• 제목/요약/키워드: Nosocomial infection control

검색결과 66건 처리시간 0.023초

손씻기 향상프로그램과 MRSA 보균자 색출프로그램이 MRSA감염 발생률에 미치는 영향 (The Effect of Handwashing Improving Program and MRSA Carrier Screening Program on the MRSA Infection Rates in an Intensive Care Unit)

  • 김영혜;전성숙;정인숙;장철훈;김정화;허정애
    • 대한간호학회지
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    • 제33권6호
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    • pp.686-692
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    • 2003
  • Purpose: To assess the effect of handwashing improving program and MRSA carrier detection program on MRSA(methicillin resistant Staphylococcus aureus) infection rate in a intensive care unit. Method: The intervention was Nosocomial Infection(NI) control program consisted of hand washing improving program and identification and treatment of MRSA carrier. Data on the NI and MRSA infections were collected by an infection control nurse based on the definition of CDC. MRSA infection rates were calculated by the number of MRSA infection per 100 admissions or 1,000 patients-days. The difference of MRSA infection rates between pre and post intervention was tested by Chi-square at =.05. Result: MRSA infection rates 3.0% or 3.2 per 1,000 patient-days at the pre, 4.6% or 3.7 per 1,000 patient-days at the post, and the differences were not statistically significant (p=.411, p=.769 respectively). Conclusion: The handwashing improving program and MRSA carrier detection program was not effective in reducing the Nosocomial Infection(NI) or MRSA infection rates. It is recommended further studies with a longer intervention and follow-up period.

치과 병원의 COVID-19 예방:문헌 검토에 따른 대응 전략 (Prevention of COVID-19 in Dental Hospitals: Literature Review and Countermeasures)

  • 이정원;김여진;정하늘;이용무
    • 대한치과의사협회지
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    • 제58권10호
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    • pp.615-626
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    • 2020
  • The outbreak of COVID-19, caused by SARS-CoV-2 infection, has spread worldwide and resulted in a pandemic for health systems. The disease is transmitted via respiration as droplets or aerosol. Due to the nature of dental treatment, aerosols, including body fluid, blood, and saliva, are frequently produced in dental hospitals. The present study investigated the potential risk of nosocomial infection of COVID-19 in dental hospitals to provide recommendations in clinical situations. The Seoul National University Dental Hospital in Korea established a countermeasure to cope with the clinical situation based on The Guidelines of Korean Centers for Disease Control & Prevention (KCDC) for dental practitioners and the available literature. Notably, numerous considerations for patient reservation and schedule management are required for space separation in the hospital, including infection control. Experiences in dental hospitals in Korea would be referable for other dental hospitals facing this infectious respiratory disease.

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실제 병원성 균주에서 Vicryl $plus^{(R)}$ (Ethicon, USA)의 효용성 (Effectiveness of Vicryl $plus^{(R)}$ (Ethicon, USA) in Nosocomial Bacteria)

  • 진영완;나영천
    • Archives of Plastic Surgery
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    • 제38권5호
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    • pp.590-593
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    • 2011
  • Purpose: Surgical site infections (SSIs) are the third most frequently reported nosocomial infection. Of these SSIs, mostly were confined to the incision associated with underlying disease as diabetes, cigarette smoking, systemic steroid use, obesity, operating room environment, suture and surgical technique. This study has been planned to reduce the SSIs by using Vicryl $plus^{(R)}$ (Ethicon, USA) which contains triclosan, a broad-spectrum antibacterial agent, into the infected wound to evaluate whether or not Vicryl $plus^{(R)}$ (Ethicon, USA) is effective to nosocomial bacteria using a zone of inhibition assay. Methods: We did a comparison of Vicryl $plus^{(R)}$ suture (with triclosan) size 2-0, 5-0 with $Vicryl^{(R)}$ suture (without triclosan) size 4-0 each as treatment and control group, applied in Mueller-Hinton agar infected by following mircroorganisms: Methicillin-sensitive $Staphylococcus$ $aureus$ (MSSA), Methicillin-resistant $Staphylococcus$ $aureus$ (MRSA), Acinetobacter baumanii, $Escherichia$ $coli$, Enterobacter faecalis, Pseudomonas aeruginosa, Candida albicans. Cultures were made of the selected mircroorganisms, seeding the study strain in agar plates for 24 and 48-hour period in an oven at $37^{\circ}C$ followed by zone of inhibition assay. Results: Vicryl $plus^{(R)}$ group has demonstrated to create a zone of inhibition against MRSA, MSSA and $A.$ $baumanii$, but no effect on $E.$ $faecalis$, $P.$ $aeruginosa$, $C.$ $albicans$. Vicryl $plus^{(R)}$ suture size 2-0 also had antibactericidal effect while Vicryl $plus^{(R)}$ suture size 5-0 did not. $Vicryl^{(R)}$ group had no zones of inhibition showing colonization at all mircroorganisms. Conclusion: Our results seem to warrant the use of Vicryl $plus^{(R)}$ as absorbable buried suture when concerning SSIs as a prophylaxis against surgical nosocomial infection.

The Epidemiological Survey of Nasal Colonization of Methicillin Resistant Staphylococcus aureus in Patients and Doctors

  • Seong Hee Kyung;Bae Young Soon;Kim Yong Ho
    • 대한의생명과학회지
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    • 제10권3호
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    • pp.309-315
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    • 2004
  • Methicillin resistant Staphylococcus aureus (MRSA) is one of the most common nosocomial pathogens. Many hospitals are facing the problems which they have to use expensive antibiotics and suffer from long term hospital study of patients due to MRSA. This study is to survey MRSA nasal colonization of patients and doctors, and to investigate the mode of transmission of MRSA by pulsed field gel electrophoresis (PFGE) and then use these data to prevent further spread of cross infection and reduce nosocomial infection. Subjects of this study were 201 patients with MRSA infection at an university hospital in Busan from Sept. 1997 to Aug. 1998. Bacterial genotypes of MRSA strains isolated from nares and wound of patients (14 cases) and nares of doctors (8 cases) were analyzed by PFGE. Nasal cultures of 20 I patients for detecting nasal colonization of MRSA were performed and incidence rate of nasal colonization was 40% (80/201). Among 201 patients MRSA were acquired from hospital in 140 (70%) patients and were acquired from community 61 (30%) patients. Among 14 pairs of MRSA from colonized or infected sites and anterior nares, DNA patterns of 10 pairs (71.4%) were equal. 86% (12/14) MRSA strains isolated from patients and 12.5% (1/8) MRSA strains isolated from doctors show same pattern. DNA patterns were changed in some doctors after nasal oint. Treatment. It could be inferred that the most sources of MRSA in hospital are the endemically existing MRSA. Therefore, we believe that it would be necessary to control MRSA nasal colonization of the patients and the related medical teams to reduce the medical cost and to improve the efficacy of medical cares.

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Epidemiological Investigation of Methicillin-Resistant Staphylococcus aureus by Arbitrarily Primed PCR

  • Yang Byoung-Seon
    • 대한의생명과학회지
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    • 제10권4호
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    • pp.473-477
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    • 2004
  • Methicillin-Resistant Staphylococcus aureus (MRSA) strains are resistant to a wide range of antibiotics and are a major cause of nosocomial infections. Accurate and rapid typing of MRSA is needed to implement effective infection control measures. Arbitrarily Primed PCR (AP-PCR) is a very useful method in rapid typing. AP-PCR is not necessary information about target DNA sequence because this is basically DNA amplification and could be useful in epidemiological typing by classified band pattern. In this study, MRSA were isolated and identified from ICU, Neu, IM and Ped environments and investigated molecular typing by AP-PCR. Ped, the MRSA pattern determines the la, IIa type, 1M is Ib type, Neu is IIa type and ICU determines the IIa, lIb types. All MRSA in this study were typeable by AP-PCR, which was easy to perform and reproduce with evidence of MRSA for purposes of nosocomial infection control.

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일 화상 치료실에 입원한 화상환자의 감염실태조사 (A Study on the Nosocomial Infection in One Burn Unit)

  • 김정애
    • 대한간호학회지
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    • 제17권3호
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    • pp.227-240
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    • 1987
  • Infection has assumed increased importance as a cause of death among thermally injured individuals. Decreased treatment effectiveness and an increase in mortality are the hallmarks of nosocomial infection. Infection control is a monumental task that must be achieved to reduce mortalities. This was a retrospective study to survey the epidemiological features of nosocomial infections in a burn unit and to identify the possibilities for infection control. During the past 6 year 2 month period from July, 1981 to August, 1987, 306 burn patients were treated in the burn unit of university hospital. Among of these, 290 cases were the subjects of this study. The data were collected from the patients' records after discharge. All data collected were analyzed using percent, x$^2$-test, t-test with SPSS program. The results of this study are summariged as follows: 1) Infection rate was 40%. According to site, there were 67 cases of wound infection, 60 cases of post-operative skin graft infection, 20 cases of septicemia and 20 cases of donor site infection. As far as the burn size was concerned, the infection rate for patients whose burn size ranged 61 to 70%, was shown to be 100%, followed by the infection rate of 93.8%, for patients whose burn size ranged from 41~50%. As far as the period of time over which the infection developed, 5 to 7 days showed the highest frequency. Further infection was the main cause of deaths and complications. 2) Based upon the results obained by comparing the general characteristics, between a hospital infection-group and non-hospital infection group, there was a significant defference according to age, the time of the year when the accident happened, the place of accident or length of hospital-admission. And according to the result obtained by comparing the general characteristics of the burn, there was a significant difference according to burn size, burn depth, burn type, and burn site. And also based upon the result obtained by comparing the two groups according to method of treatment, there was a significant difference according to the use of antibiotics and to the type of wound-treatment, and for the 8 different binds of treatment related to infection, there was a significant difference for all. In conclusion, age, length of hospital-admission, burn size, burn type, burn site, burn depth, type of woundtreatment and the 8 different binds of treatment, which are related to burns, were shown to be the factors which affect the infection rate in burn patients.

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신경외과중환자실 내에서 MRSA 감염관리 효과 (Effect of the Management of Infection for Methicillin Resistant Staphylococcus aureus at an Neurosurgical Intensive Care Unit)

  • 김윤경;이지민;홍해숙
    • Journal of Korean Biological Nursing Science
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    • 제11권2호
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    • pp.114-119
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    • 2009
  • Purpose: The effectiveness of an infection control program is important to hospital quality improvement and decreases of mortality rate and prevalence. Methicillin resistant Staphylococcus aureus (MRSA) is the most common pathogen causing nosocomial infection. The aim of the study was to identify the most important risk factors for acquiring an MRSA, to evaluate the MRSA incidence rates after the nursing intervention in Neurosurgery intensive care unit (ICU). Methods: Clinical data were collected prospectively from December 2008 until July 2009 in Neurosurgery ICU. The patients were divided into preintervention and postintervention groups. An infection was defined as an MRSA if it occurred 48 hr after admission to the Unit. Infection control program including hand washing, education of health care workers about MRSA, standard precaution and contact isolation of patients were applied for three month. Results: A total of 85 patients were included in the study. Forty-five patients of S. aurerus were detected. Among 45 of S. aurerus, MRSA were isolated from 38 patients. The incidence MRSA rate of postintervention group was 26.9% while incidence MRSA rate of preintervention group was 66.7%. In total, The incidence MRSA rate was 44.7%. The incidence of MRSA have decreased in the postintervention as compared with the preintervention group. Conclusion: The infection control program for MRSA was effective to decrease the MRSA isolation rate. The health care workers regular hand washing, education of nosocomial infection control is important enough to be emphasized.

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계획된 행위이론을 적용한 간호대생의 병원감염관리수행 (Nursing Students' Performance related to Nosocomial Infection Control: An Analysis Based on the Theory of Planned Behavior)

  • 김지미;이선혜
    • 한국간호교육학회지
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    • 제18권2호
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    • pp.229-238
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    • 2012
  • Purpose: The purpose of this study was to evaluate the theory of planned behavior (TPB) in the structural relationship of nursing students' performance related to nosocomial infection control (NIC). Method: Data was collected by using a questionnaire completed by 238 nursing students of three nursing colleges in Suwon, Sokcho. Results: The mean score of performance related to NIC was 3.86. The highest mean score of performance related to NIC was 4.18 (${\pm}0.91$) for 'hand washing' and the lowest mean score was 3.56 (${\pm}1.08$) for 'respiratory system'. In prediction of the intention of nursing students' on NIC, the attitude, the subjective norm, and the perceived behavior control(PBC) of TPB resulted in statistically significant influencing factors (p<0.050). These three variables explained 47.6% of the total variance of the intention of nursing students' on NIC. In predicting the performance related to NIC, the PBC resulted in the direct and main influencing factor of nursing students' performance related to NIC (p<0.010). Intention was not a significant determinant. These two variables explained 13.2% of total variance of the performance related to NIC. Conclusion: This study shows the TPB model's applicability in explaining performance related to NIC of nursing students and highlights the importance of PBC for strategies to enhance performance related to NIC in nursing students.

병원획득 Extended-spectrum ${\beta}$-Lactamase 생성 Escherichia coli 균혈증의 위험인자 (Risk Factors of Nosocomial Bacteremia of Extended-spectrum ${\beta}$-Lactamase Producing Escherichia coli)

  • 고대식;문송미;이지성;박윤수;조용균
    • Journal of Yeungnam Medical Science
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    • 제30권2호
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    • pp.83-89
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    • 2013
  • Background: The prevalence of extended-spectrum ${\beta}$-lactamase (ESBL)-producing Escherichia coli is increasing rapidly worldwide. Treatment options for ESBL-producing E. coli are limited, and infections caused by this organism are associated with improper antibiotic use, a long hospital stay, and increased mortality. Thus, the assessment and early recognition of the risk factors of nosocomial infections due to ESBL-producing E. coli are important for the infection control and proper treatment. Methods: A case-control study was performed that included nosocomial episodes of ESBL-producing E. coli bacteremia at a tertiary care hospital from January 2004 to December 2007. For each case patient, three controls were randomly selected and data on predisposing factors were collected. Results: Fifty-five cases of nosocomial ESBL-producing E. coli bacteremia were studied. Carbapenem usage (OR: 11.3, 95% CI: 1.1-115.9, p=0.041), quinolone usage (OR: 4.5, 95% CI: 1.1-18.8, p=0.042), biliary obstructive disease (OR: 11.8, 95% CI: 3.0-46.7, p<0.001) and the APACHE II score (OR: 1.3, 95% CI: 1.2- 1.5, p<0.001) were analyzed as independent risk factors of nosocomial ESBL-producing E. coli bacteremia. Conclusion: Our results showed that physicians caring for patients with risk factors of nosocomial bacteremia should consider ESBL-producing E. coli as the causative organisms of the disease.

일반외과 환자의 환자위험지수에 따른 수술창상감염 발생률 (Surgical Site Infection Rates according to Patient Risk Index after General Surgery)

  • 이혜령
    • 한국직업건강간호학회지
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    • 제11권1호
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    • pp.44-51
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    • 2002
  • Purpose: Surgical Site Infection(SSI) is the third most common cause of nosocomial infection, so that it results in serious socioeconomic impact such as extra hospitalization, mortality and health care cost. The aim of this study was to analyses the SSI that based on the degree of wound contamination and patient risk index after general surgery and to generate a reference data for the effective management and reducing SSI. Method: From July, 1999 to June, 2000, 1080 cases which presented with surgical site infection after general surgery at S hospital in chunchon city were included in this study. The data were collected by review of the medical records retrospectively. The collected data, in accordance with the test purpose, is analyzed by SPSS/PC+ program, using real numbers, percentage, $X^2$ test, Pearson's correlation and stepwise logistic regression. Result: The overall wound infection rate was 4.7%(51 cases out of 1,080). The infection rate of clean wounds was 1.4%. Surgical site infection rate for patient risk index scores of 0, 1, 2 and 3 was 1.9%, 8.0%, 13.1% and 20.0%, respectively and increased significantly according to patient risk index(p=.000). Sixteen of the fifty one(31.4%) surgical site infections were found during an outpatient visit after discharge. Multivariate analysis, identified two independent variables : duration of postoperation stay(p=.000), age(p=.037). The most frequent isolated organisms were Pseudomonas aeruginosa(21%) and Staphylococcus aureus(21%). Also Staphylococcus aureus were all MRSA(Methicillin Resistant S. aureus). Conclusion: In this study, SSI was analysed according to the degree of wound contamination and patient risk index after general surgery. The data that obtained from this study is expected that it would be available for surveillance and control of SSI.

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