• 한국치위생학회지
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• 제11권4호
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• pp.557-569
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• 2011

Objectives : Based on the system and control activity for the monitoring system made of components for infection control at dental hospitals and infection rate reporting, and the role of trained infection control staff, this study tried to understand approaches to the effective infection control program by surveying infection control at dental hospitals in Korea. Methods : The survey was conducted from December 14,2010 to January 31,2011 for 121 dental hospitals in Korea. For statistical analysis, PASW Statistic 18 was used. Results : And following conclusions were reached. 1. As for the infection control system at dental hospitals, 54.7% has an infection control committee, 58.7% infection control staff, 78.5% infection control rules, and 39.7% annual infection control plan and record. 2. As for surveillance indexes to report infection rates, 50.4% has the reporting system for staff's exposure to infectious disease and needle pricking. The average number of exposures to infectious disease was $0.28{\pm}2.23$ and that of needle pricking was $1.83{\pm}5.39$. 3. As for infection control indexes, it was reviewed whether infection control rules were implemented according to operation agents, general hospitals were more active in staff infection control, and hospitals annexed to a dental university or special legal entity were more active in microorganism control. As for use of personal protection gear, there was no significant difference among operation agents. More than 71% of operators and their assistants said they did not replace their masks between patients. 4. As for personnel indexes for effective infection control staff, most hospitals designated dental hygienists, which was followed by dental doctors (or doctors). Where their workload was reviewed, the ratio of other work such as treatment was relatively higher than that of infection control (n=71). Conclusions : These results show dental hospitals in Korea have a certain level of infection control system. As infection indexes are managed mainly for staff members, patient monitoring is needed, and trained and effective infection control staff should be designated. This study reviewed surveillance, infection control and personnel indexes. And further studies are needed in the future.

• 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.

• Journal of Preventive Medicine and Public Health
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• 제36권1호
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• pp.77-84
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• 2003

Objectives : Two related cases of Hemolytic-Uremic Syndrome (HUS) were reported to the Korea National Institute of Health in May, 2001. Shiga toxin 2 genes were detected in both stool samples. We suspected an enterohemorrhagic Escherichia coli (EHEC) infection as the cause of the HUS, and conducted an investigation to find the source of the infection and its route of transmission. Methods : We peformed case investigations on these two related HUS cases, and obtained interviews and rectal swabs form the family members and other close contacts. Additionally, we peformed rectal swabs on the cattle raised by the household of the index patient. Results : We found a 20 month old index patient and a 6 year-old cousin had developed HUS, where there had been a 2 day history of contact with the index, and bacteriological examinations for these two patients revealed, indistinguishably, the same E. coli O171. The grandmother of the index patient was found to be asymptomatic, but E. coli O26 was isolated. We also found a probable case in the mother of the cousin. She reported a history of contact with the index, and developed bloody diarrhea of 3 days duration. The test results for the cattle revealed E. coli O26 in one cow, and E. coli O26 and O55 in another. E. coli O26, which was isolated in both cows and the grandmother of the index, were indistinguishably the same. Conclusions : We found that the E. coli O26 in the grandmother had originated from the cows, and that the E. coli O171 found in the index patient had been transmitted to the cousin through person-to-person contact.

• Clinical and Experimental Pediatrics
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• 제61권11호
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• pp.366-370
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• 2018

Purpose: Tuberculosis (TB) is one of the most important diseases that cause significant mortality and morbidity in young children. Data on TB transmission from an infected child are limited. Herein, we report a case of disseminated TB in a child and conducted a contact investigation among exposed individuals. Methods: A 4-year-old child without Bacille Calmette-$Gu{\acute{e}}rin$ vaccination was diagnosed as having culture-proven disseminated TB. The child initially presented with symptoms of inflammatory bowel disease, and nosocomial and kindergarten exposures were reported. The exposed individuals to the index case were divided into 3 groups, namely household, nosocomial, or kindergarten contacts. Evaluation was performed following the Korean guidelines for TB. Kindergarten contacts were further divided into close or casual contacts. Chest radiography and tuberculin skin test or interferon-gamma-releasing assay were performed for the contacts. Results: We examined 327 individuals (3 household, 10 nosocomial, and 314 kindergarten contacts), of whom 18 (5.5%), the brother of the index patient, and 17 kindergarten children were diagnosed as having latent TB infection (LTBI). LTBI diagnosis was more frequent in the children who had close kindergarten contact with the index case (17.1% vs. 4.4%, P=0.007). None of the cases had active TB. Conclusion: This is the first reported case of TB transmission among young children from a pediatric patient with disseminated TB in Korea. TB should be emphasized as a possible cause of chronic diarrhea and failure to thrive in children. A national TB control policy has been actively applied to identify Korean children with LTBI.

• 간호행정학회지
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• 제7권3호
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• pp.497-509
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• 2001

The purpose of this study was to examine frequency of job performance, level of urgency, index of importance experienced by 138 new nurses who were working at 6 hospitals that had over 400 bed in Incheon and Bucheon. The data were analyzed using a SPSS program for descriptive statistics [numbers of job performance, level of urgency, index of importance(job performance+1/4 level of urgency)]. Some of the most frequent job performance were application of aseptic technique, application of principle of infection control, and medication (IV, PO, IM, supply fluid and electrolyte). Some of the most uncommon job performance were activity as a lecturer in nursing department, activity of arrangement of community resources, and participation in multidisciplinary conference. Some of the highest level of urgency were use of aseptic technique, CPR, application of principle of infection control, defibrillation for dysrhythmia, blood transfusion, observation of patient's status in procedure (operation), v/s check, intervention for improvement of respiratory function and medication of antihypertensives. Some of the lowest level of urgency were activity as a lecturer in nursing department, preceptor's activity, supervisor and delegation of job to nurse aids, attendance at nursing conference, activity of arrangement of community resources, participation in clinical teaching practice, participation in multidisciplinary conference, and delegation of patient care. Those were indirect patient care. The order was physiologic integration(60.99%), safety and effective nursing environment, psychosocial care, and health maintenance and improvement. The most importance item in maintenance of physiologic integration was medication. Some of the highest index of importance were aseptic technique and application of principle of infection control, v/s check, observation of patient's status in operation and medication. Some of the lowest index of importance were activity as a lecturer in nursing department, preceptor's activity, activity of arrangement of community resources, participation in multidisciplinary conference, nursing conference, participation in clinical teaching, and delegation of job to nurse aids.

• Asian-Australasian Journal of Animal Sciences
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• 제28권11호
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• pp.1657-1661
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• 2015

Newborn chicks are susceptible to Salmonella enterica serovar Enteritidis (SE). The objective of this study was to evaluate the effect of Lactobacillus probiotic isolated from chicken feces on heterophil phagocytosis in broiler chicks. A total of 150 newborn broiler chicks were divided into 5 groups (30 chicks per group) as follows: group 1 (normal control), given feed and water only, group 2 (positive control) given feed, water and SE infection, group 3 (L61 treated) given feed, water, SE infection followed by Lactobacillus salivarius L61 treatment, group 4 (L55 treated) given feed, water, SE infection followed by L. salivarius L55 treatment, and group 5 given feed, water, SE infection followed by L. salivarius L61 + L55 combination treatment. After SE infection, L. salivarius treatment lasted for 7 days. The results showed that L. salivarius L61 and L. salivarius L55 treatment, either alone or combination of both, increased the survival rate after SE infection, and upregulated heterophil phagocytosis and phagocytic index (PI). Conversely, chick groups treated with Lactobacillus showed lower SE recovery rate from cecal tonsils than that of the positive control group. The PI values of the chicken group with SE infection, followed by the combination of L. salivarius L61 and L. salivarius L55 were the highest as compared to either positive control or normal control group. Two Lactobacillus strains supplementation group showed significantly (p<0.05) higher PI value at 48 h than 24 h after treatment.

• Journal of Preventive Medicine and Public Health
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• 제50권4호
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• pp.274-277
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• 2017

Objectives: Legionnaires' disease (LD) is a severe type of pneumonia caused by inhalation of aerosols contaminated with Legionella. On September 22, 2016, a single case of LD was reported from a newly built apartment building in Gyeonggi province. This article describes an epidemiologic investigation of LD and identification of the possible source of infection. Methods: To identify the source of LD, we interviewed the patient's husband using a questionnaire based on the Legionella management guidelines from the Korea Centers for Disease Control and Prevention. Water samples from the site were collected and analyzed. An epidemiological investigation of the residents and visitors in the apartment building was conducted for 14 days before the index patient's symptoms first appeared to 14 days after the implementation of environmental control measures. Results: Legionella pneumophila serogroup 1 was isolated from the heated-water samples from the patient's residence and the basement of the apartment complex. Thirty-two suspected cases were reported from the apartment building during the surveillance period, yet all were confirmed negative based on urinary antigen tests. Conclusions: The likely source of infection was the building's potable water, particularly heated water. Further study of effective monitoring systems in heated potable water should be considered.

• 치위생과학회지
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• 제13권3호
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• pp.254-263
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• 2013

본 연구는 국내 치과의료기관 감염관리 평가지표를 도출하고 타당성을 검증하고자 하는 연구로서 평가지표의 구성단계, 개발단계, 검증단계로 설계되었으며, 평가지표 구성단계에서 이론적 고찰과 모형의 적용, 평가지표의 개발단계에서 국내 치과병원 감염관리담당자를 대상으로 양적, 질적방법의 예비조사와 관련 전문가를 대상으로 설문조사와 면접조사가 실시되었으며 신뢰도, 안면타당도와 내용타당도검증을 실시하였고 전국의 치과병원 감염관리담당자 121명을 대상으로 감염관리 평가지표 항목에 대한 가중치 조사 및 현장 적용의 문제점을 확인하였다. 평가지표 검증 단계에서는 탐색적 요인분석과 경로분석을 통해 구성타당도를 확인하였다. 이상의 모든 통계적 처리는 PASW Statistics 18.0 프로그램과 AMOS 5.0 프로그램을 이용하였다. 연구의 결과로 국내 치과병원 감염관리 평가지표는 구조, 과정, 결과 영역이 수립되었으며 구조 영역에서 5개 평가요인에서 21개의 세부 평가지표가 도출되었고, 과정 영역에서 8개 평가요인에서 32개의 세부 평가지표가 도출되었으며, 결과 영역에서 1개 평가요인에서 5개의 세부 평가지표가 도출되어, 각 영역에서 총 14개의 평가요인과 58개의 세부 평가지표가 도출되었다. 또한 상관성이 성립되는 8개 평가요인에 대한 경로분석 결과 '표준주의지침($x_1$)', '감염관리지원체계($x_2$)', '내외부적 특성($x_3$)'은 다른 변수들에 영향을 주는 외생관측변수이고 '표준감염관리($y_1$)', '기구 장비관리, 손씻기($y_2$)', '환경감염관리($y_3$)', '개인보호장구($y_4$)', '세탁물 및 폐기물관리($y_5$)' 등은 다른 변수들로부터 영향을 받는 내생관측변수로 작용함을 알 수 있었다. 본 연구에서는 우리나라 치과의료기관 실정에 맞는 감염관리 표준을 위해 평가지표를 개발하고자 하였으며 개발된 치과의료기관 감염관리 평가지표를 통해 국내 치과의료기관 감염관리 체계 활성화 및 감염관리 우선순위 결정에 기여하고자 한다. 향후 치과의료기관 감염관리의 질적 제고를 위하여 감염관리 평가제도 및 인증제도 활성화를 제안하며 향후 지속적인 연구와 관심이 필요하다.

• Pediatric Infection and Vaccine
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• 제23권2호
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• pp.94-101
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• 2016

목적: 대학병원에 근무하던 중 활동성 폐결핵으로 진단된 전공의에게 노출된 의료종사자들에 대하여 실시한 접촉자 조사의 결과를 보고한다. 방법: 활동성 폐결핵 환자와 밀접한 접촉을 한 사람(접촉자) 101명 중 89명이 접촉자 조사에 응하여 조사를 받았다. 1차 접촉자 조사는 지표환자의 증상 개시 후 30일경에, 2차 조사는 1차 조사 10주 후에 기침, 발열, 인후통, 체중 감소와 같은 임상증상 확인 및 단순흉부촬영과 함께 결핵반응검사(Tuberculin skin test, TST)/QuantiFERON-TB Gold (QFT-G) 2단계 검사법을 시행하였다. 결과: 1차 TST 양성자는 34명(38.2%)이었고, TST 양성자 중 35세 이하 접촉자에서 시행한 QFT-G 양성률은 37.5% (6/16)이었다. 1차 TST 음성 대상자 41명에게서 시행한 2차 TST에서 17명(41.5%)이 양전을 보였고 그들 중 시행한 QFT-G 검사에서 3명(17.6%)이 양성이었다. 활동성 결핵으로 진단된 접촉자는 없었으며 지표환자에 노출되어 발생한 결핵 전파율은 2단계 검사법으로는 7.3% (3/41)였고, TST 진단법으로는 41.5% (17/41)였다. 결론: 국내에서 처음 보고되는 병원 내 결핵 접촉자 조사 연구로서 LTBI 발생률이 그 진단 기법에 따라 달랐으며 따라서 앞으로 발생할 수 있는 의료종사자들에 대한 병원 내 결핵 접촉자 조사를 위해 조직적이고 실용적인 가이드라인이 필요할 것이다.

• Fisheries and Aquatic Sciences
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• 제15권3호
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• pp.233-239
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• 2012

Hematological analysis can provide crucial information for monitoring the health of fish. However, there is no current information available regarding hematological changes in olive flounder following infection by Vibrio scophthalmi. In this study, hematological and biochemical alterations were determined in olive flounder infected by the high virulence strain (HVS) and low virulence strain (LVS) of V. scophthalmi. Survival in serum, skin mucus, and macrophages of olive flounder was also compared between the HVS and LVS. The results demonstrated that the hematocrit value in infected fish declined from 23.4% at 0 h to 18.0% at 168 h post infection. The total protein concentration in fish infected with the HVS was significantly higher than in fish infected with the LVS and a non-infected control. Lysozyme activity was significantly different between infected and control fish. The HVS survived in serum and cell numbers increased substantially, while cell numbers of the LVS in serum decreased. These changes in hematological characteristics in fish infected by V. scophthalmi can be used as an effective and sensitive index to monitor the physiological and pathological conditions of fish. The survival and reproduction of V. scophthalmi in host serum, skin mucus, and macrophages play a major role in systemic infection and can serve as a virulence indicator for different strains.