• 제목/요약/키워드: Hospital Infections

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신생아집중치료실에서의 급성 호흡기 감염-바이러스의 검출 및 respiratory syncytial virus 감염의 임상적 특징 (Acute Respiratory Infections in the Neonatal Intensive Care Unit: Isolation of Viruses and the Characteristics of Respiratory Syncytial Virus Infection)

  • 박선희;조혜정;심소연;손동우;은병욱;선용한;차한;전인상
    • Neonatal Medicine
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    • 제16권2호
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    • pp.182-189
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    • 2009
  • 목 적 : 최근 multiplex RT-PCR의 개발로 급성 호흡기 감염에서 바이러스의 검출이 용이해졌다. 지금까지 respiratory syncytial virus (RSV)에 대한 연구는 많았지만 이전에 건강했던 신생아나 미숙아로 출생한 어린 영아에 대한 연구는 많지 않고 더욱이 이들에서의 다른 호흡기 바이러스에 대한 연구는 거의 없다. 저자들은 신생아집중치료실에 입원한 급성 호흡기 감염 환아를 대상으로 바이러스를 검출하고 다른 바이러스와 비교한 RSV 감염의 특성을 알아보고자 하였다. 방 법 : 신생아집중치료실에 급성 호흡기 감염으로 입원하여 multiplex RT-PCR을 시행한 환아를 대상으로 전향적 관찰 연구를 시행하였다. 모든 환아를 RSV군과 RSV가 검출되지 않은 No RSV 군으로 나누어 인구학적 특징과 임상양상 및 혈액검사와 흉부X-선 검사결과를 비교하였다. 결 과 : RSV 군은 23명(50%)이었다. Rhinovirus는 15.2%로 두 번째로 많이 검출되었다. RSV는 1월과 2월에, rhinovirus는 4월에 중점적으로 발생하였다. 중복감염 된 환아는 세 명(6.5%)이었다. 미숙아 수와 형제가 있거나 흡연에 노출 된 경우는 두 군간 차이가 없었으나 RSV 군에서 조리원 감염이 유의하게 많았다(60.9% vs. 21.7%, P=.007). RSV 군에서 No RSV 군에 비해 호흡곤란(34.8% vs. 8.7%, P=.032)과 폐렴(73.9% vs. 43.5%, P=.036)으로 입원한 환아가 많았고 산소 투여(52.5% vs. 13.0%, P=.005)와 금식(43.5% vs. 13.0%, P=.022)이 필요한 경우가 많았다. 우측상엽의 침윤도 RSV 군에서 많았다(56.5% vs. 8.7%, P=.001). 결 론 : 신생아나 미숙아로 출생했던 어린 영아는 RSV 뿐만 아니라 다른 다양한 호흡기 바이러스 감염으로 입원하게 된다. RSV 감염은 다른 감염에 비해 중증도가 높으므로 건강한 신생아에 대해서도 주의를 요하며 특히 조리원 등 밀집도가 높은 곳에서는 철저한 감염예방 관리가 필요하다.

Recurrent Pseudomonas aeruginosa Infection in Chronic Lung Diseases: Relapse or Reinfection?

  • Yum, Ho-Kee;Park, I-Nae;Shin, Bo-Mun;Choi, Soo-Jeon
    • Tuberculosis and Respiratory Diseases
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    • 제77권4호
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    • pp.172-177
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    • 2014
  • Background: Pseudomonas aeruginosa infection is particularly associated with progressive and ultimately chronic recurrent respiratory infections in chronic obstructive pulmonary disease, bronchiectasis, chronic destroyed lung disease, and cystic fibrosis. Its treatment is also very complex because of drug resistance and recurrence. Methods: Forty eight cultures from 18 patients with recurrent P. aeruginosa pneumonia from 1998 to 2002 were included in this study. Two or more pairs of sputum cultures were performed during 2 or more different periods of recurrences. The comparison of strains was made according to the phenotypic patterns of antibiotic resistance and chromosomal fingerprinting by pulsed field gel electrophoresis (PFGE) using the genomic DNA of P. aeruginosa from the sputum culture. Results: Phenotypic patterns of antibiotic resistance of P. aeruginosa were not correlated with their prior antibiotic exposition. Fifteen of 18 patients (83.3%) had recurrent P. aeruginosa pneumonia caused by the strains with same PFGE pattern. Conclusion: These data suggest that the most of the recurrent P. aeruginosa infections in chronic lung disease occurred due to the relapse of prior infections. Further investigations should be performed for assessing the molecular mechanisms of the persistent colonization and for determining how to eradicate clonal persistence of P. aeruginosa.

Bronchopulmonary Infection of Lophomonas blattarum: A Case and Literature Review

  • Xue, Jian;Li, Ying-Li;Yu, Xue-Mei;Li, Dai-Kun;Liu, Ming-Fang;Qiu, Jing-Fu;Xue, Jian-Jiang
    • Parasites, Hosts and Diseases
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    • 제52권5호
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    • pp.521-525
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    • 2014
  • Human infections with Lophomonas blattarum are rare. However, the majority of the infections occurred in China, 94.4% (136 cases) of all cases in the world. This infection is difficult to differentiate from other pulmonary infections with similar symptoms. Here we reported a case of L. blattarum infection confirmed by bronchoalveolar lavage fluid smear on the microscopic observations. The patient was a 21-year-old female college student. The previous case which occurred in Chongqing was 20 years ago. We briefly reviewed on this infection reported in the world during the recent 20 years. The epidemiological characteristics, possible diagnostic basis, and treatment of this disease is discussed in order to provide a better understanding of recognition, diagnosis, and treatment of L. blattarum infection.

Factors Affecting the Performance of Healthcare-Associated Infections (HAIs) control- Focus on Empowerment and Awareness of General Hospital Nurses

  • Kim, Jeoung-Mi;Han, Young-In
    • International Journal of Advanced Culture Technology
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    • 제7권3호
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    • pp.35-45
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    • 2019
  • The aims of the study to investigate the relationship between awareness, empowerment and performance of healthcare associated infections (HAIs) control and to identify factors influencing performance of HAIs among general hospital nurses. Data were collected from 230 nurses in two general hospitals in B city, with the questionnaire of an empowerment, awareness and performance of infection control tool. The data were analyzed by t-test, one-way ANOVA, Pearson's correlation coefficient and multiple regressions. The performance of infection control was significantly correlated with empowerment and awareness of infection control. The empowerment had a positive correlation with an awareness of infection control (r= .233, p <.001) respectively. The infection control performance was influenced by infection control awareness, empowerment and number of annual job training, which explained 42.2% of the performance of infection control. Infection management performance of general hospitals nurses is affected not only by infection awareness but also by empowerment and job education. Therefore, it suggests that HAIs management program could develop for the nurses and provide empowerment with job training to improve the management and performance of HAIs, also to reinforce via constant support by the hospital.

Association of body weight and urinary tract infections during infancy: a nationwide comparative matched cohort study

  • Peong Gang Park;Ji Hyun Kim;Yo Han Ahn;Hee Gyung Kang
    • Childhood Kidney Diseases
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    • 제27권2호
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    • pp.111-116
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    • 2023
  • Purpose: This article was to investigate the association between urinary tract infections (UTIs) and high weight status in infancy. Methods: We conducted a nationwide matched cohort study from January 2018 to December 2020 using data from the Korean National Health Insurance System and the Korean National Health Screening Program for Infants and Children. We analyzed the association between UTI diagnosis codes and high weight status (which was defined as being in the 90th percentile or higher of weight-for-age). Results: We found that 22.8% of infants with UTIs exhibited high weight status, compared to 20.0% of non-UTI infants (P<0.001). Per our multivariable analyses, the adjusted odds ratio for high weight status was 1.09 (95% confidence interval, 1.06-1.13). Conclusions: UTI in the first 12 months of life was associated with a weight-for-age percentile of ≥90. Our findings corroborate those of previous single-center studies and emphasize the importance of careful monitoring for this at-risk group.

Lemierre Syndrome

  • Bang, Yun-Yi;Kim, Jung-Tae;Chang, Woon-Ha;Oh, Tae-Yun;Kong, Joon-Hyuk
    • Journal of Chest Surgery
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    • 제44권6호
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    • pp.437-439
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    • 2011
  • Lemierre syndrome is caused by acute oropharyngeal infections with secondary septic thrombophlebitis of the internal jugular vein and is characterized by frequent metastatic infections. A 56-year-old man presented with severe reddish inflammatory swelling of the right cervical soft tissue. Thrombophlebitis in the right internal jugular vein and multiple pulmonary embolisms were identified on neck and chest computed tomography (CT). He was treated with antibiotics and heparin for 4 weeks and then discharged without other complications.

Management of Infections with Rapidly Growing Mycobacteria after Unexpected Complications of Skin and Subcutaneous Surgical Procedures

  • Lim, Jong-Min;Kim, Jong-Hwan;Yang, Ho-Jik
    • Archives of Plastic Surgery
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    • 제39권1호
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    • pp.18-24
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    • 2012
  • Background : Infection caused by rapidly growing mycobacteria (RGM) is not uncommon, and the prevalence of RGM infection has been increasing. Clinical diagnosis is difficult because there are no characteristic clinical features. There is also no standard antibiotic regimen for treating RGM infection. A small series of patients with RGM infections was studied to examine their treatments and outcomes. Methods : A total of 5 patients who had developed postoperative infections from January 2009 to December 2010 were retrospectively reviewed. Patients were initially screened using a mycobacteria rapid screening test (polymerase chain reaction [PCR]-reverse blot hybridization assay). To confirm mycobacterial infection, specimens were cultured for nontuberculous mycobacteria and analyzed by 16 S ribosomal RNA and rpoB gene PCR. Results : The patients were treated with intravenous antibiotics during hospitalization, and oral antibiotics were administered after discharge. The mean duration of follow-up was 9 months, and all patients were completely cured of infection with a regimen of a combination of antibiotics plus surgical treatment. Although none of the patients developed recurrence, there were complications at the site of infection, including hypertrophic scarring, pigmentation, and disfigurement. Conclusions : Combination antibiotic therapy plus drainage of surgical abscesses appeared to be effective for the RGM infections seen in our patients. Although neither the exact dosage nor a standardized regimen has been firmly established, we propose that our treatment can provide an option for the management of rapidly growing mycobacterial infection.

2% 클로르헥시딘 침상목욕이 중환자실의 의료관련감염과 다제내성균 감염 발생률에 미치는 효과에 대한 체계적 문헌 고찰 및 메타분석 (Effect of 2% Chlorhexidine Bathing on the Incidence of Hospital-Acquired Infection and Multidrug-Resistant Organisms in Adult Intensive Care Unit Patients: Systematic Review and Meta-Analysis)

  • 서지수;송라윤
    • 대한간호학회지
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    • 제51권4호
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    • pp.414-429
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    • 2021
  • Purpose: This systematic review and meta-analysis analyzed the effects of 2% chlorhexidine bathing on the incidence of hospital-acquired infection (HAI) and multidrug-resistant organisms (MDRO) in adult intensive care units. Methods: PubMed, CINAHL, Cochrane library, and RISS database were systematically searched, and 12 randomized studies were included in the analysis. Comprehensive Meta-Analysis version 3.0 was used to calculate the effect size using the odds ratio (OR) and a 95% confidence interval (CI). Subgroup analysis was performed according to the specific infection and intervention types. Results: In general, 2% chlorhexidine bathing has a significant effect on the incidence of HAI (OR, 0.59; 95% CI, 0.40~0.86) and MDRO (OR, 0.52; 95% CI, 0.34~0.79). Subgroup analyses show 2% chlorhexidine bathing is effective in bloodstream infections (OR, 0.51; 95% CI, 0.39~0.66) but not for urinary tract infections, ventilator-associated pneumonia infections, and Clostridium difficile infections. Moreover, 2% chlorhexidine bathing alone or its combination with other interventions has a significant effect on the incidence of HAI and MDRO (OR, 0.59; 95% CI, 0.38~0.92). Conclusion: This meta-analysis reveals that 2% chlorhexidine bathing significantly reduces the incidence of HAI and MDRO in intensive care units. The effect of 2% chlorhexidine bathing on pediatric patients or patients at general wards should be further assessed as a cost-effective intervention for infection control.

소아에서 발생한 A군 연쇄구균에 의한 침습성 질환의 임상적 특성 분석 (Clinical Manifestations of Invasive Infections due to Streptococcus pyogenes in Children)

  • 양누리;이현승;최재홍;조은영;최은화;이환종;이현주
    • Pediatric Infection and Vaccine
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    • 제21권2호
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    • pp.129-138
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    • 2014
  • 목적: A군 연쇄구균은 소아에서 인두염, 연조직염을 일으키며 드물게 침습성 질환을 일으키는 중요한 원인균이다. 그리하여 본 연구에서는 한국 소아에서 A군 연쇄구균 침습성 감염증의 임상 양상 및 예후에 대해 조사하고자 하였다. 방법: 1992년 3월부터 2012년 12월까지 서울대학교 어린이병원 및 2003년 3월부터 2012년 12월까지 분당 서울대학교병원에 입원한 환자 중 A군 연쇄구균 침습성 감염증으로 치료받은 18세 이하의 소아를 대상으로 하였다. 의무기록을 후향적으로 분석하여 대상환자들의 임상양상, 검사결과, 치료방법 및 예후와 합병증에 대해 조사하였다. 결과: A군 연쇄구균 침습성 감염증으로 진단 받은 총 36명의 환자 중 30명에 대해 의무기록을 확인할 수 있었다. 남자가 많았으며(남:여=2.75:1) 환자들의 중앙연령은 4년 2개월(생후 12일부터 15세까지)로 그 중 53.3%가 5세 미만이었다. 질환은 피부 및 연조직감염증(9/30, 30.0%), 국소 감염부위가 없는 균혈증(4/30, 13.3%) 그리고 관절염 및 골수염(6/30, 20.0%)가 가장 많은 것으로 확인되었다. 연쇄구균 독소쇼크증후군(3/30, 10.0%), 호흡기, 복부 및 중추신경계 감염증도 확인되었다. 전체기간 중 2012년에 환자발생이 가장 많았으며(9/30, 30.0%), 사망한 사례는 없었다. Erythromycin 및 clindamycin에 대한 항생제 내성률은 각각 3.8% 및 7.5%로 확인되었다. 결론: 본 연구를 통해 소아에서 A군 연쇄구균 침습성 감염증으로 입원치료 받은 환자들의 임상양상을 확인할 수 있었으며 주로 5세 미만의 어린 연령층에서 발생하는 것을 알 수 있었다. 지난 20년 동안 한국 소아에서 발생한 A군 연쇄구균 침습성 감염증의 임상적 특성 및 예후를 조사함으로써 향후 임상에서 환자를 빠르게 인지하고 적절하게 치료하는데 본 연구결과가 도움이 될 수 있을 것으로 생각된다.

수부 감염에 대한 물리치료와 작업치료 (Physical therapy and Occupational therapy on the hand infections)

  • 정석;김정자
    • 대한물리치료과학회지
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    • 제6권1호
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    • pp.861-877
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    • 1999
  • The hand is a very specialized organ that functions to obtain information and to execute motor acts essential to human interaction with the environment. Loss of hand function through infections affects the mechanical tasks that the hand performs and psychological adjustments to their disability. Infection is a disastrous complication of hand injuries and adequacy of circulation is of greatest importance to prevention of infection. Careful debridement, incision, and adequate drainage and antibacterial treatment are of great importance. Optimal care of the infected hand demands that carefully surgical care, early postoperative exercises and other therapy. Hand rehabilitation has grown as a specialty area of both physical and occupational therapy. It is essential that the surgeon and therapist work together, and communicate freely-all of which generally require daily contact. Treating the psychological loss suffered by the patient with a hand infections is an integral part of the rehabilitation therapy as well. Treatment techniques, Whether thermal modalities or specifically designed exercises, are used as a bridge to reach a further goal of returning to functional performance.

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