• Neonatal Medicine
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• 제28권3호
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• pp.116-123
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• 2021

Purpose: The aim of this study was to estimate the effect of targeting risk factors for the control of central line-associated bloodstream infection (CLABSI) among high-risk infants in a tertiary neonatal intensive care unit (NICU). Methods: Infants admitted to the NICU and diagnosed with CLABSI from January to December 2013 were eligible for inclusion to the study. The CLABSI group (n=47) was matched in a 1:2 ratio to the control group (n=94) based on gestational age, birth weight, and Score for Neonatal Acute Physiology-II. Risk factors for CLABSI were identified using the Cox proportional hazard model, and analysis of the effect of these risk factors targeting infection control was performed. Results: The risk factors associated with CLABSI were prolonged central line dwell days (adjusted hazard ratio [HR], 1.028; 95% confidence interval [CI], 1.011 to 1.045; P=0.001), use of a silicone catheter (adjusted HR, 5.895; 95% CI, 1.893 to 18.355; P=0.002), surgical treatment (adjusted HR, 3.793; 95% CI, 1.467 to 9.805; P=0.006), and less probiotic supplementation (adjusted HR, 0.254; 95% CI, 0.068 to 0.949; P=0.042). By targeting these risk factors with a quality improvement initiative, the mean CLABSI incidence rate per 1,000 catheter-days decreased from 6.6 to 3.1 (P=0.004). Conclusion: Targeting risk factors for infection control significantly reduced the rate of CLABSI among high-risk infants in the NICU.

• 임상간호연구
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• 제27권1호
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• pp.45-53
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• 2021

Purpose: This study was conducted to assess the factors affecting turnover intention of the nurses working in neonatal intensive care units, including the extent of fatigue, work stresses, and work overload related to infection control. Methods: This was a descriptive correlational study to test factors affecting the turnover intention of the nurses working in neonatal intensive care units. Data was analyzed utilizing descriptive statistics, t-test, One-way ANOVA, Pearsons' Correlation Coefficient, and multiple regressions by using the IBM SPSS Statistics 23.0 Program(IBM Corp., Armonk, NY). Results: The turnover intention of nurses had a positive correlation with the extent of fatigue (r=.54, p<.001), work stress (r=.40, p<.001), and with the work overload (r=.43, p<.001) related to infection control. In addition, factors affecting the turnover intention of nurses included the extent of fatigue (β=.52, p<.001) related to infection control and the number of pediatric patients assigned to each nurse (β=.26, p=.001) and the variances explained by the regression model was 37.0%. Conclusion: It is necessary to establish and implement strategies to lower the extent of fatigue related to infection control by reducing the nurses' workload. Securing additional nurses to ensure an appropriate number of pediatric patients assigned to each nurse, and providing efficient management and available resources to reduce the turnover intention of nurses working in neonatal intensive care units are suggested.

• 임상간호연구
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• 제16권2호
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• pp.69-84
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• 2010

Purpose: The purpose of this study was to identify the state of infection control in neonatal intensive care units (NICUs) including disinfection methods, disinfection cycles, and exchange cycles for medical devices and to suggest a basic framework which would help develop standardized infection control guidelines. Methods: From a list of NICU equipment developed from the NICUs in 4 tertiary hospitals, a structured questionnaire on 74 types of medical equipment was developed and sent to 31 hospitals by mail. The results were reviewed by panel of experts (56 persons), and analyzed for internal validity by a focus group (4 persons) using guidelines from the Centers for Disease Control and the Korean Hospital Nurses Association. Results: The results showed various methods, cycles, disinfectant levels for the disinfectants and exchange cycles in the medical equipment infection control of the 31 hospitals. The focus group developed a 66-item basic framework based on validity testing. Conclusion: From the results of this study, a framework of infection control standards for 66 types of medical equipment in the NICU was developed. It is suggested that further study be done to more precisely establish standard infection control guidelines for NICU medical equipment.

• Pediatric Infection and Vaccine
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• 제6권2호
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• pp.194-202
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• 1999

목 적 : 이전까지는 국내에서 발생 증례가 적었던 GBS 감염증이 최근에는 자주 접하게 되었다. 이에 최근 수년간의 발생 증례에 대한 고찰을 하여 그 임상적, 역학적 특성을 고찰하고자 하였다. 방 법 : 1985년 6월부터 1999년 6월까지 서울대학교 병원 소아과에서 균이 증명된 GBS 감염증 환아들을 대상으로 하였다. 이들의 의무 기록을 후향적으로 검토하였고, 분려된 일부 균주의 혈청형과 항균제 감수성을 경시하였다. 결 과 : 기간 별 증례 수를 비교해 보면, 1990년대 후반에 그 이전보다 증례가 많았다. 총 27례중 25례가 신생아 감염증이었고, 지발형이면서 뇌막염인 증례가 많았다. 혈청형은 III(6균주), Ib(6), Ia(1)와 II(1)였다. 검사된 10개의 항균제에 대하여 모든 균주가 감수성을 보였다. 결 론 : 국내에서 신생아 GBS 감염증은 증가하고 있는 추세이므로, 신생아 패혈증 또는 뇌막염의 원인균으로서 GBS의 가능성을 고려하여야 하며, 향후 빈도가 더욱 증가하면 산모에게 산전 검사와 예방적 항생제 요법 등을 고려해야 할 것으로 사료된다.

• Clinical and Experimental Pediatrics
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• 제58권1호
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• pp.33-36
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• 2015

Group D streptococci are known to cause newborn septicemia and meningitis, but the Streptococcus bovis group strains rarely cause serious neonatal infections in Korea. Central nervous system (CNS) complications of neonatal S. bovis group infection have rarely been reported. In adults, S. bovis group strains cause bacteremia and endocarditis, and are associated with gastrointestinal malignancy. However, only a few studies have reported meningitis and septicemia in infants. Here, we describe a case of bacteremia and meningitis due to Streptococcus gallolyticus subsp. pasteurianus with a delayed CNS complication in an infant. A 28-day-old male infant was admitted to the hospital with a 1-day history of fever. Cultures of blood, cerebrospinal fluid, and urine showed the presence of S. bovis group strain-S. gallolyticus subsp. pasteurianus. He was discharged after 21 days of intravenous ampicillin and cefotaxime administration. Two weeks later, he was readmitted with a fever and short episodes of tonic-clonic movements. Brain magnetic resonance imaging showed marked bilateral frontal subdural effusion. He was discharged after 31 days of antibiotic therapy, and no neurological sequelae were observed at the 9-month follow-up. In conclusion, we present a rare case of neonatal S. gallolyticus subsp. pasteurianus infection causing urinary tract infection, septicemia, meningitis, and delayed CNS complications. This case emphasizes the need for physicians to be aware of S. bovis infection in infants.

• Pediatric Infection and Vaccine
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• 제7권2호
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• pp.245-249
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• 2000

저자들은 재태기간 26주에 조기 진통으로 분만 후 사망한 초극소 저출생 체중아에서 L. monocytogenes에 의한 패혈증과 이에 의한 사망을 관찰하였기에 이를 문헌 고찰과 함께 보고하는 바이다.

• Pediatric Infection and Vaccine
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• 제11권1호
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• pp.121-125
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• 2004

신생아 수두는 모체가 감염된 시기에 따라 그 증상과 예후가 달리 나타날 수 있으며, 출생 후 감염된 경우는 태반을 통해 모체로부터 태아에게 항체가 전달되지 못하기 때문에 합병증의 발생 가능성이 높고, 예후가 좋지 않아 적절한 치료와 추적관찰이 필요하다. 저자는 합병증의 동반없이 acyclovir를 사용하여 치료한 불현성 감염 엄마로부터 감염된 신생아 수두 1례를 경험하였기에 보고하는 바이다.

• Clinical and Experimental Pediatrics
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• 제57권10호
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• pp.451-456
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• 2014

Purpose: We evaluated serum procalcitonin (PCT) as a diagnostic marker of neonatal sepsis, and compared PCT levels with C-reactive protein (CRP) levels. Methods: We retrospectively reviewed the medical records of 269 neonates with a suspected infection, admitted to Wonkwang University School of Medicine & Hospital between January 2011 and December 2012, for whom PCT and CRP values had been obtained. Neonates were categorized into 4 groups according to infection severity. CRP and PCT values were analyzed and compared, and their effectiveness as diagnostic markers was determined by using receiver operating characteristic (ROC) curve analysis. We also calculated the sensitivity, specificity, and positive, and negative predictive values. Results: The mean PCT and CRP concentrations were respectively $56.27{\pm}81.89$ and $71.14{\pm}37.17mg/L$ in the "confirmed sepsis" group; $15.64{\pm}32.64$ and $39.23{\pm}41.41mg/L$ in the "suspected sepsis" group; $9.49{\pm}4.30$ and $0.97{\pm}1.16mg/L$ in the "mild infection" group; and $0.21{\pm}0.12$ and $0.72{\pm}0.7mg/L$ in the control group. High concentrations indicated greater severity of infection (P<0.001). Five of 18 patients with confirmed sepsis had low PCT levels (<1.0 mg/L) despite high CRP levels. In the ROC analysis, the area under the curve was 0.951 for CRP and 0.803 for PCT. The cutoff concentrations of 0.5 mg/L for PCT and 1.0 mg/L for CRP were optimal for diagnosing neonatal sepsis (sensitivity, 88.29% vs. 100%; specificity, 58.17% vs. 85.66%; positive predictive value, 13.2% vs. 33.3%; negative predictive value, 98.6% vs. 100%, respectively). Conclusion: PCT is a highly effective early diagnostic marker of neonatal infection. However, it may not be as reliable as CRP.

• Journal of Veterinary Science
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• 제19권6호
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• pp.750-758
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• 2018

Influenza virus infection is a zoonosis that has great socioeconomic effects worldwide. Influenza infection induces respiratory symptoms, while the influenza virus can infect brain and leave central nervous system sequelae. As children are more vulnerable to infection, they are at risk of long-term neurological effects once their brains are infected. We previously demonstrated that functional changes in hippocampal neurons were observed in mice recovered from neonatal influenza infection. In this study, we investigated changes in myelination properties that could affect neural dysfunction. Mice were infected with the influenza virus on postnatal day 5. Tissues were harvested from recovered mice 21-days post-infection. The expression levels for myelin basic protein (MBP) were determined, and immunohistochemical staining and transmission electron microscopy were performed. Real-time polymerase chain reaction and Western blot analyses showed that mRNA and protein expressions increased in the hippocampus and cerebellum of recovered mice. Increased MBP-staining signal was observed in the recovered mouse brain. By calculating the relative thickness of myelin sheath in relation to nerve fiber diameter (G-ratio) from electron photomicrographs, an increased G-ratio was observed in both the hippocampus and cerebellum of recovered mice. Influenza infection in oligodendrocyte-enriched primary brain cell cultures showed that proinflammatory cytokines may induce MBP upregulation. These results suggested that increased MBP expression could be a compensatory change related to hypomyelination, which may underlie neural dysfunction in recovered mice. In summary, the present results demonstrate that influenza infection during the neonatal period affects myelination and further induces functional changes in influenza-recovered mouse brain.

• 대한수의학회지
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• 제33권4호
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• pp.665-671
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• 1993

The rate of 67 neonatal calves's infection of Theileria sergenti was investigated in random samples on the farms located in Kyeongki, Chonbuk and Jeju districts of Korea. The criteria used in verifying infection with T sergenti included the detection of parasites by giemsa's stain and acridine orange stain in the blood smear slides. Further evidence of current or previous exposure to T sergenti was based on the demonstration of T sergenti-specific antibody and antigen by the western immunoblot and the indirect immunofluorescence antibody test in the peripheral blood of the calves. The prevalence rates were 35%, 50% and 100% in Kyeongki, Chonbuk and Jeju provinces respectively and the overall prevalence in all the farms was 43.2% by means of acridine orange stain. The parasites that were observed in the peripheral blood of calves was shown surely by the western immunoblot to the characteristic 34KD antigen among the proteins of T sergenti (Korean Isolate). And the antibody of the neonatal calves reacted at the very highest titer(1 : >2,520). These data highlight the significance of T sergenti in the neonatal calf disease in Korea.