• Title/Summary/Keyword: Hospital Infection Management

검색결과 515건 처리시간 0.023초

Seroprevalence of Toxoplasma gondii Infection and Characteristics of Seropositive Patients in General Hospitals in Daejeon, Korea

  • Shin, Dae-Whan;Cha, Dong-Yeub;Hua, Quan Juan;Cha, Guang-Ho;Lee, Young-Ha
    • Parasites, Hosts and Diseases
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    • 제47권2호
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    • pp.125-130
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    • 2009
  • To figure out the epidemiological status and relevance with other diseases in toxoplasmosis, we checked serum IgG antibody titers of 1,265 patients and medical records of seropositive patients. Seropositive rates were 6.6% by latex agglutination test (LAT) and 6.7% by ELISA. No significant differences were detected between sexes and age groups. The peak seroprevalence was detected in the 40-49-year-old age group. According to clinical department, Toxoplasma-positive rates were high in patients in psychiatry, ophthalmology, health management, emergency medicine, and thoracic surgery. Major coincidental diseases in seropositive cases were malignant neoplasms, diabetes mellitus, arthritis, chronic hepatitis B, chronic renal diseases, schizophrenia, and acute lymphadenitis, in the order of frequency. In particular, some patients with chronic hepatitis B and malignant neoplasms had high antibody titers. These results revealed that the seroprevalence of toxoplasmosis in a general hospital-based study was similar to that in a community-based study, and T. gondii seropositivity may be associated with neoplasms, diabetes, and other chronic infections.

Strategy for salvaging infected breast implants: lessons from the recovery of seven consecutive patients

  • Yeo, Hyeonjung;Lee, Dongkyu;Kim, Jin Soo;Eo, Pil Seon;Kim, Dong Kyu;Lee, Joon Seok;Kwon, Ki Tae;Lee, Jeeyeon;Park, Ho Yong;Yang, Jung Dug
    • Archives of Plastic Surgery
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    • 제48권2호
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    • pp.165-174
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    • 2021
  • Background In recent years, implant-based breast reconstruction has been performed because of its simplicity, short operation time, and rapid recovery of patients. Several studies have reported treatment methods for implant surgery-related infection, which is a serious complication. The aim of this study was to introduce our strategy for salvaging infected implants and to evaluate its effectiveness. Methods The authors performed a retrospective study of 145 cases from 132 patients who underwent implant-based breast reconstruction from January 2012 to December 2018. Empirical antibiotics were immediately administered to patients with suspected infections. The patients then underwent salvage treatment including appropriate antibiotics, ultrasonography-guided aspiration, debridement, antibiotic lavage, and implant exchange through a multidisciplinary approach. Patient demographics, operative data, duration until drain removal, adjuvant treatment, and complications were analyzed. Results The total infection rate was 5.5% (8/145). A longer indwelling catheter period and adjuvant treatment were significantly associated with infection. The salvage treatment showed a success rate of 87.5% (7/8). Seven patients who received early aggressive salvage treatment recovered from infection. One patient with methicillin-resistant Staphylococcus aureus, who received salvage treatment 11 days after symptom onset, did not respond to drainage and antibiotic treatment. That patient subsequently underwent explantation. Conclusions In implant-based breast reconstruction, prevention of infection is of the utmost importance. However, if an infection is suspected, proactive empirical antibiotic therapy and collaboration with the necessary departments are required. Through a multidisciplinary approach and proactive early management, swift and appropriate salvage should be performed.

초음파실 표면의 세균 오염평가 (Bacterial Contamination of Surfaces in an Ultrasound Room)

  • 김희정;최유진;이창래
    • 대한방사선기술학회지:방사선기술과학
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    • 제44권3호
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    • pp.231-237
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    • 2021
  • The ongoing coronavirus disease 2019 (COVID-19) pandemic has highlighted the importance of hospital hygiene and infection control in hospital settings. To raise hygiene awareness among ultrasound technicians, we evaluated the hygiene status of an ultrasound room, in comparison with that of objects used in daily life. Using the swab method, the following surfaces were examined: eight surfaces in the ultrasound room including the ultrasound probes (convex, linear, sector, 3D), ultrasound track ball, ultrasound keyboard, ultrasound gel (sealed and in use) and pillow as well as four surfaces of everyday objects including subway handles, common computer keyboards, common computer mouse, and cell phones. The streak plate technique was used for inoculation into media, which was observed for the formation of bacterial colonies following incubation for 24 h. Six bacterial strains were detected from objects used in the ultrasound room, including methicillin-resistant Staphylococcus aureus. Four strains of bacteria were detected on surfaces of everyday objects. The equipment and accessories used in an ultrasound room can act as vehicles for infecting patients. Establishment of standardized hygiene protocols and periodic training of the staff are recommended to avoid cross-infection.

The Actual Condition and an Alternative of Students in the Department of Dental Hygiene about Dental Instrument Injuries during Clinical Practice

  • Yoo, Eun-Ha;Oh, Hye-Young
    • 치위생과학회지
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    • 제22권2호
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    • pp.108-114
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    • 2022
  • Background: Students in the department of dental hygiene are exposed to injections and sharp instruments during clinical practice. Therefore, it is necessary to develop measures for a safe practice environment. This study aimed to investigate dental stabbing accidents caused by dental instruments during clinical practice among students in the department of dental hygiene and suggest appropriate preventative measures. Methods: This study was conducted from May 1 to June 30, 2016, with students in the department of dental hygiene located at several universities in Seoul and Gyeonggi area. The study included 339 participants. A frequency analysis was performed to determine the general characteristics of dental infection control. A cross-analysis was conducted to identify the relationship between dental infection control education, stabbing accident prevention education, and treatment after stabbing accidents with a dental instrument. Results: Among the participants, 81.1% received dental infection control education and 66.4% received stabbing accident prevention education. Only 50.9% received hepatitis B vaccinations. Conclusion: Dental infection control education and stabbing accident prevention education were shown to be effective in preventing dental instrument stabbing in students. However, post-accident processing, such as reporting to upper management and medical treatment after the accident, was insufficient. Therefore, it is necessary to present a treatment flowchart for dealing with stab accidents in clinical practice for students in the department of dental hygiene and strengthen education.

국내 의료기관의 의료관련감염 관리 실태 (The status of Healthcare-associated Infection Control among Healthcare Facilities in Korea)

  • 정선영;김옥선;이지영
    • 디지털융복합연구
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    • 제12권5호
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    • pp.353-366
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    • 2014
  • 본 연구는 국내 의료기관의 의료관련감염 관리 현황을 파악하고자 시행된 조사연구이다. 134개 의료기관을 대상으로 강문원 등[8]이 개발한 설문지를 보완하여 사용하였다. 조사대상 의료기관의 평균 병상수는 556.4이었고 300병상 미만 의료기관이 26.9%를 차지하였다. 99.3%의 의료기관이 감염관리위원회를 설치하였고 평균 개최 횟수는 연 3.4회였다. 감염관리실무자가 1명 배치된 곳이 54.5%, 전담근무가 62.7%이었다. 실무자의 95.5%가 간호사로 평균 37.2세, 48.9%가 석사 이상, 평균 병원 경력은 13.5년, 감염관리실무 경력은 3.2년이었으며 30.8%가 1년 미만이었다. 감염감시는 100%, 개선활동은 75.4%의 의료기관에서 수행하였다. 감염관리실 설치 및 인력, 감염관리실무자 근무 형태, 감염감시 결과 비교, 감염유행조사, 음압병실, 감염관리 전산프로그램과 손위생 모니터링 실시는 의료기관의 규모에 따라 유의한 차이가 있었으며, 300병상 미만 중소 의료기관에서 인력, 조직, 시설이 부족하였다. 본 연구의 결과는 300병상 미만 중소 의료기관의 감염관리 조직과 인력, 실무 정착화를 위한 기초 자료로 이용될 수 있을 것이다.

지주막하강내 약물투여에 의한 말기암 환자의 통증관리 -증례 보고- (Pain Management of Terminal Cancer Patients by Intrathecal Injection of Local Anesthetics, Opioid and Adjuvants -A report of two cases-)

  • 이선화;김종일;이상곤;반종석;민병우
    • The Korean Journal of Pain
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    • 제13권2호
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    • pp.259-262
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    • 2000
  • There are many difficulties in the management of terminal cancer pain. We often encounter difficulties when nerve blocks or epidural injection of drugs do not produce good results. Local anesthetics, opioids and adjunctives, were administered to two patients intrathecally. The results were very satisfactory. It has complications such as hypotension or infection due to intrathecal route. In the first case, the pancreatic cancer patient complicated with severe epigastic pain but unfortunately no management was effective in pain control. Intrathecal injection of bupivacaine and morphine mixture was successful even if syncope which was relieved by bed rest. In the second case, the patient complicated with lower abdominal pain due to ovarian cancer who very well controlled by epidural injection of morphine and clonidine mixture but morphine demand was greatly increased. Intrathecal injection of morphine and ketamine were tried. The patient had comportable analgesic effect. CSF leakage to subcutaneous occurred but resolved by change of the catheter position or retunnelling. There were no significant complications reported in two cases.

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Clinical Analysis of External Ventricular Drainage Related Ventriculitis

  • Moon, Hong-Joo;Kim, Sang-Dae;Lee, Jang-Bo;Lim, Dong-Jun;Park, Jung-Yul
    • Journal of Korean Neurosurgical Society
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    • 제41권4호
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    • pp.236-240
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    • 2007
  • Objective : The aim of this study is to analyze on the external ventricular drainage [EVD] related ventriculitis, especially on their risk factors, management, and prevention. Methods : From January 2003 to December 2005, a total of 174 EVD catheters were placed in 112 patients at our institution. Of these patients, EVD-related ventriculitis were developed in 15 cases. Clinical variables such as age, sex, prior clinical diagnosis, placement of EVD insertion, duration of EVD, total numbers of EVD per person, and outcome were analyzed in theses cases to verify the risk factors, causative agents and outcomes. Results : Fifteen cases of EVD related ventriculitis were noted presenting infection incidence of 13.39 % per patient and 8.62% per procedure. Of these, five patients died from sepsis, seven patients were recovered from infection but neurological complications remained and three patients were recovered without any complications. Microbes were obtained from cerebrospinal fluid only in six patients. Acinetobactoer baumanii was the most common pathogen in our study [4 cases]. Among the various risk factors, only the prior clinical diagnosis showed the statistical significance. Patients who underwent decompressive craniectomy after severe brain trauma showed unfavorable outcome because of possible contaminative environment compared with other cases. Conclusion : EVD is considered as a safe procedure with good control of intracranial pressure if meticulous care is provided for EVD procedure and maintenance. With regards to risk factors and prevention, the higher incidence and unfavorable outcome was seen especially in patients with severe head trauma. Thus, special attention is required in these clinical settings.

병원감염에 관한 판례의 동향 (Trends of the Precedent Case concerning Hospitalized Acquired Infection)

  • 이동필
    • 의료법학
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    • 제8권1호
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    • pp.61-105
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    • 2007
  • The Hospitalized Acquired Infection is defined as the case where the hidden infection or not found at the time of hospitalization occurs during the hospitalized period or, within 30 days to those who performed the surgery operation and then left the hospital. About 2/3 of the Hospitalized Acquired Infection are found as having the internal infection cases that are occurred by the patients' own virus due to the lowered immune system, while about 1/3 are found as having the external infection. The latter 1/3 of the external infection cases can be prevented through the infection management. And in case the new Hospitalized Acquired Infection case occur to the patient who was treated in the hospital, its responsibility issue will matter. As well in the disputes over the Hospitalized Acquired Infection cases, the cause-result relation between the damages and the medical staff's fault and as to whether there is failure of the medical staff or not. personnel should be proved in the medical-malpractice cases. In addition, the difficulties in proving such as expertise, secrecy propensity, discrete propensity and incompleteness will be considered to ease the burden of patient side's proving. Probability theory, Fact based assumption theory, Most adequate plaintiff preassumption or Expressed evidence theories are being discussed as the theories of eased burden of proof. In the result of gathering and reviewing Korea's precedent cases concerning the Hospitalized Acquired Infection, there are only a few accumulated prece dent cases and the attitude of the court also are also not consistent. Therefore, there are the precedents where the cause-result relation and the failure are immediately assumed when (1) timely proximity between the medical behavior and malpractice results, (2) proximity between the medical behavior-applied parts and the malpractice results-found parts, and (3) lack of other causes are separately evidenced; while the are the precedents only when 'the existence of the medical faults based on the common sense' is separately evidenced. It was found that the former and latter cases coexisted. The former is considered as based on the theory that separates the fault and cause-result relation not to consider them together, or regarded as based on the doubts that assumes the medical staff's neglect even though the Hospitalized Acquired Infection might be completely prevented by their efforts. However, the modern medical technology has the limitation as far as the prevention of the Hospitalized Acquired Infection. In conclusion, the assumption of the cause-result relation and that of the fault should be separately reviewed. Therefore, the latter precedents are considered as more reasonable, in the point the faulty behavior may be proved based on the common sense.

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Validation of Synovial Fluid Clinical Samples for Molecular Detection of Pathogens Causing Prosthetic Joint Infection Using GAPDH Housekeeping Gene as Internal Control

  • Jiyoung Lee;Eunyoung Baek;Hyesun Ahn;Youngnam Park;Geehyuk Kim;Sua Lim;Suchan Lee;Sunghyun Kim
    • 대한의생명과학회지
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    • 제29권4호
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    • pp.220-230
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    • 2023
  • Identification of the pathogens causing infection is important in terms of patient's health management and infection control. Synovial fluids could be used as clinical samples to detect causative pathogens of prosthetic joint infections (PJIs) using molecular diagnostic assays, therefore, normalization and validation of clinical samples are necessary. Microbial culture is considered the gold standard for all infections, including PJIs. Recently, molecular diagnostic methods have been developed to overcome the limitation of microbial culture. Therefore, guideline for validating clinical samples to provide reliable results of molecular diagnostic assays for infectious diseases is required in clinical field. The present study aimed to develop an accurate validating method of synovial fluid clinical samples using GAPDH gene as an internal control to perform the quantitative PCR TaqMan probe assay to detect pathogens causing PJIs.

요양병원 종사자의 소방안전 의식조사에 관한 연구 (A Study on the Consciousness Survey of Geriatric Hospital Workers for Fire Safety)

  • 이영삼
    • 대한안전경영과학회지
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    • 제18권3호
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    • pp.91-97
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    • 2016
  • Currently many geriatric hospitals have been built in Korea because younger people don't want to care their parents and have been decreasing for labor. However, the increasing geriatric hospitals make the increasing fire safety accidents. Therefore, this study is conducted by survey and face-to-face talk for analyzing fire safety problem of twelve among 15 geriatric hospitals in the north of Chung-Buk area. The result of this study is that infection and fall accident are higher than others and fire safety implement rate of safety rule followed by CEO is 71%. Monthly safety training rate is 49% and initial fire safety training not conducted is 33%. Yearly outside fire safety training rate is 97% but workers who know how to use fire evacuation facility are 61%. Furthermore, safety instruction rate of fire safety manager is much higher than supervisor's safety instruction. The cause of accident is facility (33%). In conclusion, the institution and rule improvement need for decreasing infection and falling, increasing implement level of fire safety rule and fire safety training, participation rate of supervisor for fire safety, quality of fire safety training, and investment of fire safety facility.