• Title/Summary/Keyword: Health care-associated infections

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A Study on the Concentration and Characteristics of Methicillin-resistant Staphylococci in the Indoor Air of Childcare Facilities (일부 어린이집의 실내공기 중 메치실린내성 포도알균의 오염 실태 및 특성)

  • Kim, Jong Oh;Kim, Young Jin
    • Journal of Environmental Health Sciences
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    • v.39 no.5
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    • pp.447-455
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    • 2013
  • Objectives: This study aims to understand the concentration, diversity, and antibiotic characteristics of staphylococci present in the indoor air of child-care facilities. Methods: Air sampling was performed from October 2012 to January 2013 in 120 child-care facilities in Seoul, Korea. Methicillin-resistant bacteria were selected from the total obtained airborne bacteria and subjected to 16S rRNA analysis for methicillin-resistant staphylococcal species determination. Identified staphylococcal strains were tested for resistance to a range of antibiotics. Results: Average total airborne bacterial concentration was $508.9{\pm}246.3CFU/m^3$. Indoor concentration of total airborne bacteria had a significant positive correlation with the $CO_2$ concentration in the child-care facilities. Methicillin-resistant staphylococci were present in 13.3% of the child-care facilities studied. A total of four species (S. epidermidis, S. cohnii, S. saprophyticus, S. sp.) and 55 strains were identified from the indoor air of the child-care facilities. Staphylococcus cohnii was the most common species (54.5%), followed by S. epidermidis (38.2%). All of the isolated staphylococcal strains exhibited high resistance to oxacillin, erythromycin, mupirocin, and ceftizoxime. Especially, S. saprophyticus strains showed more multidrug resistance to oxacillin, vancomycin, clindamycin, erythromycin, lincomycin, ceftizoxime, mupirocin, and tetracycline than did other species. Conclusion: The results of this study showed that a monitoring system for multidrug-resistant bacteria is needed in facilities for children, as the community-associated infections of these bacteria are increasing.

Effects of perineal care in preventing catheter associated urinary tract infections (CAUTI) in intensive care units (ICU) (회음부 간호시 클로르헥시딘과 생리식염수 적용에 따른 유치도뇨관 관련 요로감염 발생률 비교)

  • Choi, Jeong-Sil;Yeon, Jeong-Hwa
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.19 no.2
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    • pp.223-232
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    • 2012
  • Purpose: The purpose of this study was to compare the effects of preventing CAUTIs through the practice of using 0.05% chlorhexidine gluconate (CHG) versus normal saline for perineal care in ICU patients. Methods: A randomized controlled trial was used, and participants were randomly allocated to either the CHG group (n=79) or normal saline group (n=81). CAUTI was diagnosed following the criteria of the Centers of Disease Control and Prevention (CDC). Incidence of CAUTI and characte oftics of infection were evaluated. Results: In the CHG group, 8 epofodes of CAUTI were obsevend in 79 patients and 875 foley catheter e ys. Tnce ate of CAUTI was 9.14 per 1,000 foley catheter e ys. Tncre were 2 epofodes of CAUTI in the 81 patients and 837 foley catheter e ys of the normal saline group. Tnce ate of CAUTI was 2.39 per 1,000 foley catheter e ys. Tnc difference between both groups was not significant (p=.1e ConConclusevaluUsing normal saline to provide perineal care to ICU patients with a foley catheter inserted will not increase the risk for CAUTI.

Risk Factors for Surgical Site Infections in Patients Undergoing Craniotomy (개두술을 받은 환자의 수술부위감염 관련요인 분석)

  • Cha, Kyeong-Sook;Cho, Ok-Hee;Yoo, So-Yeon
    • Journal of Korean Academy of Nursing
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    • v.40 no.2
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    • pp.298-305
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    • 2010
  • Purpose: The objectives of this study were to determine the prevalence, incidence, and risk factors for postoperative surgical site infections (SSIs) after craniotomy. Methods: This study was a retrospective case-control study of 103 patients who had craniotomies between March 2007 and December 2008. A retrospective review of prospectively collected databases of consecutive patients who underwent craniotomy was done. SSIs were defined by using the Centers for Disease Control criteria. Twenty-six cases (infection) and 77 controls (no infection) were matched for age, gender and time of surgery. Descriptive analysis, t-test, $\chi^2$-test and logistic regression analyses were used for data analysis. Results: The statistical difference between cases and controls was significant for hospital length of stay (>14 days), intensive care unit stay more than 15 days, Glasgrow Coma Scale (GCS) score (${\leq}7$ days), extra-ventricular drainage and coexistent infection. Risk factors were identified by logistic regression and included hospital length of stay of more than 14 days (odds ratio [OR]=23.39, 95% confidence interval [CI]=2.53-216.11) and GCS score (${\leq}7$ scores) (OR=4.71, 95% CI=1.64-13.50). Conclusion: The results of this study show that patients are at high risk for infection when they have a low level of consciousness or their length hospital stay is long term. Nurses have to take an active and continuous approach to infection control to help with patients having these risk factors.

Analysis of Hand Hygiene Practices of Health Care Personnels (의료기관 종사자의 손 위생 수행 분석)

  • Oh, Hyang Soon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.9
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    • pp.6160-6168
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    • 2015
  • Hand hygiene(HH)of the health care personnels(HCPs) was the most effective method to prevent the transmission of healthcare associated infections. This study was conducted to measure and analysis the status of the HH compliance of HCPs. Data were collected by the direct observation methods of the World Health Organizations(WHO) using WHO's HH monitoring tool kits from 25th October to 31th December, 2010. Data were analyzed by descriptive statistics, cross analysis, multiple logistic analysis using the SPSS/PC 21 program. A total of 8,644 opportunities for HH were observed, and the overall HH compliance rate was 94.1%. HH rates of physicians was lowest(83.4%; OR: 0.209, 95%CI:0.174-0.252). HH rates were statistically different by the job titles(p<0.001), WHO's 5 moments(p<0.001). HH rates in registered nurses(p=0.003), and medical technicians(p<0.001) were statistically different by the WHO 5Moments. Jobs specific HH strategies and WHO 5Moments should be developed to increase the HH compliances of the HCPs.

Exploring Reproductive Health Education Needs in Infertile Women in Iran: A Qualitative Study

  • Khakbazan, Zohreh;Maasoumi, Raziyeh;Rakhshaee, Zahra;Nedjat, Saharnaz
    • Journal of Preventive Medicine and Public Health
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    • v.53 no.5
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    • pp.353-361
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    • 2020
  • Objectives: An inadequate understanding of infertility can affect individuals' self-efficacy and ability to perform self-care; thus, reproductive health education is an important part of infertility treatment. The present qualitative study aimed to explore the experiences and educational needs of infertile women with regard to reproductive health. Methods: In this qualitative study, we utilized a content analysis approach. Purposive sampling was performed to ensure maximum diversity. In total, 23 individual interviews were conducted with 20 Iranian women with infertility and 3 key informants between July 2018 and February 2019 in northern Iran. Data were collected through in-depth, semi-structured interviews. Data analysis was performed using a conventional content analysis approach. Results: Reproductive health education needs were identified by analyzing interview data from 4 main categories: familiarity with the fertility process and preparation for pregnancy, recognition of infertility and expectations around seeking treatment, recognition of preventive actions associated with reproductive health, and correction of false beliefs. Recognizing the causes of infertility and understanding the different approaches to infertility treatment are among the most important educational needs of infertile women. The potential for neglect of health-related issues due to concerns about fertility and the maternal experience necessitates education about preventive measures for cervical cancer, breast cancer, and sexually transmitted infections. Correcting misconceptions, including those related to contraceptives and traditional medicine, can also help promote reproductive health. Conclusions: In infertile women, the educational needs associated with reproductive health are multifaceted. Satisfying these needs can help achieve optimal treatment results and promote reproductive health.

Utilization of Supplemental Regional Anesthesia in Lobectomy for Lung Cancer in the United States: A Retrospective Study

  • Alwatari, Yahya;Vudatha, Vignesh;Scheese, Daniel;Rustom, Salem;Ayalew, Dawit;Sevdalis, Athanasios E.;Julliard, Walker;Shah, Rachit D.
    • Journal of Chest Surgery
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    • v.55 no.3
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    • pp.225-232
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    • 2022
  • Background: Pulmonary lobectomy is the standard of care for the treatment of early-stage non-small cell lung cancer. This study investigated the rate of utilization of supplemental anesthesia in patients undergoing video-assisted thoracoscopic surgery (VATS) or open lobectomy using a national database and assessed the effect of regional block (RB) on postoperative outcomes. Methods: Patients who underwent lobectomy for lung cancer between 2014-2019 were identified in the American College of Surgeons National Surgical Quality Improvement Program. The patients' primary mode of anesthesia and supplemental anesthesia were recorded. Preoperative characteristics and postoperative outcomes were compared between 2 surgical groups: those who underwent general anesthesia (GA) alone versus GA with RB. Multivariable regression analyses were performed on the outcomes of interest. Results: In total, 13,578 patients met the study criteria, with 87% undergoing GA and the remaining 13% receiving GA and RB. The use of neuraxial anesthesia decreased over the years, while RB use increased up to 20% in 2019. Age, body mass index, and preoperative comorbidities were comparable between groups. Patients who underwent VATS were more likely to receive RB than those who underwent thoracotomy. RB was most often utilized by thoracic surgeons. An adjusted analysis showed that RB use was associated with shorter hospital stays and a reduced likelihood of prolonged length of stay, but a higher rate of surgical site infections (SSIs). Conclusion: In a large surgical database, there was underutilization of supplemental anesthesia in patients undergoing lobectomy for lung cancer. RB utilization was associated with a shorter length of hospital stay and an increase in SSI incidence.

Knowledge and Awareness of Human Papillomavirus (HPV), Cervical Cancer and HPV Vaccine among Women in Two Distinct Nepali Communities

  • Johnson, Derek Christopher;Bhatta, Madhav Prasad;Gurung, Santosh;Aryal, Shilu;Lhaki, Pema;Shrestha, Sadeep
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.19
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    • pp.8287-8293
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    • 2014
  • Background: This study assessed human papillomavirus (HPV), cervical cancer, and HPV vaccine knowledge and awareness among women in two sub-populations in Nepal - Khokana, a traditional Newari village in the Lalitpur District about eight kilometers south of Kathmandu, and Sanphebagar, a village development committee within Achham District in rural Far-Western Nepal. Methods: Study participants were recruited during health camps conducted by Nepal Fertility Care Center, a Nepali non-governmental organization. Experienced staff administered a Nepali language survey instrument that included questions on socio-demographics, reproductive health and knowledge on HPV, cervical cancer, and the HPV vaccine. Results: Of the 749 participants, 387 (51.7%) were from Khokana and 362 (48.3%) were from Sanphebagar. Overall, 53.3% (n=372) of women were aware of cervical cancer with a significant difference between Khokana and Sanphebagar (63.3% vs 43.0%; p=0.001). Overall, 15.4% (n=107) of women had heard of HPV and 32% (n=34) of these women reported having heard of the HPV vaccine. If freely available, 77.5% of the women reported willingness to have their children vaccinated against HPV. Factors associated with cervical cancer awareness included knowledge of HPV (Khokana: Odds Ratio (OR)=24.5; (95% Confidence Interval (CI): 3.1-190.2, Sanphebagar: OR=14.8; 95% CI: 3.7-58.4)) and sexually transmitted infections (Khokana: OR=6.18; 95% CI: 3.1-12.4; Sanphebagar: OR=17.0; 95% CI: 7.3-39.7) among other risk factors. Conclusions: Knowledge and awareness of HPV, cervical cancer, and the HPV vaccine remains low among women in Khokana and Sanphebagar. Acceptance of a freely available HPV vaccine for children was high, indicating potentially high uptake rates in these communities.

CARE OF TRISMUS AND OROCUTANEOUS FISTULA BY ODONTOGENIC INFECTION IN A DISABLED PATIENT (장애환자에서 치성감염에 의한 아관긴급과 구강피부누공의 관리)

  • Oh, Ji-Hyeon;Son, Jeong-Seog;Yoo, Jae-Ha;Kim, Jong-Bae
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.9 no.2
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    • pp.111-117
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    • 2013
  • Some odontogenic infections erode into fascial spaces directly and spread toward lymphatic tissues and blood streams. The principal maxillary primary spaces are the canine, buccal, and infratemporal space, the next secondary spaces are the masseteric, temporal and pharygeal space. As a result of the infection, trismus and orocutaneous fistula may be occurred. Trismus is owing to conditions not associated with temporomandibular joint itself and may be of myogenic, neurogenic, or psychogenic nature. Muscular trismus is due to infection adjacent to the elevator muscles of the jaw. The four principles of treatment of infection are as follows: (1) removal of the cause, (2) establishment of drainage, (3) institution of antibiotic therapy, and (4) provision of supportive care, including rest, nutrition and physiotherapy. Jaw physiotherapy is necessary to increase the amount of mouth opening and regain normal muscle tone. If proper care of odontogenic infection could be attained, the orocutaneous fistula will heal and close spontaneously by wound contraction mechanism of natural homeostatic response. This is a case report of the care of trismus and orocutaneous fistula due to fascial space abscess by advanced odontogenic infection in a physically disabled patient.

Affinity Apheresis for Treatment of Bacteremia Caused by Staphylococcus aureus and/or Methicillin-Resistant S. aureus (MRSA)

  • Mattsby-Baltzer, Inger;Bergstrom, Tomas;Mccrea, Keith;Ward, Robert;Msc, Lars Adolfsson;Larm, Olle
    • Journal of Microbiology and Biotechnology
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    • v.21 no.6
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    • pp.659-664
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    • 2011
  • Staphylococcus aureus (SA) bacteremia is associated with high mortality, and often results in metastatic infections. The methicillin-resistant SA (MRSA) is an urgent health care issue, as nosocomial infections with these bacteria represent limited treatment alternatives. Samples of whole blood containing challenge inoculums of SA and MRSA strains were passed through columns packed with surfaceheparinized polyethylene beads. The bound bacteria were eluted and quantitatively determined by culturing and by real-time PCR. Significant amounts of both SA and MRSA adhered to the heparinized beads (more than 65% of inoculated bacteria). After rinsing with buffer at high ionic strength, viable bacteria or bacterial DNA were eluted from the columns, indicating that the binding was specific. The conclusions that can be made from these experiments are that, as earlier reported in the literature, the high affinity of SA to heparin is retained in whole blood, and MRSA in whole blood binds to heparin with similar or higher affinity than SA. It should be possible to lower the amount of SA and/or MRSA from the blood of infected patients to levels that could be taken care of by the immune system. In previous studies, we have shown that passing blood from septic patients over beads coated with end-point-attached, biologically active heparin is a useful technique for regulating the levels of heparinbinding cytokine. These findings in combination with the present findings indicate the possibility of creating an apheresis technology for treatment of sepsis caused by SA and/or MRSA.

Perception of Patient Safety Culture, Knowledge and Performance of Standard Precaution among Long-Term Care Hospitals Nurses (요양병원 간호사의 환자안전문화 인식, 표준주의 지식 및 수행도)

  • Byun, Sang-Hee;Kang, Da-Hai-Som
    • Journal of Digital Convergence
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    • v.17 no.9
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    • pp.231-240
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    • 2019
  • The purpose of this study was to explore and describe the relationship of the perception of patient safety culture, knowledge of standard precaution and performance of standard precaution among long-term care hospital nurses. Participants were 134 nurse in long-term hospital. Data were collected with structured questionnaires from January 2 to June 4, 2018. Data were analyzed by SPSS/WIN 21.0 program for descriptive statistics t-test, ANOVA, Scheffe's test and Pearson's correlation coefficient. The perception of patient safety culture were significantly correlated with knowledge of standard precaution(r=.192, p=.027), performance of standard precaution(r=211, p=.014). Therefore, in order to enhance the perception of patient safety culture and performance of standard precaution of long-term care hospital nurses, it would be necessary to enable health-care associated infections by themselves by cultivating standard precaution knowledge through systemic education and by enabling the establishment of affirmative patient safety culture.