• Title/Summary/Keyword: Healthcare-associated Infection

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Seroprevalence of Anti-EBV IgG among Various Age Groups from Khon Kaen Province, Thailand

  • Suntornlohanakul, Rabporn;Wanlapakorn, Nasamon;Vongpunsawad, Sompong;Thongmee, Thanunrat;Chansaenroj, Jira;Poovorawan, Yong
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.17
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    • pp.7583-7587
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    • 2015
  • Epstein-Barr virus (EBV) is an extremely common herpesvirus that may cause asymptomatic infection or various diseases, including infectious mononucleosis, certain lymphoproliferative diseases and several types of neoplasms. Vaccine development is an important strategy to reduce the burden of EBV-associated diseases and the timing of vaccinations should be before primary infection occurs. In the past, more than 90% of Thai children were infected with EBV in early childhood. Now, due to the improved healthcare system in Thailand, we aim to determine current prevalence of EBV infection among people in different age groups. A total of 538 sera were collected from residents of Khon Kaen province in northeastern Thailand for detecting anti-EBV IgG. Sera of infants under 2-years-old were also tested for anti-EBV IgM and EBV-DNA. The prevalence of anti-EBV IgG was 47.1% (95% CI: 23.3-70.8) in infants aged 0-6 months, 34.9% (95% CI: 23.1-46.7) in those aged 6-24 months, 87.9% (95% CI: 79.5-96.3) in children aged 3-5 years and then maintained at above 95% through adulthood. These seropositivity rates among Thai children remain similar to those found in a previous study conducted 20 years ago. Thai children are still exposed to EBV from an early age. Therefore, a prophylactic vaccine should be given within the first two years of life.

A Review of Staphylococcus aureus Infections in Children with an Emphasis on Community-associated Methicillin-resistant S. aureus Infections (소아 황색포도알균 감염증의 임상 양상에 대한 고찰: 지역사회 관련 메티실린 내성 황색포도알균 감염을 중심으로)

  • Choe, Young June;Lee, So Yeon;Sung, Ji Yeon;Yang, Mi Ae;Lee, Joon Ho;Oh, Chi Eun;Lee, Jina;Choi, Eun Hwa;Lee, Hoan Jong
    • Pediatric Infection and Vaccine
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    • v.16 no.2
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    • pp.150-161
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    • 2009
  • Purpose : Staphylococcus aureus causes a variety of infections, ranging from benign skin infections to fatal invasive infections. Recently, methicillin-resistant S. aureus (MRSA) infections have emerged in patients who do not have established risk factors. This study was conducted to characterize S. aureus infections in children with an emphasis on communityassociated MRSA infections at a tertiary care pediatric facility during a 3-year period. Methods : Four hundred twenty-nine cases of S. aureus infections diagnosed at the Seoul National University Children's Hospital between January 2004 and December 2006 were retrospectively reviewed. The cases were classified as hospitalonset (HO) or community-onset (CO), healthcare-associated (HA), or community-associated (CA) infections. Results : Among the 206 cases <1 year of age, 72%, 7%, and 21% were HO-HA, CO-HA, and CA infections, respectively, as compared to 48%, 28%, and 24% among the 223 cases >1 year of age. The proportion of CO-HA infections among HA infections (8.6% vs. 37.1%, P<0.001) and the proportion of HA infections among the CO infections (24.5% vs. 54.3%, P <0.001) were greater in older children than in infants. Overall, 57% of the isolates were methicillin-resistant. Twenty-nine (30%) of 96 CA strains were MRSA, and the most common site of CA-MRSA infection was the skin and soft tissues (26 cases). Conclusion : The methicillin resistance rate of S. aureus from CA infections was high and CA-MRSA was most often associated with skin and soft tissue infections.

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Epidemiology of Staphylococcus aureus Bacteremia in Children at a Single Center from 2002 to 2016 (단일 기관에서 2002년부터 2016년까지 발생한 소아 황색포도알균 균혈증의 역학)

  • Lim, Seonhee;Ha, Seok Gyun;Tchah, Hann;Jeon, In Sang;Ryoo, Eell;Son, Dong Woo;Cho, Hye Jung;Sun, Yong Han;Kim, Hyo Jung;Ahn, Jung Min;Cho, Hye-Kyung
    • Pediatric Infection and Vaccine
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    • v.26 no.1
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    • pp.11-21
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    • 2019
  • Purpose: We aimed to investigate the epidemiological characteristics of Staphylococcus aureus bacteremia in Korean children. Methods: We retrospectively collected and analyzed data from the medical records of the patients with S. aureus bacteremia ${\leq}18years$ of age in Gil Medical Center from 2002 to 2016. Results: A total of 212 SAB cases were detected. The annual incidence of SAB from 2002 to 2016 ranged from 0.77 to 1.95 per 1,000 patients hospitalized. The neonate group (<28 days of age) and the pediatric group (28-18 years of age) were 51.4% (n=109) and 48.6% (n=103), respectively. According to the origin of infection, there were 93 cases (43.9%) of community-associated (CA)-SAB and 119 cases (56.1%) of healthcare-associated (HA)-SAB. The rates of HA-SAB among the neonate group and among the pediatric group were 64.2% and 47.6%, respectively (P=0.015). There was no difference in complications between CA-SAB and HA-SAB, but mortality was higher in HA-SAB. The proportion of methicillin-resistance S. aureus (MRSA) was the highest in neonates (88.1%), decreased with age, and was 36.4%-37.5% among children aged ${\geq}5years$. The MRSA proportion was 72.2%, showing no consistent trend over the period. Conclusions: The annual incidence of SAB and the proportion of MRSA in SAB remained constant in the recent 15 years in children. Judicious decision of antimicrobial agents for treatment considering the patient's age and the origin of infection is necessary.

Effects of Empowerment and Regarding Standard Precautions for Healthcare associated Infection Control in Healthcare Workers on Performances (의료종사자의 임파워먼트와 의료관련감염 관리 표준주의지침 인지도가 수행도에 미치는 요인)

  • Jung, Mi-Ra
    • Journal of Digital Convergence
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    • v.16 no.2
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    • pp.243-250
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    • 2018
  • The purpose of this study was to examine relationships among empowerment, awareness and performance on standard precautions and identify the factors that affect performance of standard precaution in the health care workers. The data were collected from 200 health care workers working in the general hospital located Y city. The data were analyzed by descriptive statistics, t-test, ANOVA, Scheffe, Pearson's correlation coefficient, and stepwise multiple regression. The result of the stepwise multiple regression indicates the awareness predict 49.0% (F=191.98, P<.001) in the performance of standard precaution. Therefore, it is necessary to develop awareness of the standard precaution strategy program for improving the performance of standard precautions in health care workers.

Causes of Bacterial Growth in Gels and Gel Containers Used for Ultrasonography (초음파 검사용 젤과 젤 용기의 세균증식 원인)

  • Kim, A-Young;Cho, Pyoung-Kon;Song, Do-Young;Kim, Su-Jung
    • Journal of radiological science and technology
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    • v.43 no.5
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    • pp.359-365
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    • 2020
  • This study aimed to investigate the causes of bacterial growth to prevent infection caused by ultrasound gel and gel containers in contact with patients during ultrasonography. To investigate bacterial contamination during manufacturing or storage, we cultured ultrasound gels originally supplied from three manufacturers. To analyze bacterial growth according to the lapse of time and frequency of use of the ultrasound gel container, the gel and container were cultured at regular intervals every week for 4 weeks. In addition, to determine the source of infection, the examiner's hand was inspected with hand plate and the degree of bacterial contamination was measured before the test. As a result of the study, bacteria were not detected in the gel provided at the initial supply, and in the gel and gel container used repeatedly for 4 weeks, the same bacteria residing on the skin were identified in the examiner's hand, such as Staphylococcus epidermidis, Micrococcus luteus, Leuconostoc mesenteroid spp cremoris, Kocuria rhizophila, and etc. Separated strains were classified as those of the low- or non-pathogenicity; however, most of these strains may render fatal consequences to patients of lower level of immunity due to acquired tolerance to antibiotics. At week 1, when the number of tests was the highest, 44 colonies were identified, and at week 4, when the number of tests was the lowest, 4 colonies were identified. As r=0.994, it was found that the number of colonies increased as the number of tests increased. In conclusion, it was confirmed that the cause of the infection was not the ultrasound gel, but the examiner's hand. The ultrasound gel or gel container may be contaminated by skin flora of examiner's hands, which can cause opportunistic infection in patients with low immunity. The ultrasound gel or gel container may be contaminated by skin flora of examiner's hands, which can cause opportunistic infection in patients with low immunity. Therefore, it was confirmed that thorough hand disinfection was necessary to block healthcare-associated infections.

Sepsis: Early Recognition and Optimized Treatment

  • Kim, Hwan Il;Park, Sunghoon
    • Tuberculosis and Respiratory Diseases
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    • v.82 no.1
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    • pp.6-14
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    • 2019
  • Sepsis is a life-threatening condition caused by infection and represents a substantial global health burden. Recent epidemiological studies showed that sepsis mortality rates have decreased, but that the incidence has continued to increase. Although a mortality benefit from early-goal directed therapy (EGDT) in patients with severe sepsis or septic shock was reported in 2001, three subsequent multicenter randomized studies showed no benefits of EGDT versus usual care. Nonetheless, the early administration of antibiotics and intravenous fluids is considered crucial for the treatment of sepsis. In 2016, new sepsis definitions (Sepsis-3) were issued, in which organ failure was emphasized and use of the terms "systemic inflammatory response syndrome" and "severe sepsis" was discouraged. However, early detection of sepsis with timely, appropriate interventions increases the likelihood of survival for patients with sepsis. Also, performance improvement programs have been associated with a significant increase in compliance with the sepsis bundles and a reduction in mortality. To improve sepsis management and reduce its burden, in 2017, the World Health Assembly and World Health Organization adopted a resolution that urged governments and healthcare workers to implement appropriate measures to address sepsis. Sepsis should be considered a medical emergency, and increasing the level of awareness of sepsis is essential.

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.

Association of Lower Socioeconomic Status and SARS-CoV-2 Positivity in Los Angeles, California

  • Allan-Blitz, Lao-Tzu;Goldbeck, Cameron;Hertlein, Fred;Turner, Isaac;Klausner, Jeffrey D.
    • Journal of Preventive Medicine and Public Health
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    • v.54 no.3
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    • pp.161-165
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    • 2021
  • Objectives: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spreads heterogeneously, disproportionately impacting poor and minority communities. The relationship between poverty and race is complex, with a diverse set of structural and systemic factors driving higher rates of poverty among minority populations. The factors that specifically contribute to the disproportionate rates of SARS-CoV-2 infection, however, are not clearly understood. Methods: We evaluated SARS-CoV-2 test results from community-based testing sites in Los Angeles, California, between June and December, 2020. We used tester zip code data to link those results with United States Census report data on average annual household income, rates of healthcare coverage, and employment status by zip code. Results: We analyzed 2 141 127 SARS-CoV-2 test results, of which 245 154 (11.4%) were positive. Multivariable modeling showed a higher likelihood of SARS-CoV-2 test positivity among Hispanic communities than among other races. We found an increased risk for SARS-CoV-2 positivity among individuals from zip codes with an average annual household income

Laboratory Diagnosis of Coronavirus Disease 19 (COVID-19) in Korea: Current Status, Limitation, and Challenges (국내 중증 급성 호흡기 증후군 코로나 바이러스의 검사실 내 진단: 현재, 한계점 그리고 직면한 과제)

  • Song, Gi Seon;Lee, You-Rim;Kim, Sungmin;Kim, Wontae;Choi, Jungwon;Yoo, Dahyeon;Yoo, Jungyoung;Jang, Kyung-Tae;Lee, Jaewang;Jun, Jin Hyun
    • Korean Journal of Clinical Laboratory Science
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    • v.52 no.3
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    • pp.284-295
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    • 2020
  • In December 2019, the first coronavirus disease- 2019 (COVID-19) patient was reported in Wuhan, Hubei Province, China. Since then, the number of patients who suffered severe acute respiratory syndrome caused by the novel Coronavirus (SARS-CoV-2 or 2019-nCoV) has increased dramatically in Korea. This new variant virus induces pulmonary diseases, including cough, sore throat, rhinorrhea, dyspnea, and pneumonia. Because SARS-CoV-2 is an RNA virus, real-time reverse-transcriptase PCR has been used widely to diagnose COVID-19. As the Korea Centers for Disease Prevention and Control (KCDC) and Ministry of Food & Drug Safety (MFDS) approved emergency use authorization, clinical specimens collected from COVID-19 patients and even healthy people have been clinically diagnosed by laboratory medicine. Based on a literature search, this paper reviews the epidemiology, symptoms, molecular diagnostics approved by KCDC, a current diagnosis of COVID-19 in the laboratories, the difference between molecular and serological diagnosis, and guidelines for clinical specimens. In addition, the Korean guidelines of biosafety for clinical laboratory scientists are evaluated to prevent healthcare-associated infection. The author's experience and lessons as clinical laboratory scientists will provide valuable insights to protect the domestic and international health community in this COVID-19 pandemic around the world.

Does the Gut Microbiota Regulate a Cognitive Function? (장내미생물과 인지기능은 서로 연관되어 있는가?)

  • Choi, Jeonghyun;Jin, Yunho;Kim, Joo-Heon;Hong, Yonggeun
    • Journal of Life Science
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    • v.29 no.6
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    • pp.747-753
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    • 2019
  • Cognitive decline is characterized by reduced long-/short-term memory and attention span, and increased depression and anxiety. Such decline is associated with various degenerative brain disorders, especially Alzheimer's disease (AD) and Parkinson's disease (PD). The increases in elderly populations suffering from cognitive decline create social problems and impose economic burdens, and also pose safety threats; all of these problems have been extensively researched over the past several decades. Possible causes of cognitive decline include metabolic and hormone imbalance, infection, medication abuse, and neuronal changes associated with aging. However, no treatment for cognitive decline is available. In neurodegenerative diseases, changes in the gut microbiota and gut metabolites can alter molecular expression and neurobehavioral symptoms. Changes in the gut microbiota affect memory loss in AD via the downregulation of NMDA receptor expression and increased glutamate levels. Furthermore, the use of probiotics resulted in neurological improvement in an AD model. PD and gut microbiota dysbiosis are linked directly. This interrelationship affected the development of constipation, a secondary symptom in PD. In a PD model, the administration of probiotics prevented neuron death by increasing butyrate levels. Dysfunction of the blood-brain barrier (BBB) has been identified in AD and PD. Increased BBB permeability is also associated with gut microbiota dysbiosis, which led to the destruction of microtubules via systemic inflammation. Notably, metabolites of the gut microbiota may trigger either the development or attenuation of neurodegenerative disease. Here, we discuss the correlation between cognitive decline and the gut microbiota.