• 디지털융복합연구
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• 제19권1호
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• pp.211-216
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• 2021

본 연구는 다제내성균 환자가 사용한 병실 환경에 대한 환경관리 평가 방법 중 미생물 배양검사와 Adenosin Triphosphate Bioluminescence 방법을 이용하여 오염도를 파악 한 후 환경소독제를 이용하여 소독효과를 평가하고자 시도되었다. 환경표면은 다제내성균으로 격리된 환자병실을 대상으로 하였다. 검체채취는 인퓨전펌프, IV 폴대, 상두대, 침대난간, 키보드 혈압기 커프 5곳을 실시하였고 소독 전, 소독 직후, 소독 후 5분 후 ATP와 미생물배양검사를 실시하였다. 연구결과 Infusion pump의 환경표면이 소독·후 오염도가 통계적으로 유의하게 감소하였다. 또한 IV 폴대, 침상난간, 키보드는 소독 전후 균 검출이 감소하였다. 즉 정기적인 환경표면소독은 환자에게 감염으로부터 안전한 환경을 제공할 수 있다. 따라서 향후 다기관을 대상으로 소독제의 지속성 등을 평가하여 환경표면 소독방법, 소독주기 등의 지침을 마련하는 것이 필요하다.

• 한국환경보건학회지
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• 제41권1호
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• pp.40-48
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• 2015

Objectives: This study aims to understand the concentration, diversity, and antibiotic characteristics of oxytetracycline resistant bacteria present in a surface water environment. Methods: Water sampling was performed in Cheongmi Stream in Gyeonggi-do, Korea in February and August 2014. Water samples collected from two sites were plated in triplicate on tryptic soy agar plates with 30 mg/L of oxytetracycline. Oxytetracycline resistant bacteria were selected from surface water in Cheongmi Stream and were subjected to 16S rDNA analysis for oxytetracycline resistant species determination. Identified resistant strains were tested for resistance to various antibiotics. Results: Results from this study indicate that the dominant resistant organisms in this aquatic environment are from family Acinetobacter and family Aeromonas. As to culturable heterotrophic bacteria, Oxytetracycline resistant bacteria were present 0.45-0.93% during winter and 0.08-0.38% during summer. Most oxytetracycline resistant bacteria exhibited resistance to more than ten of the antibiotics studied. The diversity of oxytetracycline resistant bacteria in winter was higher than in summer. Conclusion: Most of these resistant bacteria are Gram negative and are closely related to pathogenic species. These results suggest that increasing multi-antibiotic resistant bacteria in the surface water environment has a close relation to the reckless use of antibiotics in livestock.

• Journal of Korean Biological Nursing Science
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• 제20권1호
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• pp.38-46
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• 2018

Purpose: The aim of this study was to verify the effects of daily 2% chlorhexidine gluconate (CHG) bathing on the acquisition of multidrug-resistant organisms (MDRO) and healthcare-associated infection (HAI) in a medical intensive care unit (MICU). Methods: The study was a randomized controlled group posttest only design, involving 91 patients in MICU at a tertiary hospital (47 patients in the experimental group and 44 patients in the control group). The 2% CHG bathing was performed daily according to bathing protocol to the patients in the experimental group, and traditional bath was performed every three days to those in the control group. Fisher's exact test and x2 test were used to analyze the data. Results: MDRO were found in 6 patients of the experimental group and in 15 patients of the control group. The difference was statistically significant (p= .016). HAI occurred in 2 patients of the experimental group and in 7 patients of the control group. The difference was not statistically significant (p= .084). Conclusion: The results confirmed that daily bathing with CHG was effective in reducing the incidence of MDRO acquisition. Therefore, it is expected that daily bathing with CHG will be used as an effective nursing intervention to reduce the incidence of MDRO acquisition.

• 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.

• Asian Pacific Journal of Cancer Prevention
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• 제16권14호
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• pp.5691-5695
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• 2015

Background: Continuous surveillance of pattern of blood stream infection is necessary in febrile neutropenia (FN)especially with the recent escalating trend in the management of pediatric cancer patients towards intensified regimens and with the increase in infections caused by resistant organisms limiting the choice of antibiotics. Aim: To monitor change in pattern of blood stream infections (BSI) in FN pediatric cancer patients. Materials and Methods: Surveillance of FN episodes with positive BSI was prospectively monitored and compared to a previous surveillance in the same pediatric oncology unit. Results: A total of 232 BSI positive episodes were documented in 192 patients during a 6 months period. The results of recent surveillance analysis showed an increase in intensified regimens of chemotherapy, antimicrobial resistance, fungal infections, and prolonged duration of episodes when compared to previous surveillance, with p value sof <0.001, 0.005, 0.021, and <0.001, respectively. There was an apparent decrease in the crude mortality but this was not statistically significant, to 6% in 2011 from 10 % in 2006. Conclusions: The pattern of BSI at our institution is still inclining towards gram positive organisms but is showing a shift towards more antibiotic resistance and fungal infections.

• 한국보건간호학회지
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• 제34권3호
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• pp.490-502
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• 2020

Purpose: This study aimed to identify the factors influencing competency for Multi-Drug Resistant Organisms (MDRO) infection control in nursing students with clinical practice experience. Methods: This cross-sectional descriptive study was conducted from May 2020 to August 2020 by including 175 nursing students in two nursing schools located in Daegu. The data were collected using self-report questionnaires. The data were analyzed using the SPSS/WIN 25.0 program with descriptive statistics, independent t-test, ANOVA, correlation, and multiple regression. Results: The competency of MDRO infection control was 3.41.±0.38. The attitude to patient safety management and - knowledge of MDRO infection control were 3.81±0.47 and 16.98±3.02, respectively. Factors influencing the competency of MDRO infection control were perceived benefit(β=.38, p<.001), knowledge toward MDRO infection control(β=.21, p=.001), attitude in patient safety management(β=.17, p=.028), and perceived barrier(β=-.15, p=.029) with an explanatory power of 34.2%. Conclusion: A systemic education program regarding MDRO infection control is needed for nursing students to provide knowledge related to MDRO infection control and help establish positive beliefs toward MDRO infection control and attitudes in patient safety management.

• Childhood Kidney Diseases
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• 제12권2호
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• pp.245-249
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• 2008

복막염은 지속성 외래 복막투석 환자에게 있어 중요한 합병증 중 하나이다. 이러한 복막염은 잦은 재발과 최근 내성균의 출현으로 치료에 어려움을 겪고 있다. vancomycin 내성 장구균(VRE, Vancomycin-resistant Enterococcus)에 의한 복막염은 1999년에 국내에서 처음 보고된 이래로 계속 증가하고 있으나 아직까지 치료에 대해 명확한 기준이 없는 실정이다. 저자들은 복막투석 소아에서 리네졸리드(linezolid)로 VRE에 의한 복막염을 성공적으로 치료한 1례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• Tuberculosis and Respiratory Diseases
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• 제44권5호
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• pp.975-991
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• 1997

배 경 : INH와 RFP에 동시내성을 보이는 다제내성 폐결핵은 적극적인 내과적 치료에도 불구하고 치료실패율이 40%에 이른다. 과거 폐결핵의 치료에 사용되었던 폐절제술이 다제내성 폐결핵의 보조적 치료수단으로 최근 다시 등장하였다. 방 법 : 1991년 1월부터 1995년 12월까지 HIV 감염이 없으면서 INH와 RFP에 동시내성을 보이는 다제내성 폐결핵 환자중 폐결핵 자체에 대한 보조적 치료로써 시행한 환자 14명을 대상으로 하여 후향적으로 의무기록과 방사선촬영소견 등을 조사하였다. 결 과 : 내과적 치료에도 불구하고 12명 (86%)의 환자에서 수술전 객담 균음전에 실패하였고 수술전 균음전이 이루어진 2명의 환자에서도 절제된 폐조직에서 실시한 결핵균 배양검사는 양성이었다. 흉부 전산화단층촬영상 양측성 병변이 10명(71%)에서 관찰되었다. 늑막폐절제술을 포함한 전폐절제술을 6명, 엽절제술 6명, 2명에서 시행하였다. 수술전 1초간 노력성 폐활량이 2L 이하였던 7명의 환자에서 수술전 폐관류스캔을 실시하였고, 절제된 폐로의 관류 중앙값 4.8%에 불과하였다. 수술과 관련한 사망은 없었으며, 1명에서 수술후 폐늑막루를 포함한 농흉이 발생하였고, 1명에서 3주이상 흉관을 통한 공기유출이 있었다. 수술후 13명(93%)의 환자에서 균음전화가 이루어졌고 중앙값 23개월간의 추적관찰기간동안 재발은 없었다. 1명(7%)의 환자는 폐절제술후에도 객담 균양성이 지속되었다. 결 론 : 과거 국내외에서 보고된 다제내성 폐결핵의 내과적 치료성적과 비교해 볼 때, 병변이 국한되어있고 적절한 폐기능을 가진 다제내성 폐결핵 환자에서 실시되는 보조적인 폐절제술은 중요한 역할을 할 것으로 기대된다.

• Archives of Plastic Surgery
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• 제34권6호
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• pp.691-696
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• 2007

Purpose: The emergency of multi-drug resistant stains of bacteria represents a challenge in the field of plastic surgery. Especially, MRSA(methycillin-resistant Staphylococcus aureus) and Pseudomonas aeruginosa have strong pathogenicity as well as multi-drug resistance so that they have become a lot more problematic strains. This study has been planned to reduce the bacterial burden by applying $Acticoat^{(R)}$(Smith & Nephew Healthcare, Hull, England)dressing into the chronic wounds infected by multi-drug resistant strains and to facilitate their healing. Methods: Nanocrystalline silver dressings($Acticoat^{(R)}$) were applied to chronic wound infected by MRSA or Pseudomonas aeruginosa. Multi-drug resistant bacteria were smeared over a slide glass using sterilized cotton swabs and gram stains were performed directly before and after applying $Acticoat^{(R)}$ dressings at 1, 24, 48 and 72 hours. The gram-stained slides were observed using an optical microscope magnified 1000 times(${\times}1000$). The bacterial counts of the control group(0 hour) were compared to those of the experimental groups(1, 24, 48, and 72 hour). Paired T-test was used to assess a statistical significance. MRSA was cultured in two BAPs(blood agar plate) and two MacConkey plates with streak plate method. None were interventions on one culture plate, while on the other culture plate, $Acticoat^{(R)}$ was placed in a square shape and cultured for 72 hours at $37^{\circ}C$, then plates were examined. Pseudomonas aeruginosa was cultured in the same manner as MRSA. Results: There are the large amount of declination of bacterial counts with statistical significance after $Acticoat^{(R)}$ dressing. The bacteria grew in culture plate without specific intervention, but no bacteria grew in culture plate with applying of $Acticoat^{(R)}$ dressing. Conclusion: We believe that $Acticoat^{(R)}$ dressing could be used as an effective method of treating chronic wounds which are infected by multi-drug resistant organisms.

• 생명과학회지
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• 제24권3호
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• pp.266-273
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• 2014

본 연구에서는 국내 시판 중인 정유의 화학적 구성, 항균 및 항산화 효과를 조사하였다. 정유의 성분 분석은 GC-MS법을 이용하였다. 정유는 그람음성, 양성 및 다약제 내성균에 대하여 광범위한 항균 범위를 보여주었다. 정유 5종의 항균활성은 40개 병원성 세균에 대한 MIC로 측정하였다. Lemongrass와 manuka는 0.0625-0.5% (v/w), tea tree는 0.03125-1.0% (v/w), thyme 0.0625-1.0% (v/w) 및 ravensara는 1-4% (v/w)의 MIC 수치를 나타내었다. 정유의 항산화 활성은 환원력 및 DPPH법으로 평가하였다. 5종의 정유 모두 농도 의존적으로 DPPH free radical 저해 및 환원력을 가지고 있었으며, thyme이 대조군인 ascorbic acid와 비교 시 가장 높은 항 산화능을 보였다. 5종의 정유 모두 고른 항균 및 항산화능을 가지고 있으며, 이중 thyme이 가장 높은 항균활성 및 항산화능을 가지고 있어 천연 항균 항산화제로써의 가치가 있다고 생각되었다. 본 연구진은 국내 시판중인 정유 5종의 성분분석, 항균 및 항산화 활성을 처음으로 비교 분석하여 보고하였다.