• Title/Summary/Keyword: Prevention of nosocomial infection

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Risk Factors of Nosocomial Rotavirus Infections in Children (소아 로타바이러스 원내 감염의 위험 인자)

  • Park, Sin Ae;Yu, Sun Hee;Lim, Seon Woong;Choi, Kyung Dan
    • Clinical and Experimental Pediatrics
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    • v.48 no.4
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    • pp.395-400
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    • 2005
  • Purpose :Rotavirus is one of the most important causes of nosocomial infections among children. The aim of this study is to determine the risk of nosocomial rotavirus infections and to evaluate the effectiveness of breast-feeding and probiotics in the prevention of nosocomial rotavirus infections. Methods : This study was carried out on admitted children without diarrhea between March 1, 2003 and February 29, 2004. Three hundred ninety patients aged 4 days to 13 years during this study were available. We examined the feces of all children for rotavirus by latex agglutination on admission, during hospital, and after discharge, to see whether they developed diarrhea or not. Results : Nosocomial rotavirus infections was significantly increased with children under 12 months of age(P=0.008). The monthly attack rate was great between December and March(P=0.046). Prolonged hospital stay was associated with an increased attack rate of nosocomial rotavirus infections (P=0.003). The risk of nosocomial rotavirus infections was not associated with the number of roommates and whether or not they were breast-fed or fed on probiotics. Conclusion : Nosocomial rotavirus infections are significantly more likely to occur in children under 12 months of age, admitted between December and March, and with prolonged hospital stays. Prompt identification and isolation of children with nosocomial rotavirus infections, even without diarrhea, may decrease rates of nosocomial rotavirus infections.

Contamination of operator's clothing by aerosols during scaling (스케일링 시 에어로졸에 의한 술자의 의복 오염도)

  • Kang, Kyung-Hee;Kim, Ye-Jin;Min, Ji-Yeon;Park, Seul-Gi;Woo, Ju-Hee;Goong, Haw-Soo
    • Journal of Korean Academy of Dental Administration
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    • v.5 no.1
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    • pp.31-37
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    • 2017
  • Recently interest in infection control is increasing in hospitalsnfection control has become more important in the overall health care practiceental hospital also requires thorough infection control. There are various kinds of vectormedical clothing. Contaminated clothing of a hospital staff can be a vector of nosocomial infecton. actual case of nosocomial infecton caused by contaminated medical clothing, nursing students were measuring contamination levels of uniforms and pathogenic microorganism wdetected in front of the uniform and pocket. There is also a high risk of exposure to contamination in the dental hospital. We conducted a study to enhance awareness about infection and proper clothing management by comparing before and after contamination of clothing caused by aerosols produced during scaling. Subjects were scaling operators' uniforms in the department of dental hygiene, K University located in Daejeon. Before scaling, the uniform was sterilized by autoclavecaling was performed times in the same place (an average of 60 minutes per person, a total of 180 minutes). ive parts of the uniform (sleeves, chest, belly, thigh, edge of pants) contracted Rodak-plate for 15 seconds. After incubating the contacted Rodak-plate at 37℃ incubator, contamination levels by measuring the number of colonies. As a result, all parts increased number of colonies. ontamination order chestedge of pants thigh belly sleeves. Increase rate of colonies was also high in the order chest edge of pants thigh belly sleeves. This study showed seriousness of clothing contaminationcaused by aerol produced during scalingcontamination of clothing can be a path to nosocomial infecton. According to th study, infection control for clothing as well as dental instruments should be implemented and thorough infection control training needed for dental staff. In further researches, practical infection prevention supplementing clothing management method.

The effect of surgical site infection on the length of stay and health care costs (수술부위감염이 재원일수와 비용에 미치는 영향)

  • Chang, Jin-Hee;Kim, Kyoung-Hoon;Kwon, Soon-Man;Yeom, Seon-A;Park, Choon-Seon
    • Health Policy and Management
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    • v.21 no.1
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    • pp.44-60
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    • 2011
  • Background : Surgical site infection(SSI) is one of the important nosocomial infections with pneumonia, urinary tract infection. SSI increases mortality, morbidity, length of stay, and costs for postoperative patients. The purpose of this study was to estimate length of stay(LOS) and health care costs from SSI using the large observational data. The ultimate objective was to show the effect of prevention of SSI. Method : This study used antibiotic prophylaxis evaluation data and claims data of the HIRA(Health Insurance Review and Assessment Service). The study population included 18,361 patients who underwent gastric surgery, endoscopic cholecystectomy, colon surgery, hysterectomy, cesarean section in nationwide hospitals from August to October 2007. SSI group and non-SSI group were matched according to propensity score resulted from logistic regression. The paired t-test was used to compare the difference of the LOS and health care costs between SSI group and non-SSI group. Results : The 598 cases of SSI were detected of total subjects, and the crude SSI rate was 3.3%. For each surgery, SSI rates were 5.5% for gastric surgery, 4.7% for cholecystectomy, 6.6% for colon surgery, 2.6% for hysterectomy, and 1.6% for cesarean section. The 596 cases of SSI and the 596 cases of non-SSI were matched by propensity score. The LOS of SSI group was longer than that of non-SSI group, and the difference was statistically significant. Health care costs of SSI group was more than that of non-SSI group which was significant. Conclusions : SSI increased apparently the LOS and healthcare costs. The economic loss might affect the cost of national healthcare as well as patients and hospitals. This study provided the evidence that the healthcare expenditure could be reduced by preventing SSI.

Analysis of Risk Factors for Patient Safety Management (환자안전 관리를 위한 위험요인 분석)

  • Ahn, Sung-Hee
    • Journal of Korean Academy of Nursing Administration
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    • v.12 no.3
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    • pp.373-384
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    • 2006
  • Purpose: This is a pilot study to identify patient safety risk factors and strategies for patient safety management perceived by nurses. Methods: Data were collected and analyzed with an open questionnaire from April to May 2005, targeted on 100 nurses working in two hospitals. The issues were 'what are risk factors for patients, nurses, and other medical practitioners? How do they prevent with the aftermath of risk factors, causes of incidents?' For data analysis, types and frequency of risk factors were worked out, using the Australian Incident Monitoring System Taxonomy. Results: The types of patient safety risk factor perceived by nurses were as follows ; therapeutic devices or equipment, infrastructure and services (29.5%), nosocomial infections (16.3%), clinical processes or procedures (15.4%), behavior, human performance, violence, aggression, security and safety (12.2%), therapeutic agents (9.7%), injuries and pressure ulcers (8.7%), logistics, organization, documentation, and infrastructure technology (5.6%). Strategies for patient safety included training of prevention of infection, education about safety management for patients and medical professionals, establishment of reporting system, culture of care, pre-elimination of risk factors, cooperative system among employees, and sharing information. Conclusion: These results will be used to provide evidences for patient safety management and educational program.

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An update on necrotizing enterocolitis: pathogenesis and preventive strategies

  • Lee, Jang-Hoon
    • Clinical and Experimental Pediatrics
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    • v.54 no.9
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    • pp.368-372
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    • 2011
  • Necrotizing enterocolitis (NEC) is one of the most critical morbidities in preterm infants. The incidence of NEC is 7% in very-low-birthweight infants, and its mortality is 15 to 30%. Infants who survive NEC have various complications, such as nosocomial infection, malnutrition, growth failure, bronchopulmonary dysplasia, retinopathy of prematurity, and neurodevelopmental delays. The most important etiology in the pathogenesis of NEC is structural and immunological intestinal immaturity. In preterm infants with immature gastrointestinal tracts, development of NEC may be associated with a variety of factors, such as colonization with pathogenic bacteria, secondary ischemia, genetic polymorphisms conferring NEC susceptibility, anemia with red blood cell transfusion, and sensitization to cow milk proteins. To date, a variety of preventive strategies has been accepted or attempted in clinical practice with regard to the pathogenesis of NEC. These strategies include the use of breast feeding, various feeding strategies, probiotics, prebiotics, glutamine and arginine, and lactoferrin. There is substantial evidence for the efficacy of breast feeding and the use of probiotics in infants with birth weights above 1,000 g, and these strategies are commonly used in clinical practice. Other preventive strategies, however, require further research to establish their effect on NEC.

Application of the Extract of Zanthoxylum piperitum DC to Manufacturing Eco-friendly Nosocomial Infection Control Protective Materials (초피의 항균 활성을 이용한 원내 감염 제어 친환경 방호 소재 개발)

  • Shin Young Park;Ki Yun Kim;Do Youn Jun;Sung Chul Kim;Hyo-Il Jung;Young Ho Kim
    • Journal of Life Science
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    • v.33 no.10
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    • pp.820-827
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    • 2023
  • Since COVID-19 began at the end of 2019, the wearing time of protective clothing used to prevent pathogenic bacteria and virus infection has increased, and the development of safe protective materials that are human-friendly and have antibacterial and antiviral functions has been required. In this study, we investigated the possibility of developing natural antibacterial protection materials using ethanol extract of the medicinal plant Zanthoxylum Piperitum DC. The antibacterial activity assay of the 80% ethanol extract of Z. piperitum DC leaves against various nosocomial infectious bacteria, using the disk diffusion method, showed that Staphylococcus aureus ATCC 25923, Klebsiella pneumoniae ATCC 13883, Salmonella typhimurium, and Aeromonas hydrophila are sensitive to the inhibitory action of the extract. The IC50 values of the ethanol extract against S. aureus, K. pneumoniae, P. vulgaris and A. hydrophila were about 0.59 mg/ml, 0.50 mg/ml, 1.06 mg/ml, and 0.06 mg/ml, respectively. To determine whether the ethanol extract of Z. piperitum DC leaves can be applied to the development of antibacterial protective fabric, the ethanol extract was tested using a protective fabric from the KM Health Care Corp. using the JIS L1902-Absorption method. As a result, the bacteriostatic and bactericidal activity values of S. aureus ATCC 25923 and K. pneumoniae ATCC 13883 appeared to be more than 2.0 when treated with the ethanol extract at a concentration of 1% (w/v). Together, these results suggest that Z. piperitum DC leaves can be applied to develop natural antibacterial functional protective fabrics.

Isolation Effectiveness by Progressive Space Organization in Negative Pressured Isolation Unit (음압격리병실에 있어서 단계별 공간구성의 격리효과)

  • Kwon, Soonjung;Sung, Minki
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.22 no.4
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    • pp.79-86
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    • 2016
  • Purpose: The purpose of this study is to identify the effect of Progressive Space Organization (ante-rooms) in Negative Pressured Isolation Unit(NPIU) such as National and Regional Isolation Units in Korea in order to build basic data for the evidence based design of Airborne Infection Isolation Units which should prepare and respond effectively to the public health crisis due to the hazardous airborne infectious disease. Methods: 1) Gas(SF6) test and analysis on the 23 Korean Isolation Units under operation. 2) Assessment of the isolation level of the space components by checking the Gas concentration. 3) Analysis of the Isolation Effectiveness according to Space Organizational levels. Results: 1) The higher segregation level is, the lower Gas(SF6) concentration is. 2) Too many segregations(anterooms) of Isolation Unit are not efficient for the prevention of infectious bacillus spread. For example, 4 level of segregation has similar segregation effect to the 3 level of segregation. Implications: Many anterooms in front of the isolated patient bedroom will guarantee the safe environment against the danger of hazardous airborne nosocomial infection. On the other hand, too many segregations is inefficient, expensive, inconvenient, narrow(unflexible) and so on. This study can be used as basic data for further development of design guidelines of isolation units.

CQI Activities for the Reduction of Clostridium difficile Associated Diarrhea in NCU of a University Hospital (일개 대학병원 신경외과중환자실에서 Clostridium difficile 관련 설사 감소를 위한 CQI활동)

  • Park, Eun Suk;Chang, Kyung Hee;Youn, Young Ok;Lee, Jung Sin;Kim, Tae Gon;Yea, Han Seung;Kim, Sun Ho;Shin, Jeong Won;Lee, Kyungwon;Kim, June Myung
    • Quality Improvement in Health Care
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    • v.8 no.1
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    • pp.10-21
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    • 2001
  • Background : The Clostridium difficile is the most important identifiable cause of nosocomial infectious diarrhea and colitis, which lengthens hospital stay. Recently incidence of C. difficile has been increasing in an university hospital, and an intervention for prevention and control of C. difficile associated diarrhea (CDAD) was in prompt need. Methods : Subjects were the patients in the neurosurgical intensive care unit(NCU) where C. difficile was most frequently isolated. To increase participation of various departments, we used the CQI method, because management of CDAD requires a wholistic approach including control of antibiotics, barrier precaution and environmental cleaning and disinfection. Duration of the CQI activities was 9 months from April to December 1999. Results : The identified problems were misuse and overuse of antibiotics, lack of consciousness of medical personnels and the possibility of transmission from the contaminated environment and tube feeding. Education for proper use of antibiotics and management of C. difficile infection, use of precaution stickers, supplement of handwashing equipments, emphasis on environmental disinfection, and the change of the process of tube feeding were done. The CDAD rate in NCU was significantly decreased after the CQI program (8.6 case per 1,000 patient days from January to April 1999 vs 4.8 from May to December 1999). The distribution of neurosurgical wards including NCU among the total number of isolated C. difficile from the clinical specimens dropped from 49.4% in January to April to 33,7% in May to December. The average hospital stay of the neurosurgical department changed from 19.6 days to 15.2 days. Also, the effect of the CQI activities for C. difficile may have affected the incidence of vancomycin resistant enterococci (VRE). Duration and dosage of certain antibiotics used in the NS department were decreased. The distribution of neurosurgical department in the number of VRE isolated patients declined from 18.4% to 11.1%. Conclusion : Infection control of resistant organisms such as C. difficile is likely to be successful when management of environmental contamination an collaborative efforts of decreasing the patients' risk factors such as antibiotics management and decreasing the length of hospital stay come simultaneously. For this work, related departments need to actively participate in the entire process under a common target through discussions for identifying problems and bringing up solutions. In this respect, making use of a CQI team is an efficient method of infection control for gathering participation and cooperation of related departments.

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Assessment about the measles elimination from cases and outbreaks, 2002-2007 - Assessment about the measles elimination - (2002-2007년 사례 및 유행을 통해서 본 홍역퇴치 수준에 대한 평가 - 홍역퇴치 수준에 대한 평가 -)

  • So, Jae Sung;Go, Un Yeong;Oh, Hyun Kyung;Baek, Soo Jin;Lee, Jong Koo
    • Clinical and Experimental Pediatrics
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    • v.52 no.1
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    • pp.68-74
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    • 2009
  • Purpose : We assessed about the measles elimination in Korea according to analyzing national data on measles cases for 2002-2007. Methods : We estimated the effective reproduction number according to the proportion of imported cases and outbreak size. Results : Eleven cases, thirteen cases, six cases, six cases, 25 cases (60.0% were linked to 1 outbreak of 15 cases), and 180 cases (55.6% were linked 11 outbreaks of 2, 2, 2, 3, 3, 3, 5, 9, 9, 12, 50 cases) were reported in 2002, 2003, 2004, 2005, 2006 and 2007, respectively. In 2002-2007, R is 0.95 by imported case and 0.43 by outbreak sizes. In 2007, multiple chains of transmission occurred in hospital. Most of cases were below 4 ages and unvaccinated. We didn't find most of the infection source. Conclusion : We should prevent outbreak of susceptibility pocket like nosocomial infection, conduct reliable routine surveillance and epidemiological investigation to solve a problem of the measles elimination.

Effects of Nutritional and Environmental Conditions on Planktonic Growth and Biofilm Formation of Citrobacter werkmanii BF-6

  • Zhou, Gang;Li, Long-Jie;Shi, Qing-Shan;Ouyang, You-Sheng;Chen, Yi-Ben;Hu, Wen-Feng
    • Journal of Microbiology and Biotechnology
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    • v.23 no.12
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    • pp.1673-1682
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    • 2013
  • Citrobacter sp. is a cause of significant opportunistic nosocomial infection and is frequently found in human and animal feces, soil, and sewage water, and even in industrial waste or putrefaction. Biofilm formation is an important virulence trait of Citrobacter sp. pathogens but the process and characteristics of this formation are unclear. Therefore, we employed in vitro assays to study the nutritional and environmental parameters that might influence biofilm formation of C. werkmanii BF-6 using 96-well microtiter plates. In addition, we detected the relative transcript levels of biofilm formation genes by RT-PCR. Our results indicated that the capacity of C. werkmanii BF-6 to form biofilms was affected by culture temperature, media, time, pH, and the osmotic agents glucose, sucrose, NaCl, and KCl. Confocal laser scanning microscopy results illustrated that the structure of biofilms and extracellular polysaccharide was influenced by 100 mM NaCl or 100 mM KCl. In addition, nine biofilm formation genes (bsmA, bssR, bssS, csgD, csgE, csgF, mrkA, mrkB, and mrkE) were found to contribute to planktonic and biofilm growth. Our data suggest that biofilm formation by C. werkmanii BF-6 is affected by nutritional and environmental factors, which could pave the way to the prevention and elimination of biofilm formation using proper strategies.