• Title/Summary/Keyword: Healthcare Associated Infection

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Clostridioides difficile Infection Is Associated with Adverse Outcomes among Hospitalized Pediatric Patients with Acute Pancreatitis

  • Thavamani, Aravind;Umapathi, Krishna Kishore;Khatana, Jasmine;Sankararaman, Senthilkumar
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.25 no.1
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    • pp.61-69
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    • 2022
  • Purpose: Studies in adults have shown an increasing incidence of Clostridioides difficile infection (CDI) in patients hospitalized with acute pancreatitis (AP). There is lack of epidemiological data on CDI and its impact on hospitalized pediatric patients with AP. Methods: We analyzed the National Inpatient Sample and Kids' Inpatient Database between the years 2003 and 2016 and included all patients (age <21 years) with a primary diagnosis of AP using specific International Classification of Diseases codes. We compared clinical outcomes between children with CDI and those without CDI. Our primary outcome was severe AP and secondary outcomes included length of stay and hospital charges. Results: A total of 123,240 hospitalizations related to AP were analyzed and CDI was noted in 0.6% of the hospital. The prevalence rate of CDI doubled from 0.4% (2003) to 0.8% (2016), p=0.03. AP patients with CDI had increased comorbidities, and also underwent more invasive surgical procedures, p<0.05. AP patients with CDI had a higher in-hospital mortality rate and increased prevalence of severe AP, p<0.001. Multivariate regression models showed that CDI was associated with 2.4 times (confidence interval [CI]: 1.91 to 3.01, p<0.001) increased odds of severe AP. CDI patients had 7.24 (CI: 6.81 to 7.67, p<0.001) additional hospital days while incurring $59,032 (CI: 54,050 to 64,014, p<0.001) additional hospitalization charges. Conclusion: CDI in pediatric patients with AP is associated with adverse clinical outcomes and increased healthcare resource utilization. Further studies are needed to elucidate this association to prevent the development of CDI and to improve outcomes.

Prevalence size and risk factors for latent tuberculosis infection among Korean Medicine workers (한의의료기관 종사자의 잠복결핵감염 유병규모 및 위험인자)

  • Hojung Lee;Chunhoo Cheon;Kwan-Il Kim;Joowon Hwang;Bo-Hyoung Jang
    • Journal of Society of Preventive Korean Medicine
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    • v.28 no.2
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    • pp.55-65
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    • 2024
  • Background : Tuberculosis (TB) remains a significant public health issue worldwide, particularly among healthcare workers (HCWs) at high risk of exposure. Latent tuberculosis infection (LTBI) is a state where individuals are infected with Mycobacterium tuberculosis but do not show clinical symptoms. Early detection and treatment of LTBI are crucial to prevent progression to active TB. This study aimed to investigate the prevalence and risk factors of LTBI among Korean Medicine (KM) workers in Seoul, South Korea. Methods : This study analyzed 368 adults aged 19 and over working in Korean medicine institutions in Seoul by September 2023. Participants underwent a tuberculin skin test (TST) and completed a survey collecting demographic information, occupation, work duration, smoking status, BCG vaccination, TB history, and comorbidities. Data were analyzed using descriptive statistics and chi-square tests, with significance set at p < 0.05. Results : The average age of participants was 43.1 years, with an LTBI prevalence rate of 3.5%. Significant risk factors included age and history of TB, Older age and a history of TB were associated with higher LTBI positivity. Conclusion : The study identified the prevalence and risk factors of LTBI among Korean medicine workers in Seoul. The findings highlight the need for targeted LTBI screening and preventive measures, especially for older workers and those with a history of TB. While the prevalence was lower than in other healthcare settings, the results emphasize the importance of regular LTBI testing and prevention education for KM workers. Future large-scale studies are needed to confirm these findings and further understand the relationship between various risk factors and LTBI in KM settings.

Clinical Implications of Drug-Resistant $Streptococcus$ $pneumoniae$ as a Cause of Community Acquired Pneumonia (폐렴원인균으로서 약제내성 폐렴사슬알균 ($Drug-resistant$ $Streptococcus$ $pneumoniae$)의 현황과 임상적 의미)

  • Shin, Kyeong-Cheol
    • Journal of Yeungnam Medical Science
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    • v.28 no.1
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    • pp.13-19
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    • 2011
  • The emergence of antibiotic-resistant pathogens is a Serious clinical problem in the treatment of infectious diseases that increase mortality, morbidity, hospitalization length, and the cost of healthcare. In particular, $Streptococcus$ $pneumoniae$ is a major etiologic pathogen of pneumonia, sinusitis, otitis media, and meningitis. As the definition of penicillin resistance to $S.$ $pneumoniae$ was recently changed, macrolide-resistant $S.$ $pneumoniae$ is a major resistant pathogen in the community. Infections caused by antibiotic-resistant strains are associated with incorrect use of antibiotics and critical clinical outcomes. For the appropriate use of antibiotics to treat infections, physicians always should have up-to-date information on the current epidemiologic status of antibiotic resistance for common pathogens and their susceptibility to antimicrobials. Appropriate selection of antimicrobials, strict control of infection, vaccination, and development of a feasible national policy of infection control are important strategies for the control of antimicrobial resistance. This review article focuses on the current status of antibiotic-resistant $S.$ $pneumoniae$ in community-acquired pneumonia in Korea.

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Intraventricular Vancomycin Therapy for Intractable Bacillus cereus Ventriculitis

  • Hahn, Jong Woo;Ju, Hee young;Park, Meerim;Yi, Eun Sang;Park, Byung-Kiu;Shin, Sang-Hoon;Lee, Sang-Hyun;Park, Hyeon Jin;Kang, Ji-Man
    • Pediatric Infection and Vaccine
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    • v.26 no.2
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    • pp.124-128
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    • 2019
  • Bacillus cereus causes serious central nervous system infections, especially in immunocompromised patients. Successful treatment requires adequate antimicrobial concentrations in the cerebrospinal fluid; however, in some cases, achieving this with systemic treatment alone is difficult. We treated intractable B. cereus ventriculitis with intraventricular vancomycin, with no major adverse events.

Review of cranioplasty after decompressive craniectomy

  • Cho, Yong Jun;Kang, Suk Hyung
    • Korean Journal of Neurotrauma
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    • v.13 no.1
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    • pp.9-14
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    • 2017
  • Cranioplasty is an in evitable operation conducted after decompressive craniectomy (DC). The primary goals of cranioplasty after DC are to protect the brain, achieve a natural appearance and prevent sinking skin flap syndrome (or syndrome of the trephined). Furthermore, restoring patients' functional outcome and supplementing external defects helps patients improve their self-esteem. Although early cranioplasty is preferred in recent year, optimal timing for cranioplasty remains a controversial topic. Autologous bone flaps are the most ideal substitute for cranioplasty. Complications associated with cranioplasty are also variable, however, post-surgical infection is most common. Many new materials and techniques for cranioplasty are introduced. Cost-benefit analysis of these new materials and techniques can result in different outcomes from different healthcare systems.

Post Treatment Application of Jaungo after a Combined Therapy of Carbon Dioxide Laser and Trichloroacetic Acid in a Case of Vulvar Syringoma

  • Kim, En Hyung;Kim, Wonnam
    • Journal of Pharmacopuncture
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    • v.22 no.3
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    • pp.200-203
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    • 2019
  • Syringoma is a benign eccrine sweat gland tumor that predominantly appears in females during puberty with multiple smooth papules measuring 1-2 mm in diameter. Common locations are on lower eyelids and cheeks. Vulvar syringoma is quite a rare, occurring condition with only a few cases reported. Here, we are reporting a case of 31-year-old female with vulvar syringoma associated with pruritus. The lesion was treated with carbon dioxide (CO2) laser ablation and 50% trichloroacetic acid (TCA) chemical peeling. Jaungo was used for wound care after laser abrasion. The combination treatment was effective for removing syringoma lesions. Post laser management with fusidic acid cream and jaungo cream was sufficient to prevent infection and promote wound healing.

Education of Bioterrorism Preparedness and Response in Healthcare-associated Colleges-Current Status and Learning Objectives Development (보건의료 교육기관에서 생물테러 관련 교육 현황조사 및 학습목표 개발)

  • Lee, Ha-Gyung;Chun, Byung-Chul;Yi, Sung-Eun;Oh, Hyang-Soon;Wang, Sun-Ju;Kim, Jee-Hee;Sohn, Jang-Wook
    • Journal of Preventive Medicine and Public Health
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    • v.41 no.4
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    • pp.225-231
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    • 2008
  • Objectives: Bioterrorism (BT) preparedness and response plans are particularly important among healthcare workers who will be among the first involved in the outbreak situations. This study was conducted to evaluate the current status of education for BT preparedness and response in health care-related colleges/junior colleges and to develop learning objectives for use in their regular curricula. Methods: We surveyed all medical colleges/schools, colleges/junior colleges that train nurses, emergency medical technicians or clinical pathologists, and 10% (randomly selected) of them that train general hygienists in Korea. The survey was conducted via mail from March to July of 2007. We surveyed 35 experts to determine if there was a consensus of learning objectives among healthcare workers. Results: Only 31.3% of medical colleges/schools and 13.3% of nursing colleges/junior colleges had education programs that included BT preparedness and responses in their curricula. The most common reason given for the lack of BT educational programs was 'There is not much need for education regarding BT preparedness and response in Korea'. None of the colleges/junior colleges that train clinical pathologists, or general hygienists had an education program for BT response. After evaluating the expert opinions, we developed individual learning objectives designed specifically for educational institutions. Conclusions: There were only a few colleges/junior colleges that enforce the requirement to provide education for BT preparedness and response in curricula. It is necessary to raise the perception of BT preparedness and response to induce the schools to provide such programs.

Screening and isolation of antibacterial proteinaceous compounds from flower tissues: Alternatives for treatment of healthcare-associated infections

  • de Almeida, Renato Goulart;Silva, Osmar Nascimento;de Souza Candido, Elizabete;Moreira, Joao Suender;Jojoa, Dianny Elizabeth Jimenez;Gomes, Diego Garces;de Souza Freire, Mirna;de Miranda Burgel, Pedro Henrique;de Oliveira, Nelson Gomes Junior;Valencia, Jorge William Arboleda;Franco, Octavio Luiz;Dias, Simoni Campos
    • CELLMED
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    • v.4 no.1
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    • pp.5.1-5.8
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    • 2014
  • Healthcare-associated infection represents a frequent cause of mortality that increases hospital costs. Due to increasing microbial resistance to antibiotics, it is necessary to search for alternative therapies. Consequently, novel alternatives for the control of resistant microorganisms have been studied. Among them, plant antimicrobial protein presents enormous potential, with flowers being a new source of antimicrobial molecules. In this work, the antimicrobial activity of protein-rich fractions from flower tissues from 18 different species was evaluated against several human pathogenic bacteria. The results showed that protein-rich fractions of 12 species were able to control bacterial development. Due its broad inhibition spectrum and high antibacterial activity, the protein-rich fraction of Hibiscus rosa-sinensis was subjected to DEAE-Sepharose chromatography, yielding a retained fraction and a non-retained fraction. The retained fraction inhibits 29.5% of Klebsiella pneumoniae growth, and the non-retained fraction showed 31.5% of growth inhibition against the same bacteria. The protein profile of the chromatography fractions was analyzed by using SDS-PAGE, revealing the presence of two major protein bands in the retained fraction, of 20 and 15 kDa. The results indicate that medicinal plants have the biotechnological potential to increase knowledge about antimicrobial protein structure and action mechanisms, assisting in the rational design of antimicrobial compounds for the development of new antibiotic drugs.

A Study on Restriction of Access to Medical Institutions and Discrimination on Human Rights of Persons with Disabilities Not Wearing Masks to Prevent Healthcare-Associated Infections (의료관련감염 예방을 위한 마스크 미착용 장애인의 의료기관 출입제한과 인권차별 결정에 대한 검토)

  • Moon, Sang Hyuk;Kim, Je Sun
    • The Korean Society of Law and Medicine
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    • v.24 no.1
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    • pp.67-98
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    • 2023
  • In the early stages of the COVID-19 pandemic, Korea took the lead in implementing "social distancing" policies more strongly than other countries. In addition to making it mandatory to wear a mask according to the policy, all patients using medical institutions are tested for COVID-19 to prevent Healthcare-Associated Infections, and only those patients who test negative have been regulated to receive face-to-face medical treatment. In this process, situations such as the disabled, who have difficulty wearing masks, were not taken into account, and emergency patients did not receive timely treatment or surgery from medical personnel. In response, the National Human Rights Commission of Korea has decided that forcing everyone to wear a mask and restricting access to medical institutions constitutes discrimination against the disabled. Therefore, the purposes this study has that, the first is to review cases of human rights discrimination against persons with disabilities due to measures to prevent the transmission of infectious diseases that did not consider the characteristics of persons with disabilities in the COVID-19 situation and issues regarding the decisions of the National Human Rights Commission of Korea, the second is to find a reasonable plan and the need for measures to prevent refusal of treatment by medical institutions for the disabled who have difficulty wearing masks.

Source Investigation and Control of Ralstonia mannitolilytica Bacteremia in a Neonatal Intensive Care Unit: A Case Report

  • Dabin Kim;Min Hye Kim;Seul Gi Park;Sujin Choi;Chan Jae Lee;Young Hwa Jung;Chang Won Choi;Myoung-Jin Shin;Kyoung-Ho Song;Eu Suk Kim;Jeong Su Park;Hong Bin Kim;Hyunju Lee
    • Pediatric Infection and Vaccine
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    • v.30 no.1
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    • pp.33-38
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    • 2023
  • A case of persistent Ralstonia mannitolilytica bacteremia in the neonatal intensive care unit prompted source investigation due to its rarity. After an extensive investigation, a contaminated ultrasonic nebulizer was identified as the source, and the infection was controlled by removing the source. This study emphasizes the importance of further investigations, even in single cases of rare pathogens.