• 제목/요약/키워드: Hospital Infections

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세균성 감염으로 오인된 발가락의 헤르페스 손끝염: 증례 보고 (A Case of Herpetic Whitlow of Toe Misdiagnosed as Bacterial Infection: A Case Report)

  • 정예랑;윤영식
    • 대한족부족관절학회지
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    • 제28권2호
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    • pp.68-70
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    • 2024
  • Finger infections are a common problem often caused by viruses, bacteria, or fungi. Similarly, toe infections can present with similar clinical symptoms. Prompt identification of the cause of an infection is crucial for preventing disease progression to a state necessitating immediate and appropriate medical or surgical intervention. Herpetic whitlow is characterized by erythema and painful, non-purulent vesicles and typically results from a herpes simplex virus type 1 or 2 finger infections. However, while herpes whitlow of a finger is common, cases involving a toe are rare. Consequently, a lack of experience of herpetic whitlow of the toe could lead to a misdiagnosis as a bacterial infection and potentially result in unnecessary surgical treatment. Herein, we present a case of herpetic whitlow affecting a great toe that was initially misdiagnosed as a bacterial infection and subsequently treated surgically.

하악골 골절에 대한 수술 시 예방적 항생제 사용과 술후 항생제 투여의 효율성 (ANTIBIOTIC PROPHYLAXIS IN THE OPERATION OF THE CLOSED MANDIBULAR FRACTURES AND THE EFFICACY OF POSTOPERATIVE ANTIBIOTICS)

  • 강상훈;최영수;변인영;김문기
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제35권1호
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    • pp.31-34
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    • 2009
  • Purpose: This study compared the frequency of postoperative infections in patients for a closed mandibular fracture with that without the postoperative antibiotic prophylaxis. Patients and Methods: 48 patients without any specific medical history were divided into two groups depending on whether or not antibiotics had been applied after the surgery. The 24 patients in group 1 received only a second-generation cephalosporin ($Cefotetan^{(R)}$) intravenously from admission to immediate after the surgery. Likewise, 24 patients in group 2 received 1.0g of $Cefotetan^{(R)}$ twice daily longer than the third day after surgery. The mean (SD) duration of antibiotics administration after surgery was 6.9 (${\pm}3.56$). The patients were evaluated after surgery for any postoperative infections according to the criteria: purulent drainage from a wound, spontaneous wound dehiscence accompanied by swelling, pain, and fever around the wound. Results: Postoperative infections were encountered in 2 out of 24 patients in group 1, who received antibiotic medication until shortly after surgery, and in 3 out of the 24 patients in group 2, in whom the medication was continued even after the surgery. There was no sig nificant difference in the incidence of postoperative infections between the two groups. Conclusion: From this study, postoperative use of antibiotics seems to be unnecessary with view of the little significance of the factors that could affect the wound infection.

Mechanisms and Control Strategies of Antibiotic Resistance in Pathological Biofilms

  • Luo, Ying;Yang, Qianqian;Zhang, Dan;Yan, Wei
    • Journal of Microbiology and Biotechnology
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    • 제31권1호
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    • pp.1-7
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    • 2021
  • Bacterial biofilm is a community of bacteria that are embedded and structured in a self-secreted extracellular matrix. An important clinical-related characteristic of bacterial biofilms is that they are much more resistant to antimicrobial agents than the planktonic cells (up to 1,000 times), which is one of the main causes of antibiotic resistance in clinics. Therefore, infections caused by biofilms are notoriously difficult to eradicate, such as lung infection caused by Pseudomonas aeruginosa in cystic fibrosis patients. Understanding the resistance mechanisms of biofilms will provide direct insights into how we overcome such resistance. In this review, we summarize the characteristics of biofilms and chronic infections associated with bacterial biofilms. We examine the current understanding and research progress on the major mechanisms of antibiotic resistance in biofilms, including quorum sensing. We also discuss the potential strategies that may overcome biofilm-related antibiotic resistance, focusing on targeting biofilm EPSs, blocking quorum sensing signaling, and using recombinant phages.

Successful Treatment of Vancomycin-Resistant Enterococcus Bacteremia With a Combination of Daptomycin and Tigecycline in an Infant who Underwent Heart-Lung Transplantation

  • Kang, Jeong Eun;Byun, Joung-Hee;Kim, Younga;Park, Su Eun
    • Pediatric Infection and Vaccine
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    • 제29권2호
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    • pp.105-109
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    • 2022
  • 다제내성 반코마이신 저항성 장내구균(multidrug-resistant vancomycin-resistant enterococci, VRE)에 의한 침습감염의 치료는 특히 기저질환을 가진 소아 환자들에게 어려운 점이 있다. 소아환자들에게서 VRE 감염을 치료하기 위한 새로운 항생제에 대한 연구가 충분히 이루어지지 않았다. 본 증례는 심폐이식을 받은 생후 6개월 된 영아에서 linezolid 중단 이후 재발된 VRE 균혈증에 대해 daptomycin과 tigecycline 조합으로 성공적으로 치료하여 이를 보고하는 바이다.

Cerebral Venous Sinus Thrombosis with Meningitis and Septicemia due to Haemophilus influenzae Type f in an Immunocompetent Child

  • Han, HyungKyu;Lee, Kyung Jae;Yu, Hee Joon
    • Pediatric Infection and Vaccine
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    • 제26권3호
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    • pp.188-193
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    • 2019
  • b형 헤모필루스 인플루엔자균 예방접종이 시행된 이후 b형 헤모필루스 인플루엔자균에 의한 감염률은 급격히 감소하였으나, non-b형 헤모필루스 인플루엔자균에 의한 감염의 비율이 증가하는 추세이다. 대뇌 정맥동 혈전증은 드물지만 세균성 수막염의 합병증 중 하나로 발생할 수 있다. 대뇌 정맥동 혈전증이 동반된 f형 헤모필루스 인플루엔자균에 의한 뇌수막염 환자를 진단 및 치료하였기에 보고하는 바이다.

Management and rehabilitation of moderate-to-severe diabetic foot infection: a narrative review

  • Chi Young An;Seung Lim Baek;Dong-Il Chun
    • Journal of Yeungnam Medical Science
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    • 제40권4호
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    • pp.343-351
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    • 2023
  • Diabetic foot is one of the most devastating consequences of diabetes, resulting in amputation and possibly death. Therefore, early detection and vigorous treatment of infections in patients with diabetic foot are critical. This review seeks to provide guidelines for the therapy and rehabilitation of patients with moderate-to-severe diabetic foot. If a diabetic foot infection is suspected, bacterial cultures should be initially obtained. Numerous imaging studies can be used to identify diabetic foot, and recent research has shown that white blood cell single-photon emission computed tomography/computed tomography has comparable diagnostic specificity and sensitivity to magnetic resonance imaging. Surgery is performed when a diabetic foot ulcer is deep and is accompanied by bone and soft tissue infections. Patients should be taught preoperative rehabilitation before undergoing stressful surgery. During surgical procedures, it is critical to remove all necrotic tissue and drain the inflammatory area. It is critical to treat wounds with suitable dressings after surgery. Wet dressings promote the formation of granulation tissues and new blood vessels. Walking should begin as soon as the patient's general condition allows it, regardless of the wound status or prior walking capacity. Adequate treatment of comorbidities, including hypertension and dyslipidemia, and smoking cessation are necessary. Additionally, broad-spectrum antibiotics are required to treat diabetic foot infections.

A comparative analysis of odontogenic maxillofacial infections in diabetic and nondiabetic patients: an institutional study

  • Kamat, Rahul D.;Dhupar, Vikas;Akkara, Francis;Shetye, Omkar
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제41권4호
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    • pp.176-180
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    • 2015
  • Objectives: The increased prevalence of antibiotic resistance is an outcome of evolution. Most patients presenting with odontogenic space infections also have associated systemic co-morbidities such as diabetes mellitus resulting in impaired host defense. The present study aims to compare the odontogenic spaces involved, antibiotic susceptibility of microorganisms, length of hospital stay, and the influence of systemic comorbidities on treatment outcome in diabetic patients. Materials and Methods: A 2-year prospective study from January 2012 to January 2014 was conducted on patients with odontogenic maxillofacial space infections. The patients were divided into two groups based on their glycemic levels. The data were compiled and statistically analyzed. Results: A total of 188 patients were included in the study that underwent surgical incision and drainage, removal of infection source, specimen collection for culture-sensitivity, and evaluation of diabetic status. Sixty-one out of 188 patients were found to be diabetic. The submandibular space was the most commonly involved space, and the most prevalent microorganism was Klebsiella pneumoniae in diabetics and group D Streptococcus in the nondiabetic group. Conclusion: The submandibular space was found to be the most commonly involved space, irrespective of glycemic control. Empiric antibiotic therapy with amoxicillin plus clavulanic acid combined with metronidazole with optimal glycemic control and surgical drainage of infection led to resolution of infection in diabetic as well as nondiabetic patients. The average length of hospital stay was found to be relatively longer in diabetic individuals.

Factors Associated with Vancomycin-Resistant Enterococcus Colonization in Patients Transferred to Emergency Departments in Korea

  • Kim, Hyun Soon;Kim, Dae Hee;Yoon, Hai-jeon;Lee, Woon Jeong;Woo, Seon Hee;Choi, Seung Pill
    • Journal of Korean Medical Science
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    • 제33권48호
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    • pp.295.1-295.7
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    • 2018
  • Background: Vancomycin-resistant enterococci (VRE) infections have become a major healthcare-associated pathogen problem worldwide. Nosocomial VRE infections could be effectively controlled by screening patients at high risk of harboring VRE and thereby lowering the influx of VRE into healthcare centers. In this study, we evaluated factors associated with VRE colonization in patients transferred to emergency departments, to detect patients at risk for VRE carriage. Methods: This study was conducted in the emergency department of a medical college-affiliated hospital in Korea. Every patient transferred to the emergency department and admitted to the hospital from January to December 2016 was screened for VRE using rectal cultures. In this cross-sectional study, the dependent variable was VRE colonization and the independent variables were demographic and clinical factors of the patients and factors related to the transferring hospital. Patients were divided into two groups, VRE and non-VRE, and previously collected patient data were analyzed. Then we performed logistic regression analyses of characteristics that differed significantly between groups. Results: Out of 650 patients, 106 (16.3%) had positive VRE culture results. Significant variables in the logistic analysis were transfer from geriatric long-term care hospital (adjusted odds ration [aOR]: 8.017; 95% confidence interval [CI]: 1.378-46.651), hospital days (4-7 days; aOR: 7.246; 95% CI: 3.229-16.261), duration of antimicrobial exposure (1-3 days; aOR: 1.976; 95% CI: 1.137-3.436), and age (aOR: 1.025; 95% CI: 1.007-1.043). Conclusion: VRE colonization in patients transferred to the emergency department is associated primarily with factors related to the transferred hospitals rather than demographic and clinical characteristics.

비강 내 약물 도포가 병원 감염 예방에 미치는 효과 (The Effects of a Mupirocin Smear in the Nasal Cavity Against Nosocomial Infections)

  • 길숙영
    • 기본간호학회지
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    • 제6권2호
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    • pp.255-266
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    • 1999
  • This study was done to analyze the effects of a smear in the nasal cavity against nosocomial Infection. The smear used was mupirocin, and the study centered on infection which constitutes the majority of nosocomial infections called MRSA. The data were collected between March 23 1998 and June 31 of the same year in a university hospital in the Kyongi Province, and is made up of a experimental group of 14 patients who were given nasal cavity smears and a control group of 16 patients who were not given nasal cavity smears. The data were analyzed through frequency and the Chi-square tests and gave forth these results. 1. Of the experimental group 28.6% developed nosocomial infections while 62.5% of the control group developed infections. This difference was significant. 2. In the experimental group, all of the patients developed infections within the first week in the ICU, while 80% of the control group developed infections in the first week and 20% in the second week. The difference was not as marked here. 3. In the experimental group the DM group 66.7% contracted MRSA while 18.2% developed it in the non-DM group showing that the DM group had infection rate was 3.7 times higher than the non-DM groups. In the control group the DM group had a 100% infection rate while 50% of the non-DM group developed it. Overall the DM group's rate infection was 2.4 times higher than the non-DM group. 4. In the experimental group, 37.55% of the patients who had a tracheostomy developed it while 16.7% of the patients who did not have a tracheostomy developed infections. In the control group, 62.5% of the patients who had tracheostomy, and 37.5% of the patients who did not have tracheostomies developed infections. Those who had tracheostomies, and the control group had double the rate contracting infections. From these results we can see that nasal cavity smears are effective against nosocomial infections. In spite of the smears, patients with the diabetes mellitus had a high MRSA infection rate, which requires new alternative treatments.

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