• 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.

• Parasites, Hosts and Diseases
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• v.56 no.5
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• pp.401-408
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• 2018

Korea is successfully controlled intestinal parasitic infections owing to economic development and high health consciousness. The Division of Vectors and Parasitic Diseases (formerly the Division of Malaria and Parasitology) is in the Center for Laboratory Control of Infectious Diseases of the Korea Centers for Disease Control and Prevention. It has been the governmental agency responsible for controlling and leading scientific research on parasitic diseases. The Division of Vectors and Parasitic Diseases has conducted and funded basic research and disseminated the research results to various medical fields, ultimately promoting public health in Korea. Among the noteworthy achievements of this division are the national surveillance of healthcare-associated parasitic infections, prevention and control for parasitic infections, and the elimination of lymphatic filariasis from Korea. On a broader scale, the division's research programs and academic supports were influential in preventing and treating infectious parasitic diseases through public policies and laws. In this review, we summarize the past and present role of the Division of Vectors and Parasitic Diseases in preventing and treating infectious parasitic diseases in Korea.

• 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.

• Journal of Preventive Medicine and Public Health
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• v.53 no.4
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• pp.236-244
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• 2020

Objectives: Although the World Health Organization (WHO) initiative "My 5 Moments for Hand Hygiene" has been lauded as effective in preventing hospital-associated infections, little is known about healthcare workers (HCWs)' hand hygiene behavior. In this study, we sought to assess knowledge and attitudes towards the concepts in this initiative, as well as associated factors, among Vietnamese HCWs at a general hospital. Methods: A structured questionnaire was administered to HCWs at a central Vietnamese general hospital in 2015. Multiple logistic regression analysis was used to identify factors associated with HCWs' knowledge and attitudes towards hand hygiene. Results: Of 120 respondents, 65.8% and 67.5% demonstrated appropriate knowledge and a positive attitude, respectively, regarding all 5 hand hygiene moments. Logistic regression indicated better knowledge of hand hygiene in workers who were over 30 years old, who were direct HCWs (rather than managers), who had frequent access to clinical information, and who received their clinical information from training. Those who worked in infectious and tropical disease wards, who had frequent access to clinical information, and who received information from training were more likely to have a positive attitude towards hand hygiene than their counterparts. Conclusions: Although many Vietnamese HCWs displayed moderate knowledge and positive attitudes towards the WHO hand hygiene guidelines, a key gap remained. Regular education and training programs are needed to increase knowledge and to improve attitudes and practices towards hand hygiene. Furthermore, a combination of multimodal strategies and locally-adapted interventions is needed for sustainable hand hygiene adherence.

• Biomedical Science Letters
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• v.26 no.3
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• pp.230-237
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• 2020

Staphylococcus aureus (S. aureus) is known as a bacterium that can cause skin infections, respiratory system infections, and sinusitis; however, it can exist as a normal flora rather than a pathogen. Recently, methicillin-resistant S. aureus (MRSA) infections have emerged in the community as a new variant of community-associated (CA)-MRSA. In the present study, S. aureus and MRSA were isolated and cultured by collecting samples from facilities and environments where students and educational personnel have multiple contacts on university campuses; specifically, the nostrils and hands of college students were tested from July to September of 2019. The molecular properties of the isolated MRSA were analyzed, and the one MRSA strain was isolated from the university campuses. One MRSA that was isolated and cultured on campus was the mec complex group A and staphylococcal cassette chromosome (SCC) mec type II, which is a characteristic of healthcare-associated (HA)-MRSA, and SCCmec type V, which is a characteristic of CA-MRSA. This result was similar to other studies wherein the SCCmec type II was detected in SCCmec typing analysis in CA-MRSA. To confirm whether there is a new variant of CA-MRSA in the Republic of Korea, additional follow-up studies on the analysis of virulence factors of MRSA are needed by additionally separating CA-MRSA from the body parts of university students and educational personnel.

• Journal of Trauma and Injury
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• v.35 no.2
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• pp.76-83
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• 2022

Purpose: Ventilator-associated pneumonia is the most common nosocomial infection in patients with mechanical ventilation. In 2013, the new concept of ventilator-associated events (VAEs) replaced the traditional concept of ventilator-associated pneumonia. We analyzed risk factors for VAE occurrence and in-hospital mortality in trauma patients who received mechanical ventilatory support. Methods: In this retrospective review, the study population comprised patients admitted to the Jeju Regional Trauma Center from January 2020 to January 2021. Data on demographics, injury characteristics, and clinical findings were collected from medical records. The subjects were categorized into VAE and no-VAE groups according to the Centers for Disease Control and Prevention/National Healthcare Safety Network VAE criteria. We identified risk factors for VAE occurrence and in-hospital mortality. Results: Among 491 trauma patients admitted to the trauma center, 73 patients who received ventilator care were analyzed. Patients with a chest Abbreviated Injury Scale (AIS) score ≥3 had a 4.7-fold higher VAE rate (odds ratio [OR], 4.73; 95% confidence interval [CI], 1.46-17.9), and those with a glomerular filtration rate (GFR) <75 mL/min/1.73 m² had 4.1-fold higher odds of VAE occurrence (OR, 4.15; 95% CI, 1.32-14.1) and a nearly 4.2-fold higher risk for in-hospital mortality (OR, 4.19; 95% CI, 1.30-14.3). The median VAE-free duration of patients with chest AIS ≥3 was significantly shorter than that of patients with chest AIS <3 (P=0.013). Conclusions: Trauma patients with chest AIS ≥3 or GFR <75 mL/min/1.73 m² on admission should be intensively monitored to detect at-risk patients for VAEs and modify the care plan accordingly. VAEs should be closely monitored to identify infections early and to achieve desirable results. We should also actively consider modalities to shorten mechanical ventilation in patients with chest AIS ≥3 to reduce VAE occurrence.

• Korean Journal of Clinical Laboratory Science
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• v.50 no.3
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• pp.359-369
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• 2018

An essential measure to prevent healthcare-associated infections (HAI) is to develop a consistent system of surveillance, thereby promoting a reliable situation diagnosis to perform efficient control for the problem. Patient-to-patient transmission of pathogens within the hospital plays a substantial role in the epidemiology of HAIs. Contamination of healthcare environments commonly occurs, including facilities surfaces (e.g., bed rails, bedside tables), drinking water, cooling tower water, endoscopic instruments, food, airborne, endotoxin test, sterile test and medical equipment, with pathogenic organisms. In addition, epidemiological analysis is performed by multi locus sequence tying, pulsed-field gel electrophoresis for active surveillance. Therefore, an environmental surveillance culture test for prevention improves patient safety and blocks infection agents. Effective infection control and increased safety are possible by controlling the national infection control system. In conclusion, this study contributes to an effective infection control system through the standardization of active surveillance culture laboratory and secure expertise as infection control specialist. The primary objective of the standardization is to improve the safety of the nation's healthcare system by reducing the rates of HAIs.

• Journal of Korean Critical Care Nursing
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• v.15 no.3
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• pp.75-87
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• 2022

Purpose : This retrospective investigation study aimed to determine the predictive validity of superficial surgical site infection assessment tools by measuring the risk score at the surgical site. Methods : This study included patients hospitalized to the general surgery department of a Hospital from January 2021 to December 31, 2021. The inclusion criteria were age ≥19 years, general abdominal surgery under general anesthesia, and hospital stay longer than 2 days. Patients who had undergone transplantation were excluded. Results : Tool validity results showed that tools including surgical time and operative procedure were more accurate than previously developed tools, with a sensitivity of 71.1%, specificity of 71.4%, positive prediction of 12.3%, negative prediction of 97.8%, and area under the curve of 0.743 (95% confidence interval, 0.678~0.745). The tool's cut-off score was 15, and the risks of infection was increased by 6.14 times at or above this cut-off point. Preoperative hair removal period, surgical wound classification, surgery time, body temperature on the second day after surgery, drainage tube type, and suture type affected the risk of infection at the surgical site. Conclusion : The incidence of healthcare-associated infections has been declining in the past decade; however, surgical site infections still account for a considerable proportion. Therefore, early identification of high-risk groups for surgical site infection is crucial for reducing the incidence of surgical site infection using appropriate management.

• Biomedical Science Letters
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• v.28 no.2
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• pp.127-136
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• 2022

Uropathogenic Escherichia coli (UPEC) is main causative agent of urinary tract infections. They are classified based on various types of O antigen. UPEC strains commonly possess many genes encoding virulece-associated factors. E. coli strains are generally divided into four main phylogenetic groups. The virulence factor (VF) profiles of UPEC are related with their O-serogroups in each strains. A total of 681 strains of UPEC clinical isolates were collected from Korean healthcare facility (1989: 123 strains and 2010-2014: 558 strains). The UPEC clinical isolates were analyzed by polymerase chain reaction (PCR) methods. A total of 14 O-serotypes (O1, O2, O4, O6, O7, O8, O15, O16, O18, O21, O22, O25, O75 and O83), 6 virulence factors (papC, fimG/H, sfaD/E, hly1, cnf1 and usp) and phylogenetic groups were identified. The most prevalent O-serogroups were O6 (11.1%) in 1989 UPEC strains and O25 (21.0%) in 2010-2014 UPEC strains. The identified VFs, phylogenetic groups in 1989 UPEC strains and 2010-2014 UPEC strains were fimG/H and B2 group. In this study, O6 serotype was revealed the close relationships with VFs. Also, the distribution of prevalence O-serogroups of UPEC has been changed from O6 to O25 and virulence of UPEC strains was increased during past twenty-one years.

• Tuberculosis and Respiratory Diseases
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• v.80 no.2
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• pp.201-209
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• 2017

Background: Methicillin-resistant Staphylococcus aureus (MRSA) infection is a severe and life-threatening disease in patients with community-onset (CO) pneumonia. However, the current guidelines lack specificity for a screening test for MRSA infection. Methods: This study was retrospectively conducted in elderly patients aged ${\geq}65years$, who had contracted CO-pneumonia during hospitalization at the Jeju National University Hospital, between January 2012 and December 2014. We analyzed the risk factors of MRSA in these patients and developed a scoring system to predict MRSA infection. Results: A total of 762 patients were enrolled in this study, including 19 (2.4%) with MRSA infection. Healthcare-associated pneumonia (HCAP) showed more frequent MRSA infection compared to community-acquired pneumonia (4.4% vs. 1.5%, respectively; p=0.016). In a multivariate logistic regression analysis, admissions during the influenza season (odds ratio [OR], 2.896; 95% confidence interval [CI], 1.022-8.202; p=0.045), chronic kidney disease (OR, 3.555; 95% CI, 1.157-10.926; p=0.027), and intensive care unit admission (OR, 3.385; 95% CI, 1.035-11.075; p=0.044) were identified as predictive factors for MRSA infection. However, the presence of HCAP was not significantly associated with MRSA infection (OR, 1.991; 95% CI, 0.720-5.505; p=0.185). The scoring system consisted of three variables based on the multivariate analysis, and showed moderately accurate diagnostic prediction (area under curve, 0.790; 95% CI, 0.680-0.899; p<0.001). Conclusion: MRSA infection would be considered in elderly CO-pneumonia patients, with three risk factors identified herein. When managing elderly patients with pneumonia, clinicians might keep in mind that these risk factors are associated with MRSA infection, which may help in selecting appropriate antibiotics.