• 제목/요약/키워드: infection process

검색결과 517건 처리시간 0.03초

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

  • 박은숙;장경희;윤영옥;이정신;김태곤;여한승;김선호;신정원;이경원;김준명
    • 한국의료질향상학회지
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    • 제8권1호
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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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실험적으로 기니픽에 유발시킨 렙토스피라병에 대한 미생물학적 및 병리학적 연구 (Microbiological and Pathological Features of Experimentally Induced Leptospirosis in Guinea Pigs)

  • 장우현;김익상;이우곤;박경희;이재호;지제근;이정빈
    • 대한미생물학회지
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    • 제21권2호
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    • pp.211-226
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    • 1986
  • To understand the pathogenesis of anicteric leptospirosis with severe pulmonary hemorrhage occured in Korea, the microbiological and pathological features were observed in the experimentally induced leptospirosis in guinea pigs infected with a virulent strain of Leptospira interrogans isolated from the patient at Wonju, Korea, and the results are summarized as follows. 1. The main pathological features were widespread hemorrhages, especially affecting lung, skeletal muscles, retroperitoneal and perirenal adipose tissues. The hemorrhages accompanied inflammatory process especially of vasculitic pattern as well as occasional coagulation necrosis in the liver, skeletal muscle, and myocardium. The main inflammatory cells were of plasma cell even in the fairly early stage of the infection. 2. Those pathologic changes were more exaggerated in the inoculation site. 3. Within 144 hours of infection, the longer the infection time, the more antigens were observed in the tissues, and the severer the pathologic changes. 4. Leptospiral antigens were detected at first by indirect immunofluorescent and immunoperoxidase technics. As the infection time extended, the antigens were observed in all of the tissues examined except in the skeletal muscle. The shape of the antigens was spiral or thread-like within 72 hours of infection. As the infection progressed, they became fragmented and granular. 5. Leptospires were detected in the blood within 144 hours of infection by darkfield microscopic examination. Thereafter, none was observed. 6. Antibody to leptospires were detected as early as 72 hours of infection. In summary, the virulent strain of L. interrogans used in this experiment induced widespread hemorrhages with inflammatory reaction especially in lung, skeletal muscles, and retroperitoneal adipose tissue. With these findings, it is suggested that the direct toxic effect of leptospires might playa great role in the pathogenesis of this infection.

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Outcome of Intestinal Metaplasia in Gastric Biopsy of Patients with Dyspepsia in Guilan Province, North Iran

  • Mansour-Ghanaei, Fariborz;Joukar, Farahnaz;Soati, Fatemeh;Mansour-Ghanaei, Alireza;Atrkar-Roushan, Zahra
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권6호
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    • pp.3549-3554
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    • 2013
  • Background: It is generally accepted that gastric carcinomas are preceded by a sequential multistage process that includes chronic gastritis, gastric atrophy, usually with intestinal metaplasia (IM), and dysplasia. This series of changes in gastric carcinogenesis is often initiated by Helicobacter pylori (H pylori) infection. The aim of the present study was determination of gastric histopathologic changes in IM patients after at least one year in Guilan province, Iran. Materials and Methods: This case-series study was conducted in Guilan Gastrointestinal and Liver Disease Research Center (GLDRC) during 2010 to 2011. Gastric biopsy was performed for all 71 known cases of IM and precanceric lesions including gastric atrophy, IM, dysplasia and H pylori infection were determined after at least one year. Results: Of the total of 71 patients with established IM who were enrolled, 50 had complete-type IM and 21 had incomplete-type IM. Fifty two people had H pylori infection. H pylori eradication was achieved in 39 patients (75%). Secondary pathology findings of patients with IM were complete metaplasia (39.4%), incomplete metaplasia (32.4%), dysplasia (23.9%) and other precanceric lesions (4.2%). Dysplasia (20%vs 33%) occurred in patients who had complete and incomplete IM at baseline respectively (p>0.05). Age, gender, family history of gastric cancer(GC); smoking habits and NSAIDs use were not associated with gastric premalignant lesions in initial and secondary pathologies (p>0.05). The difference became statistically significant between H pylori infection in patients with more than 3 years diagnostic intervals (p<0.05). Statistical difference between eradicators and non-eradicators was not significant. Conclusions: We found that incomplete IM increased the risk of subsequent dysplasia in this study.

Serial Changes of MR Images Throughout the Stages of Infection of Spondylodiscitis

  • Kwon, Tae-Hyung;Shin, Zun-Zae;Kuh, Sung-Uk;Yoon, Young-Sul;Cho, Yong-Eun;Kim, Young-Soo
    • Journal of Korean Neurosurgical Society
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    • 제40권5호
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    • pp.351-356
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    • 2006
  • Objective : Spondylodiscitis has been diagnosed by clinical, radiological and laboratory methods. MR imaging is well known as an excellent diagnostic tool for spondylodiscitis. However, the changes in MR images throughout the treatment process has not been studied. Thus we have analyzed the serial changes of MR images throughout the stages of infection. Methods : Ten patients were selected for retrospective reviewed who had been treated at our institute for infectious spondylodiscitis between 2000 and 2005. These patients had been followed-up at least six months and had taken more than a couple of series of MR scans. We classified the MR images into four groups according to the stages of treatment for the infection and compared them to the clinical and laboratory findings. Results : MR image signals changed minimally or appeared to be normal in the early stages. The progression of spondylodiscitis was characterized by a low T1 WI signal and a high T2 WI signal in disc and vertebral body. The signal changes of the MR images were then propagated and the end plate was destructed. During the treatment, the destructed endplate became stabilized and the signal intensity of both T1 and T2 WI were fixed to low-or iso-intensity. Conclusion : We can determine the serial signal changes based on MR images according to the treatment of spondylodiscitis. We can therefore determine the status of the infection and the stage of treatment, as well as the diagnosis of spondylodiscitis using serial MR images.

급성 백혈병 환자에서 점막 질환과 진균감염의 외과적 처치 (SUGICAL TREATMENT OF MUCOSITIS AND FUNGAL INFECTION IN THE ACUTE LEUKEMIC PATIENTS)

  • 하원석;예영근;박재홍;표성운;윤현중;이상화
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제28권2호
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    • pp.172-177
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    • 2006
  • It is generally known that mucositis which often occur on hematopoietic disease patients, shows local necrosis of oral mucosa when the CBC is below the normal range. But sometimes, the lesions are occasionally infiltrate into adjacent tissue. When the pathologic destructive expansion is occurred, differential diagnosis with fungal infection, one of opportunistic infections, is needed. This means treatment and prognosis can be changed according to the diagnosis. So the diagnostic process is more important in this hematopoietic disease patients. In case of fungal infection, the range of tissue damage can expand broadly, and also proper antifungal agent and surgical extirpation should be done. After operation, continuous antifungal therapy and observations are needed. We made a comparative study of following 2 cases of fungal infection appeared on the acute lymphatic leukemia patients to discuss what the proper surgical treatment and medications are, and when the proper surgical intervention time is.

치성감염의 확산으로 인한 후인두간극농양: 증례보고 (Retropharyngeal space abscess due to spread of odontogenic infection: two cases report)

  • 정태영;채병무;정용선;박상준
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제36권4호
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    • pp.314-319
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    • 2010
  • Odontogenic infections are a normally locally confined, self-limiting process that is easily treated by antibiotic therapy and local surgical treatment. However, it may spread into the surrounding tissues through a perforation of the bone, and into contiguous fascial spaces or planes like the primary or secondary fascial spaces. If the infection extends widely, it may spread into the lateral pharyngeal and retropharyngeal space. The retropharyngeal space is located posterior to the pharynx. If an odontogenic infection spreads into this space, severe life-threatening complications will occur, such as airway obstruction, mediastinitis, pericarditis, pleurisy, pulmonary abscess, aspiration pneumonia and hematogenous dissemination to the distant organs. The mortality rate of mediastinitis ranges from 35% to 50%. Therefore, a rapid evaluation and treatment are essential for treating retropharyngeal space abscesses and preventing severe complications. Recently, we encountered two cases of a retropharyngeal space abscess due to the spread of an odontogenic infection. In all patients, early diagnosis was performed by computed tomography scanning and a physical examination. All patients were treated successfully by extensive surgical and antibiotic therapy.

대상포진 후 피부의 2차 감염으로 인한 단독 증례 보고 1례 (A case report of erysipelas, from secondary skin infection after herpes zoster)

  • 김하얀;김선미;하광수;하수연;송인선;정아롱;홍솔이
    • 대한한방소아과학회지
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    • 제20권3호
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    • pp.97-104
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    • 2006
  • Objectives : There were few reports on Erysipelas, from Secondary Skin Infection after Herpes Zoster. We treated Erysipelas, from Secondary Skin Infection after Herpes Zoster with Oriental medical approach, and got a significant results. So We are reporting this case. Methods : Herb medication, acupuncture treatment were applied for treating patient`s chief symptoms (erythema, heat sensation, swelling, pain, itching and general weakness) Results : The patient was 5-year-old boy who had the symptoms caused by Erysipelas, which was caused by secondary skin infection after herpes zoster. He had erythema, heat sensation, swelling, pain, itching and general weakness. We judged him as Soyangin(少陽人), and prescribed Hyeongbangsaback-san. After he took Hyeongbangsaback-san, the symptom and general condition were improved. In this report, we want to explain the healing process and the result of the treatment of Erysipelas. Conclusions : More study about oriental treatment on Erysipelas, from Secondary Skin Infection after Herpes Zoster is needed.

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Timing of Fusarium Head Blight Infection in Rice by Heading Stage

  • Kim, Yangseon;Kang, In Jeong;Shin, Dong Bum;Roh, Jae Hwan;Heu, Sunggi;Shim, Hyeong Kwon
    • Mycobiology
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    • 제46권3호
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    • pp.283-286
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    • 2018
  • Fusarium graminearum causes the devastating plant disease Fusarium head blight and produces mycotoxins on small cultivated grains. To investigate the timeframe of F. graminearum infection during rice cultivation, a spore suspension of F. graminearum was applied to the rice cultivars Dongjin 1 and Nampyeongbyeo before and after the heading stage. The disease incidence rate was the highest (50%) directly after heading, when the greatest number of flowers were present, while only 10% of the rice infected 30 days after heading showed symptoms. To understand the mechanism of infection, an F. graminearum strain expressing green fluorescent protein (GFP) was inoculated, and the resulting infections were visually examined. Spores were found in all areas between the glume and inner seed, with the largest amount of GFP detected in the aleurone layer. When the inner part of the rice seed was infected, the pathogen was mainly observed in the embryo. These results suggest that F. graminearum migrates from the anthers to the ovaries and into the seeds during the flowering stage of rice. This study will contribute to uncovering the infection process of this pathogen in rice.

Systematic Literature Review on Coronavirus Infectious Disease-19 and Dental Masks

  • Kim, Ji-Hyun;Kim, Min-Young
    • 치위생과학회지
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    • 제21권1호
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    • pp.1-7
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    • 2021
  • Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is transmitted primarily through droplets, and dental practitioners are at risk of occupational exposure to SARS-CoV-2 infection owing to direct contact with the patient's mouth, aerosols from dental procedures, and saliva. Wearing a mask is believed to be the best method of protection against infection, and a systematic literature review was conducted on whether the dental masks used in dentistry are effective in preventing Coronavirus Infectious Disease-19 (COVID-19). Methods: We used PubMed, Google Scholar, DBpia, NDSL, and KISS databases for this study. Of the 917 documents narrowed down by the search terms "Coronavirus, COVID-19, and dental," 83 documents were collected and studied. Ultimately, 42 of these papers were selected for analysis after considering duplication from the flow chart of the literature selection process. Results: While dental masks are often used when treating patients with unknown COVID-19 status, the Ministry of Food and Drug Safety stated that the use of dental masks is insufficient in preventing cross-transmission of COVID-19; instead, it was recommended that N95 masks, which correspond to KF94 masks, should be worn daily. On the other hand, wearing a dental mask and following precautions such as hand hygiene may not pose a significantly higher risk of infection than wearing an N95 mask when treating COVID-19 patients. Conclusion: There is an ongoing discussion regarding the use of dental masks when treating dental patients, and many argue that different types of masks should be selected according to the degree of infection and the individual's respiratory condition. By considering the safety and efficacy of dental masks in preventing infection, improvements can be made in the management of COVID-19 and dental-related infections.