• Pediatric Infection and Vaccine
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• 제16권1호
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• pp.1-5
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• 2009

Methicillin-resistant Staphylococcus aureus (MRSA), a leading cause of nosocomial infections, has been increasingly recognized in communities of the United States. This article will review the clinical spectrum and treatment of MRSA infections in children in the context of recent epidemiological changes of MRSA infections. In general, community-associated (CA) MRSA most frequently causes skin and soft tissue infections and has an increased association with invasive infections, particularly pneumonia and musculoskeletal infections. Hospital-associated (HA) MRSA strains tend to be associated with bloodstream infections, pneumonia, and surgical site infections. Different from the United States, CA-MRSA infections are not common in Korea (only 5.9%); however, there are some CA-MRSA clones that are different from HA-MRSA clones in Korea and from CA-MRSA clones in other countries. The treatment of MRSA infections should be guided by antimicrobial susceptibility testing, the site of infection, and the infection severity. Vancomycin is the treatment of choice for invasive MRSA infections. Other agents such as trimethoprim-sulfamethoxazole, clindamycin, linezolid, quinupristin-dalfopristin, and daptomycin have been used for some conditions.

• Journal of Yeungnam Medical Science
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• 제28권2호
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• pp.133-144
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• 2011

Background: Tigecycline (TIG), a new broad-spectrum glycylcycline with anti-multidrug-resistant-(MDR)-pathogen activity, was launched in March 2009 in South Korea, but there are insufficient clinical studies on its use in the country. As such, this study was performed to analyze cases of severe MDR-pathogen-caused infections treated with TIG. Methods: Patients treated with TIG within the period from May 2009 to June 2010 were enrolled in this study. Their clinical and microbiologic data were reviewed retrospectively. Results: Twenty-one patients were treated with TIG for complicated skin and soft-tissue infections (cSSTIs) (42.9%), complicated intra-abdominal infections (cIAIs) (38.1%), or pneumonia (19.1%) caused by MDR pathogens like carbapenem-resistant $Acinetobacter$ $baumannii$ (76.2%), methicillin-resistant $Staphylococcus$ $aureus$ (61.9%), extended-spectrum beta-lactamase-producing $Escherichia$ $coli$ and $Klebsiella$ $pneumoniae$ (38.1%), and penicillin-resistant $Enterococcus$ species (33.3%). Thirteen patients (61.9%) had successful clinical outcomes while five (23.8%) died within 30 days. The rate of clinical success was highest in cSSTI (77.8%), followed by cIAI (50%) and pneumonia (50%), and the mortality rate was highest in pneumonia (50%), followed by cIAI (25%) and cSSTI (11.1%), Conclusion: Tigecycline therapy can be an option for the treatment of severe MDR-pathogen-caused infections in South Korea, Due to its high risk of failure and mortality, however, prudence is required in its clinical use for the treatment of severe infections like nosocomial pneumonia.

• 대한응급의학회지
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• 제29권5호
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• pp.474-484
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• 2018

Objective: The time to positivity (TTP) of blood culture reflects bacterial load and has been reported to be associated with outcome in bloodstream infections. This study was performed to evaluate the relationship between the TTP of blood culture and the mortality rates associated with sepsis and septic shock according to the site of infection. Methods: We performed a retrospective cohort study on patients with sepsis and septic shock. The rates of blood culture positivity and mortality as well as the relationship between the TTP and 28-day mortality rate were compared among patients with different sites of infection, such as the lungs, abdomen, urogenital tract, and other sites. Results: A total of 2,668 patients were included, and the overall mortality rate was 21.6%. The rates of blood culture positivity and mortality were different among the different infection sites. There was no relationship between the TTP and mortality rates of total, lung, and urogenital infections. Patients with abdominal infections showed a negative correlation between the TTP and 28-day mortality rate. In patients with abdominal infections, a TTP<20 hours was independently associated with 28-day mortality compared with patients with negative blood culture (hazard ratio, 1.73; 95% confidence interval, 1.16-2.58). However, there was no difference in mortality rates of patients with a $TTP{\geq}20$ hours and a negative blood culture. Conclusion: The shorter TTP in patients with abdominal infections in sepsis and septic shock was associated with a higher 28-day mortality rate.

• 디지털융복합연구
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• 제19권7호
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• pp.463-471
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• 2021

본 연구는 요양병원 간호인력을 대상으로 병원감염관리 지식과 병원감염관리 수행 간의 건강신념의 매개효과 확인하기 위해 실시되었다. 부산 소재 5개 요양병원에 근무하는 간호사, 간호조무사를 대상으로 연구하였으며, 최종적으로 212부의 설문지를 이용하여 SPSS 25.0, SPSS Procee Macro를 통해 분석하였다. 연구결과, 병원감염관리 지식은 병원감염관리 수행에 유의미하였고(B=2.90, p<.001), 건강신념의 영향력도 유의미하게 나타났다(B=.52, p<.001). 병원감염관리 지식은 병원감염관리 수행에 직접적인 영향을 미치며, 건강신념을 통해서도 간접적으로 병원감염관리 수행에 영향을 미치는 것으로 나타나 부분매개효과를 확인하였다. 본 연구는 요양병원에 근무하는 간호사, 간호조무사가 인지하는 병원감염관리 지식이 병원감염관리 수행에 미치는 영향에 있어 건강신념의 매개효과를 확인함으로써 요양병원 간호조직의 효과적인 병원감염관리를 수행함에 필요한 기초자료를 제공함에 그 의의가 있다.

• Journal of Korean Dental Science
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• 제7권2호
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• pp.94-98
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• 2014

Numerous oral and maxillofacial surgeons have found facial space infections after tooth extraction. Most of these infections can be managed easily, but some of them could be life-threatening. Among the facial infections, temporal space infections are rare. Most temporal space infections could be observed as secondary to maxillary third molar infections, maxillary sinusitis, and maxillary sinus fractures. Note, however, that there are insufficient studies on temporal space abscess due to mandibular second molars, especially with acupuncture. A 74-year-old female came to our hospital with severe trismus and facial swelling on the right temporal, buccal, posterior auricular, and cervical regions. The patient had undergone extraction of tooth #47 secondary to dental caries by a general dentist about a month ago. After the dental procedure, the patient had been treated with acupuncture therapy around the right temporomandibular joint area at the oriental medicine clinic. We performed emergency incision and drainage under general anesthesia and started antibiotic treatment with IV ampicillin/sulbactam 3 g every 24 hours and vancomycin 1 g every 24 hours for 5 days. The patient's symptoms subsided and ultimately disappeared. Temporal space abscess after mandibular molar extraction is quite rare. In this case, the spreading mechanism against gravity is considered to be acupuncture therapy.

• Journal of Chest Surgery
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• 제51권5호
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• pp.350-355
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• 2018

Background: The complication rate of fungal disease is higher among patients with hematological malignancies. We investigated the clinicobacteriological outcomes of resected pulmonary fungal infections complicating hematological malignancies. Methods: Between 2001 and 2017, 21 patients with pulmonary fungal infections complicating hematological malignancies underwent resection, and their clinical records and survival were retrospectively reviewed. Results: The median age of the patients was 47 years, and 13 were male. The histological diagnoses were pulmonary aspergillosis (19 cases), mucormycosis (1 case), and cryptococcosis (1 case). The indications for surgery were resistance to antifungal therapy and the necessity of surgery before hematopoietic stem cell transplantation in 13 and 8 cases, respectively. The diagnoses of the hematological malignancies were acute myelogenous leukemia (10 cases), acute lymphocytic leukemia (5 cases), myelodysplastic syndrome (3 cases), and chronic myelogenous leukemia, malignant lymphoma, and extramedullary plasmacytoma (1 case each). The surgical procedures were partial resection (11 cases), segmentectomy (5 cases), lobectomy (4 cases), and cavernostomy (1 case). The size of the lesions was 0.9-8.5 cm. Fourteen cases had cavitation. There were no surgical-related deaths or fungal progression. Conclusion: Pulmonary fungal infections are resistant to treatments for hematological malignancies. Since the treatment of the underlying disease is extended and these infections often recur and are exacerbated, surgery should be considered when possible.

• Journal of Korean Neurosurgical Society
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• 제60권4호
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• pp.481-483
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• 2017

Sphingomonas paucimobilis (S. paucimobilis) is a gram negative bacillus. It has existed in soil, drinking water and plants. It has been isolated from distilled water tanks, respirators, and hemodialysis devices at the hospital setting. Patients with chronic disorders or immune suppression may be susceptible to infections with it. This microorganism has also been reported to infect healthy persons. Both nosocomial and community-acquired infections have been reported. So far, a variety of infections have been reported, including sepsis, septic pulmonary embolism, septic arthritis, peritonitis, and endophthalmitis. Only 2 cases of meningitis have been reported so far in the literature. So far, no previous reports of culture proliferation have been reported in patients with external ventricular drains, as was the case in our patient. Therefore, our case is the first to have S. paucimobilis proliferation in cerebrospinal fluid culture during intensive care unit stay for an external ventricular drain.

• IMMUNE NETWORK
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• 제16권3호
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• pp.159-164
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• 2016

IL-33 is a multifunctional cytokine that is released in response to a variety of intrinsic and extrinsic stimuli. The role of IL-33 in Candida albicans infections is just beginning to be revealed. This cytokine has beneficial effects on host defense against systemic C. albicans infections, and it promotes resistance mechanisms by which the immune system eliminates the invading fungal pathogens; and it also elevates host tolerance by reducing the inflammatory response and thereby, potentially, tissue damage. Thus, IL-33 is classified as a cytokine that has evolved functionally to protect the host from damage by pathogens and immunopathology.

• Asian Pacific Journal of Cancer Prevention
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• 제13권1호
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• pp.269-273
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• 2012

We aimed to estimate the prevalence of high-risk human papillomavirus (HPV) infections in women of high socioeconomic status (SES) in Seoul, Republic of Korea and to identify risk factors. This study included 13,386 women visiting a prestigious healthcare center located in Seoul between 2003 and 2008. High-risk HPV infections were detected in 994 (7%) and the age-standardized prevalence was 8%. Abnormal Pap smear results ${\geq}$ atypical squamous cells of unknown significance (ASCUS) were observed in 280 of 12,080 women (2%). Based on univariate analysis, age, level of education and number of children were associated with high-risk HPV infections. Based on multivariate analysis, age and high-risk HPV infections had an inverse relationship. In women with high SES in Seoul, the prevalence of high-risk HPV infection was 7% and the age-standardized prevalence was 8%. Age was a strong determinant of high-risk HPV infection.

• Childhood Kidney Diseases
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• 제24권1호
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• pp.27-35
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• 2020

Purpose: Urinary tract infections (UTIs) are the most common and serious bacterial infections in children. Therefore, early diagnosis of vesicoureteral reflux (VUR) for treatment planning and the identification of noninvasive markers that can predict renal injury are important in patients with UTIs. We analyzed the clinical features of pediatric UTIs commonly encountered by general practitioners and reinterpreted the blood tests and imaging findings to identify the important clinical predictive markers of VUR in order to selectively perform VCUG. Methods: This retrospective study was performed among 183 children diagnosed with a UTI or acute pyelonephritis. Results: The most significant predictor of high grade and bilateral VUR identified using area under the curve analyses was hydronephrosis on kidney ultrasound images with renal cortical defects on dimercaptosuccinic acid (DMSA) kidney scan simultaneously, followed by hydronephrosis only on kidney ultrasound. Conclusion: The presence of hydronephrosis on kidney ultrasound images or cortical defects or asymmetric kidneys on the DMSA kidney scans can be predictive markers of VUR, reducing the need for VCUG. Our study can thus help minimize the exposure to radiation among patients through selective VCUG.