• Title/Summary/Keyword: Management of infections

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Selecting QA Items & Guidelines for Hospital Safety Management (병원내 안전관리 향상을 위한 항목 및 지침 선정)

  • Park, Jee-Won;Kim, Yong-Soon;Jin, Hye-Young
    • Quality Improvement in Health Care
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    • v.3 no.1
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    • pp.78-93
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    • 1996
  • Background : The goal of this study was to establish the QA items and guidelines for preventing and improving of safety management. Therefore we investigated the nurses' recognition and knowledge of the safety and risk procedures and policies, and the agreement between the nurses beliefs on the degree of importance of those procedures and policies, with actual implementation in hospitals. Method : The subjects of this study were 201 nurses who participated in a program called continuing education for nurses, which held in December, 1993. Result: The results of this study were as follows: 1. Among 18 types of hospital risks, the items that scored highest or the need of closer attention in safety management was the needle stick, medication errors, falling, and bed sores. 2. In most questions of the 18 incidences, the nurses showed that the estimated result would have positive signs except for hospital infections, burns, and bed sores. 3. Even though the survey shows that incidences and types of occurences varies according to the person's age and the time of incident, they mostly occur between midnight to 6AM. Falls and bed sores can be seen more in the elderly. Medications errors, hospital infections and burns are frequently found between the ages of one through twenty. 4. There was a higher mean score for recognizing the importance of those items than the importance of implementing them. Conclusion : In summary, nurses did perceive the need of safety management but the hospital policy for proper safety management was not established. So we recommended that the hospital administration would undertake an early detection and proper management system for hospital precautions, based on QA items & guidelines presented in this study.

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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
    • Biomedical Science Letters
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    • v.29 no.4
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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.

Concomitant use of corticosteroid and antimicrobials for liver abscesses in patients with chronic granulomatous disease

  • Shin, Kyung-Sue;Lee, Mu Suk
    • Clinical and Experimental Pediatrics
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    • v.59 no.4
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    • pp.196-201
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    • 2016
  • Chronic granulomatous disease (CGD) is a rare inherited disorder caused by defective nicotinamide adenine dinucleotide phosphate oxidase enzyme and characterized by recurrent bacterial and fungal infections. Although liver abscess is a common manifestation of CGD, its management in CGD patients is not well-defined. In addition, the generalized guidelines for treating liver abscesses do not necessarily apply to CGD patients. Corticosteroids are commonly used to control granulomatous complications, such as inflammatory gastrointestinal and genitourinary lesions, in patients with CGD, Corticosteroids have also been used in combination with antimicrobials to treat refractory infections in patients with CGD. Because corticosteroids are capable of suppressing symptomatic inflammation, all potential infections must be adequately controlled prior to corticosteroid initiation. We report 3 typical CGD cases with liver abscesses refractory to conventional treatments that were successfully treated with the concomitant use of corticosteroid and antimicrobials. It remains unclear whether corticosteroid therapy is required for liver abscesses in CGD refractory to conventional treatments. However, based on our observations, use of corticosteroids in combination with optimal antimicrobials should be considered for refractory liver abscesses in CGD.

Nurses' Knowledge and Performance for the Prevention of Intravascular Catheter-related Infections according to the Strength of Recommendations of Evidence based Guidelines (정맥관 감염예방 근거중심 가이드라인의 권고강도 별 간호사의 지식 및 수행정도)

  • Ryu, Se-Ang;Kim, Yun-Hee;Jang, Keum-Seong;Chung, Kyung-Hee;Choi, Ja-Yun;Yang, Jin-Ju;Park, Soon-Joo
    • Korean Journal of Adult Nursing
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    • v.24 no.5
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    • pp.546-555
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    • 2012
  • Purpose: The objective of this study was to examine the relationships between nurses' knowledge and performance for the prevention of intravascular catheter-related infections (ICRI) according to the strength of recommendations in evidence based guidelines (EBG). Methods: The total participants were 144 nurses working for medical surgical unit and intensive care unit. Data were collected from July 12 to July 30, 2010 and analyzed by one way ANOVA and Pearson's correlation analysis. Results: The knowledge and performance mean scores were $0.80{\pm}0.17$ and $3.04{\pm}0.31$ for peripheral venous catheter (PVC) management, and $0.83{\pm}0.17$ and $3.00{\pm}0.30$ for central venous catheter (CVC) management respectively. The items of category IA had the highest knowledge score (F=44.70, p<.001) and the items of category II had the highest performance score (F=47.09, p<.001) in PVC management, while the items of category IA had the highest knowledge (F=20.04, p<.001) and performance scores (F=18.20, p<.001) in CVC management. Knowledge and performance scores were significantly correlated in CVC management (r=.24, p=.004), but not in PVC management (r=.03, p=.753). Conclusion: EBG for the prevention of ICRI was not fully implemented in clinical settings. These findings emphasize that clinical professions need to develope strategies to enhance nursing practices with evidence based guideline.

Prescription of Systemic Steroids for Acute Respiratory Infections in Korean Outpatient Settings: Overall Patterns and Effects of the Prescription Appropriateness Evaluation Policy

  • Kim, Taejae;Do, Young Kyung
    • Journal of Preventive Medicine and Public Health
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    • v.53 no.2
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    • pp.82-88
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    • 2020
  • Objectives: The objective of this study was to identify individual and institutional factors associated with the prescription of systemic steroids in patients with acute respiratory infections and to investigate the role of a policy measure aimed to reduce inappropriate prescriptions. Methods: We used data from the National Health Insurance Service-National Sample Cohort from 2006 to 2015 and focused on episodes of acute respiratory infection. Descriptive analysis and multiple logistic regression analysis were performed to identify individual-level and institution-level factors associated with the prescription of systemic steroids. In addition, steroid prescription rates were compared with antibiotic prescription rates to assess their serial trends in relation to Health Insurance Review and Assessment Service (HIRA) Prescription Appropriateness Evaluation policy. Results: Among a total of 9 460 552 episodes of respiratory infection, the steroid prescription rate was 6.8%. Defined daily doses/1000 persons/d of steroid increased gradually until 2009, but rose sharply since 2010. The steroid prescription rate was higher among ear, nose and throat specialties (13.0%) than other specialties, and in hospitals (8.0%) than in tertiary hospitals (3.0%) and other types of institutions. Following a prolonged reduction in the steroid prescription rate, this rate increased since the HIRA Prescription Appropriateness Evaluation dropped steroids from its list of evaluation items in 2009. Such a trend reversal was not observed for the prescription rate of antibiotics, which continue to be on the HIRA Prescription Appropriateness Evaluation list. Conclusions: Specialty and type of institution are important correlates of steroid prescriptions in cases of acute respiratory infection. Steroid prescriptions can also be influenced by policy measures, such as the HIRA Prescription Appropriateness Evaluation policy.

Outpatient Antibiotic Prescription Patterns for Respiratory Tract Infections of Infants (소아 호흡기감염 외래환자에 대한 항생제 처방양상)

  • Kim, Yejee;Lee, Suehyung;Park, Sylvia;Na, Hyen Oh;Tchoe, Byongho
    • Health Policy and Management
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    • v.25 no.4
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    • pp.323-332
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    • 2015
  • Background: Antibiotic resistance has been becoming serious challenge to human beings. Overuse of antibiotics, especially, for infants is concerned, but studies are very few for the prescribing pattern of antibiotic use for infants. This study analyzes prescribing patterns of antibiotics in outpatients of preschool children with acute respiratory tract infections in South Korea. Methods: Data are used from 2011 Health Insurance Review & Assessment Services-pediatric patients sample. Inclusion criteria is outpatient children (0 to 5 years) with top five frequent diseases. Prescription rates are analyzed by types of disease, provider, specialty, region, and ages. Binary or multinomial logit models are used to analyze determinants of providers' prescription pattern. Results: The main findings are as follows. First, distributions of prescription rates are shown as L-shape or M-shape depending on the types of disease. Second, the prescription variation is so large among providers, where providers are polarized as a group with low prescription rates and the other group with high prescription rates, though the shapes are shown diversified across types of disease. Third, prescription rates appear to be lower in pediatrics and higher in ENT (ear-nose-throat). Fourth, broad spectrum antibiotics are widely used among children. Finally, the logit analysis shows similar results with descriptive statistics, but partly different results across types of disease. Conclusion: Antibiotics for respiratory tract infections of infants are used excessively with a large variation among providers, and especially broad spectrum antibiotics are used. The prescription guideline for antibiotics should be provided for each specific disease to reduce antibiotic resistance in the future.

Assessing Seasonality of Acute Febrile Respiratory Tract Infections and Medication Use (인플루엔자 등 급성 호흡기계 질환과 의약품 사용의 계절적 상관성 분석)

  • Park, Juhee;Choi, Won Suk;Lee, Hye-Yeong;Kim, Kyoung-Hoon;Kim, Dong-Sook
    • Health Policy and Management
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    • v.28 no.4
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    • pp.402-410
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    • 2018
  • Background: Monitoring appropriate medication categories can provide early warning of certain disease outbreaks. This study aimed to present a methodology for selecting and monitoring medications relevant to the surveillance of acute respiratory tract infections, such as influenza. Methods: To estimate correlations between acute febrile respiratory tract infection and some medication categories, the cross-correlation coefficient (CCC) was used and established. Two databases were used: real-time prescription trend of antivirals, anti-inflammatory drugs, antibiotics using Drug Utilization Review Program between 2012 and 2015 and physicians' number of encounters with acute febrile respiratory tract infections such as influenza outbreaks using the national level health insurance claims data. The seasonality was also evaluated using the CCC. Results: After selecting six candidate diseases that require extensive monitoring, influenza with highly specific medical treatment according to the health insurance claims data and its medications were chosen as final candidates based on a data-driven approach. Antiviral medications and influenza were significantly correlated. Conclusion: An annual correlation was observed between influenza and antiviral medications, anti-inflammatory drugs. Suitable models should be established for syndromic surveillance of influenza.

Development of a trivalent vaccine for prevention of co-infection by Miamiensis avidus and Tenacibaculum maritimum in farmed olive flounder

  • Hanchang Sohn;Hyukjae Kwon;Seongdo Lee;Qiang Wan;Jehee Lee
    • Fisheries and Aquatic Sciences
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    • v.26 no.10
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    • pp.605-616
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    • 2023
  • Scuticociliatosis, caused by the parasitic pathogen Miamiensis avidus, poses a significant threat to olive flounder farms in South Korea. Infected fish suffer from severe systemic infections affecting various organs, with potential secondary bacterial diseases. This study investigated the emergence of different M. avidus serotypes in 20 olive flounder farms on Jeju island, South Korea, from 2015 to 2020. Additionally, we identified Tenacibaculum maritimum as a co-infecting bacteria. Based on serotyping and monitoring data, we developed a trivalent vaccine targeting two serotypes of M. avidus and one strain of T. maritimum. The efficacy of the vaccine was evaluated under laboratory conditions and demonstrated a relative percentage of survival (RPS) of 75%, 80%, and 93% for M. avidus serotype I, M. avidus serotype II and T. maritimum, respectively. Furthermore, successful field trials conducted on four different olive flounder farms resulted in significantly higher survival rates (52%-76% RPS) and weight gains in vaccinated fish. Overall, this study presents an effective vaccine against M. avidus and T. maritimum infections in farmed olive flounder, making a valuable contribution to sustainable aquaculture in South Korea.

Antibiotic resistance in Neisseria gonorrhoeae: broad-spectrum drug target identification using subtractive genomics

  • Umairah Natasya Mohd Omeershffudin;Suresh Kumar
    • Genomics & Informatics
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    • v.21 no.1
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    • pp.5.1-5.13
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    • 2023
  • Neisseria gonorrhoeae is a Gram-negative aerobic diplococcus bacterium that primarily causes sexually transmitted infections through direct human sexual contact. It is a major public health threat due to its impact on reproductive health, the widespread presence of antimicrobial resistance, and the lack of a vaccine. In this study, we used a bioinformatics approach and performed subtractive genomic methods to identify potential drug targets against the core proteome of N. gonorrhoeae (12 strains). In total, 12,300 protein sequences were retrieved, and paralogous proteins were removed using CD-HIT. The remaining sequences were analyzed for non-homology against the human proteome and gut microbiota, and screened for broad-spectrum analysis, druggability, and anti-target analysis. The proteins were also characterized for unique interactions between the host and pathogen through metabolic pathway analysis. Based on the subtractive genomic approach and subcellular localization, we identified one cytoplasmic protein, 2Fe-2S iron-sulfur cluster binding domain-containing protein (NGFG RS03485), as a potential drug target. This protein could be further exploited for drug development to create new medications and therapeutic agents for the treatment of N. gonorrhoeae infections.

Deoxynojirimycin extracted from the Korean Mulberry Plant and Silkworm Exhibits Antiviral Activity in Surrogate Hepatitis C Virus Assays

  • James R. Jacob;Keith Mansfield;You, Jung-Eun;Bud C. Tennant;Kim, Young-Ho
    • Proceedings of the Korean Society of Sericultural Science Conference
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    • 2003.10a
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    • pp.28-33
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    • 2003
  • Over 100 million people worldwide are chronic carriers of hepatitis C virus (HCV)(1). Chronic viral infections of the liver can prouess to cirrhosis, which may ultimately lead to hepatic failure or the development of hepatocellular carcinoma. There are a limited number of antiviral drugs on the market approved fur clinical management of chronic HCV infections; interferon-alpha (IFN$\alpha$) and the nucleoside analog ribavirin. However, whether used as monotherapy or in combination, adverse side-effects are associated with each drug and better therapeutic regimens are needed. (omitted)

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