection of VUR was 38%; specificity was 50%. Conclusion : Clinical and laboratory data were not helpful for identifying patients with bacteremia at the time of presentation. Consequently, blood cultures need to be obtained from all febrile infants under 3 months of age with UTIs. A large-scale study including the indication of lumbar puncture for infants with a febrile UTI and study of evaluation and treatment of infants under 3 months of age with UTIs are required.

Outcome and risk factors of pediatric hemato-oncology patients admitted in pediatric intensive care unit (소아 중환자실에 입실한 소아 종양/혈액 질환 환자의 예후 및 위험인자)

  • Kim, Bo Eun;Ha, Eun Ju;Bae, Keun Wook;Kim, Seon Guk;Im, Ho Joon;Seo, Jong Jin;Park, Seong Jong
    • Clinical and Experimental Pediatrics
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    • v.52 no.10
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    • pp.1153-1160
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    • 2009
  • Purpose:To evaluate the risk factors for mortality and prognostic factors in pediatric hemato-oncology patients admitted to the pediatric intensive care unit (PICU). Methods:We retrospectively reviewed the medical records of pediatric hemato-oncology patients admitted at the PICU of the Asan Medical Center between September 2005 and July 2008. Patients admitted at the PICU for perioperative or terminal care were excluded. Results:Total 88 patients were analyzed. Overall ICU mortality rate was 34.1%. Mean age at PICU admission was $7.0{\pm}5.7$ years and mean duration of PICU stay was $18.1{\pm}22.2$ days. Hematologic diseases contributed to 77.3% of all the primary diagnoses, and the primary cause of admission was respiratory failure (39.8%). The factors related to increased mortality were C-reactive protein level (P<0.01), ventilation or dialysis requirement (P<0.01), and hematopoietic stem cell transplantation (P<0.05). In all, 3 scoring systems were investigated [Number of Organ System Failures (OSF number), the Pediatric Risk of Mortality III (PRISM III) score, and the Sequential Organ Failure Assessment (SOFA) score]; higher score correlated with worse outcome (P<0.01). The Oncological Pediatric Risk of Mortality (O-PRISM) scores of the 21 patients who had received hematopoietic stem cell transplantation were higher among the non-survivors, but not statistically significant (P=0.203). Conclusion:The PRISM III and SOFA scores obtained within 24 hours of PICU admission were found to be useful as early mortality predictors. The highest OSF number during the PICU stay was closely related to poor outcome.

Rheological properties of dental resin cements during polymerization (치과용 레진 시멘트의 유변학적 성질)

  • Lee, Jae-Rim;Lee, Jai-Bong;Han, Jung-Suk;Kim, Sung-Hun;Yeo, In-Sung;Ha, Seung-Ryong;Kim, Hee-Kyung
    • The Journal of Korean Academy of Prosthodontics
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    • v.52 no.2
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    • pp.82-89
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    • 2014
  • Purpose: The purpose of this study was to observe the change of viscoelastic properties of dental resin cements during polymerization. Materials and methods: Six commercially available resin cement materials (Clearfil SA luting, Panavia F 2.0, Zirconite, Variolink N, RelyX Unicem clicker, RelyX U200) were investigated in this study. A dynamic oscillation-time sweep test was performed with AR1500 stress controlled rheometer at $32^{\circ}C$. The changes in shear storage modulus (G'), shear loss modulus (G"), loss tangent (tan ${\delta}$) and displacement were measured for twenty minutes and repeated three times for each material. The data were analyzed using one-way ANOVA and Tukey's post hoc test (${\alpha}$=0.05). Results: After mixing, all materials demonstrated an increase in G' with time, reaching the plateau in the end. RelyX U200 demonstrated the highest G' value, while RelyX Unicem (clicker type) and Variolink N demonstrated the lowest G' value at the end of experimental time. Tan ${\delta}$was maintained at some level and reached the zero at the starting point where G' began to increase. The tan ${\delta}$and displacement of the tested materials showed similar pattern in the graph within change of time. The displacement of all 6 materials approached to zero within 6 minutes. Conclusion: Compared to other resin cements used in this study, RelyX U200 maintained plastic property for a longer period of time. When it completed the curing process, RelyX U200 had the highest stiffness. It is convenient for clinicians to cement multiple units of dental prostheses simultaneously.

Immune responses of hepatitis B vaccination among very low birth weight infant (극소 저출생체중아의 영아기 B형 간염 항체 생성률 조사)

  • Kim, Young-Deuk;Han, Myung-Ki;Kim, Ai-Rhan E.;Kim, Ki-Soo;Pi, Soo-Young
    • Clinical and Experimental Pediatrics
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    • v.49 no.8
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    • pp.857-863
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    • 2006
  • Purpose : To evaluate the immunogenicity of hepatitis B vaccine among very low birth weight infants(VLBWI) who were vaccinated at 0, 1, 6 months of chronological age and to determine the factors associated with antibody formations. Methods : A total of 243 VLBWI admitted to Seoul and Gangneung Asan Medical Center neonatal intensive care units from 1997 to 2004 were included. Of 243, 13 infants were born to HBs Ag positive mother. All infants were given DNA recombinant vaccine at 0, 1, and 6 months of chronological age. Infants born to HBs Ag positive mothers received hepatitis B immunoglobulin at birth and a total of 4 doses of vaccinations. An antibody level over 10 mIU/mL, tested at 3-4 months after last vaccination, was regarded as a positive seroconversion. Results : The seroconversion rates were 84.4 percent and 84.5 percent for VLBWI and extremely low birth weight infants(ELBWI), respectively. Of 28 seronegative infants who were given revaccinations, 60.7 percent seroconverted, resulting in 95.3 percent, 97.5 percent seroconversion rates for VLBWI and ELBWI, respectively. 76.9 percent of infants born to HBsAg positive mothers seroconverted and none became hepatitis B carriers. Factors such as gestational age, sex, various neonatal illness, and kinds of vaccinations did not influence the formation of the hepatits B antibody, however, the higher the weight at time of first vacciation yielded better seroconversion rate. Conclusion : Revaccination of seronegative VLBWI after 3 doses of hepatitis B vaccinaton is very effective. Therefore, testing the immune status after the hepatitis B vaccination, a practice not routinely done, is highly recommended.

Analysis on the cause of eosinophilia in a neonatal intensive care unit (신생아 집중 치료실에서 호산구 증가증 원인에 관한 분석)

  • Kim, Jeong Young;Im, Hyo Bin;Sung, Min Jung;Son, Sang Hee;Seo, Son Sang
    • Clinical and Experimental Pediatrics
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    • v.53 no.1
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    • pp.28-32
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    • 2010
  • Purpose : Although eosinophilia is a common laboratory finding in many neonatal intensive care units (ICUs), its causative mechanisms remain obscure. We aimed to determine the causes of eosinophilia in the neonatal ICU environment. Methods : Serial eosinophil counts were determined weekly for 288 hospitalized, appropriately grown neonates. Infants were divided into four groups according to gestational age, and the incidence and etiologic factors of eosinophilia were retrospectively studied. Results : Absolute eosinophilia (>$700/mm^3$) was documented in 18% (52/288) of neonates. Twenty-two infants (42.3%) exhibited mild eosinophilia ($700-999cells/mm^3$), 27 (51.9%) exhibited moderate eosinophilia ($1,000-2,999cells/mm^3$), and 3 (5.8%) exhibited severe eosinophilia (>$3,000cells/mm^3$). Of the 288 infants studied, 54 suffered sepsis. Thirty of these 54 infants (55.6%) showed eosinophilia, and 22 out of the remaining 234 infants (9%) without sepsis showed eosinophilia, indicating that eosinophilia was more prevalent in the sepsis group (P <0.05). All 5 infants suffering from bronchopulmonary dysplasia showed eosinophilia, and 47 out of the remaining 283 infants (16.7%) without bronchopulmonary dysplasia showed eosinophilia. Thus, eosinophilia was more prevalent in the bronchopulmonary dysplasia group (P<0.05). Furthermore, increased prevalence of eosinophilia was associated with respiratory distress syndrome, ventilator use, blood transfusion, and total parenteral nutrition (P<0.05). Conclusion : Our results suggest that eosinophilia is influenced by sepsis and bronchopulmonary dysplasia, although it can also occur idiopathically at birth. Moreover, the potential role of eosinophils in conditions such as wound healing and fibrosis in sepsis or chronic lung disease may be a cause of eosinophilia.

Pain reducing effect of vapocoolant spray during injection and heelstick procedure in neonates (신생아에서 근육 주사 및 발뒤꿈치 천자 시 냉각 분사의 통증감소효과: 냉각 분사와 30% 경구 포도당액의 비교)

  • Choi, Eun Kyong;Jung, Ji Mi;Sin, Jong Beom
    • Clinical and Experimental Pediatrics
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    • v.51 no.5
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    • pp.481-486
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    • 2008
  • Purpose : The aims of this study were to test the efficacy of vapocoolant spray to decrease the symptoms associated with pain in newborns undergoing heel stick and intramuscular injection and compare the pain relief effect of oral glucose. Methods : Randomized, controlled study including sixty newborns undergoing heel stick and intramuscular injection. Group 1 was heelsticked, Group 2 was intramuscular injected, Group A did not recieve any treatment, Group B recieved 30% glucose solution orally, Group C was applied vapocoolant spray symptoms and signs associated with pain at heel stick and intramuscular injection were measured with the premature Infant Pain Profile (PIPP) scale. Results : There was no significant difference in the PIPP score between intramuscular injected group control and heel stick group control (P=0.07). The mean PIPP score of Group 1A (control) $10.6{\pm}2.4$, Group 1B $5.5{\pm}2.0$, Group 1C $5.2{\pm}1.8$. The mean PIPP score 1B and 1C were significantly lower than control (1B P<0.001, 1C P<0.001). The mean PIPP score of Group 2A (control) $12.5{\pm}1.4$, Group 2B $7.0{\pm}1.7$, Group 2C $6.4{\pm}1.6$. The mean PIPP score 2B and 2C were significantly lower than control (2B P<0.001, 2C P<0.001). Conclusion : The antinociceptive effect of vapocoolant sparay is as effective as 30% oral glucose solution for pain control. So this study support the use of vapocoolant spray for reducing pain during painful procedure in the neonatal intensive care units.

Effects of Dietary Organic Selenium and Vitamin E on Performance, Selenium Retention and Quality of Egg in Laying Hens (유기태 셀레늄과 비타민 E의 복합 급여가 산란계의 생산성, 셀레늄 축적 및 난질에 미치는 영향)

  • Na, J.C.;Kim, J.H.;Yu, D.J.;Jang, B.G.;Kang, G.H.;Kim, S.H.;Kang, B.S.;Choi, C.H.;Suh, O.S.;Lee, W.J.;Lee, J.C.
    • Korean Journal of Poultry Science
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    • v.34 no.3
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    • pp.157-163
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    • 2007
  • To examine the effects of dietary organic selenium and vitamin E supplementation on egg production, egg weight, daily egg mass, feed intake, feed conversion, egg quality, lipid-soluble antioxidative capacity (ACL) in egg yolk, and selenium retention of egg in laying hens, Hy-Line laying hens of 77 wk old were replaced in the individual cage for 12 week. A corn-soybean meal based diet was supplemented with 0 (control), vitamin E 100 IU/kg and the combination of 0.9 ppm Se from selenium yeast (SY) and vitamin E 50, 100 and 150 IU/kg. Egg production and daily egg mass were significantly increased (P<0.05) in supplemental vitamin E 100 IU, and 0.9 ppm SY + vitamin E 50 IU than control for the whole experimental period. However, feed intake and feed conversion were not affected by supplemental vitamin E and SY. Haugh unit was significantly (P<0.05) higher in supplemental vitamin E 100 IU and 0.9 ppm SY + vitamin E 50 IU than control, 0.9 ppm SY + vitamin E 100 and 0.9 ppm SY + 150 IU in week 5. Haugh unit of the eggs during storage decreased significantly(P<0.05) from day 1 to day 11. However, Haugh units of the eggs from 0.9 ppm SY + vitamin E 150 IU treated groups did not decreased significantly until day 5. Yolk color was significantly (P<0.05) higher in 0.9 ppm SY + vitamin E 50 and 0.9 ppm SY + 100 IU than other treatment groups in week 1. Selenium concentrations of egg were significantly increased (P<0.05) in 0.9 ppm SY + vitamin E than control and vitamin E 100 IU groups. Lipid-soluble antioxidative capacity (ACL) in egg yolk was significantly (P<0.05) higher in supplemental combination of 0.9 ppm SY + vitamin E 150 IU when compared to those of other treatment groups.