• Pediatric Infection and Vaccine
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• v.31 no.1
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• pp.64-74
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• 2024

Purpose: Despite the recent increased number of nosocomial measles, the outbreak investigation reports are not usually standardized, thus posing unclear understanding of magnitude of its public health burden. We used the Outbreak Reports and Intervention Studies of Nosocomial Infection (ORION) statement, to compare nosocomial outbreaks and synthesize evidence to prevent hospital transmission of measles. Methods: A PubMed, Web of Science, Embase, Scopus, and Cochrane search in English, using the medical subject headings "measles," "nosocomial," "hospital," and "healthcare," was performed. We evaluated the quality of outbreak reports of nosocomial measles infection worldwide using the ORION statement findings and recommendations. Results: We reviewed 24 studies in accordance to the ORION statement. Measles transmission in healthcare settings is a significant burden on the morbidity, mortality, and economy of measles. The healthcare workers' booster vaccination guidelines should be monitored and enhanced during the post-elimination period of measles. The outcomes of infections must be explicit for outbreak reports. Conclusions: This study identified the epidemiological and clinical characteristics of nosocomial measles infections and provided strong evidence for infection control policies in hospitals.

• Parasites, Hosts and Diseases
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• v.47 no.3
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• pp.269-273
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• 2009

A 57-year old man who was admitted to an emergency room of a tertiary hospital with hemoptysis developed malarial fever 19 days later and then died from severe falciparum malaria 2 days later. He had not traveled outside of Korea for over 30 years. Through intensive interviews and epidemiological surveys, we found that a foreign patient with a recent history of travel to Africa was transferred to the same hospital with severe falciparum malaria. We confirmed through molecular genotyping of the MSP-1 gene that Plasmodium falciparum genotypes of the 2 patients were identical. It is suggested that a breach of standard infection control precautions resulted in this P. falciparum transmission between 2 patients in a hospital environment. This is the first report of a nosocomial transmission of falciparum malaria in Korea.

• Journal of Korean Academy of Nursing
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• v.36 no.7
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• pp.1204-1214
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• 2006

Purpose: This retrospective study was done to evaluate the status of nosocomial urinary tract infections and to determine the risk factors and transmission route of causal IRPA through molecular epidemiology. Method: Two hundred ninety-nine of 423 patients admitted to the internal medicine and surgery ICU at a university hospital incity B had a positiveurine culture. Twelve of the 299 patients who had a urinary tract infection had IRPA strains. The data was collected from November 1, 2004 to January 31, 2005. The following results were obtained after the data was analyzed using percentile and UPGMA. Result: The rate of nosocomial urinary tract infections in the ICU was 10.8%. Therewere 16.8 cases of infection based on the period of hospitalization. There were 16.9 cases of infection based on the use of a foley catheter. The rate of nosocomial urinary tract infection in the ICU and urinary tract infections related to IRPA were higher in patients with the following characteristics: men, old age, admission through the emergency room, longer than seven days admission, severity of admitting causes, disturbance of consciousness, hydration less than 300cc in 24hours, a long course of antibiotics, a long period of foley catheterization and perineal care. Most of the microorganisms that caused the urinary tract infection were gram negative bacilli, among which P. aeruginosa was found in 70 patients (18.5%) and IRPA in 12 (4.0%). Among the 12 IRPA strains that were tested with PFGE, eight showed a dice coefficient higher than 80%, suggesting a genetic relationship. They were related with the period of hospitalization in the same ICU. These patients all received direct care for a urinary tract infection. Conclusion: Through these results, IRPA can be consideredas a contributing factors to urinary tract infections thus, active preventative measures are needed by the medical staff.

• Biomedical Science Letters
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• v.10 no.3
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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.

• Clinical and Experimental Pediatrics
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• v.61 no.11
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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.

• Korean Journal of Health Education and Promotion
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• v.32 no.3
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• pp.1-9
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• 2015

Objectives: The purpose of this article was to assess epidemiological characteristics and recommendations for strengthening national response and preparedness after MERS-CoV outbreak in Korea, 2015. Methods: The author reviewed epidemiological reports and policy recommendations on MERS-CoV outbreak in Korea, 2015. Results: There was no evidence that genetical difference between the MERS viruses in the Republic of Korea and recent viruses in the Middle East. From the index case to last laboratory-confirmed case, there were 186 laboratory-confirmed cases that included 36 deaths(19.4%), all of whom appear epidemiologically linked to the index cases or subsequent secondary, tertiary, and quaternary cases. This outbreak spread to hospitals through nosocomial transmission. At least, three large clusters were investigated. However, there was at least one case of community transmission of MERS-CoV. Several factors had contributed to the MERS outbreak in Korea, 2015 that including epidemiological characteristics, and infrastructure of national healthcare system for preventing and controlling emerging infectious diseases. Conclusions: It is very important that to share experiences and identify underlying causes of this outbreak for prevention and control of emerging infectious disease in the future; including epidemiology, clinical features, and public health response and preparedness.

• Journal of Microbiology and Biotechnology
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• v.31 no.5
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• pp.733-739
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• 2021

Acinetobacter strains are widely present in the environment. Some antimicrobial-resistant strains of this genus have been implicated in infections acquired in hospitals. Genetic similarities have been reported between Acinetobacter strains in nosocomial infections and those isolated from foods. However, the antimicrobial resistance of Acinetobacter strains in foods, such as meat, remains unclear. This study initially aimed to isolate Campylobacter strains; instead, strains of the genus Acinetobacter were isolated from meat products, and their antimicrobial resistance was investigated. In total, 58 Acinetobacter strains were isolated from 381 meat samples. Of these, 32 strains (38.6%) were from beef, 22 (26.5%) from pork, and 4 (4.8%) from duck meat. Antimicrobial susceptibility tests revealed that 12 strains were resistant to more than one antimicrobial agent, whereas two strains were multidrug-resistant; both strains were resistant to colistin. Cephalosporin antimicrobials showed high minimal inhibitory concentration against Acinetobacter strains. Resfinder analysis showed that one colistin-resistant strain carried mcr-4.3; this plasmid type was not confirmed, even when analyzed with PlasmidFinder. Analysis of the contig harboring mcr-4.3 using BLAST confirmed that this contig was related to mcr-4.3 of Acinetobacter baumannii. The increase in antimicrobial resistance in food production environments increases the resistance rate of Acinetobacter strains present in meat, inhibits the isolation of Campylobacter strains, and acts as a medium for the transmission of antimicrobial resistance in the environment. Therefore, further investigations are warranted to prevent the spread of antimicrobial resistance in food products.

• Clinical and Experimental Pediatrics
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• v.51 no.10
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• pp.1071-1076
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• 2008

Purpose : Respiratory syncytial virus (RSV) is the most frequent cause of lower respiratory infections in infants and young children. Early detection allows quarantining of infected inpatients to prevent nosocomial transmission and to choose a treatment. To achieve rapid reporting, to facilitate prompt antiviral therapy, and to avoid unnecessary use of antibiotics, an easy, rapid diagnostic method for RSV is needed. We evaluated a lateral flow immunochromatography (RSV Respi-Strip test) and EIA (Enzyme immuno assay) compared to RT-PCR. Methods : From April 2007 to March 2008, 112 consecutive respiratory specimens (nasopharyngeal aspirates, throat swabs, tracheal aspirates, sputum) from patients who were suffering from the clinical signs and symptoms of respiratory tract infection were enrolled in Busan. A total of 112 patients were tested with RSV Respi-Strip (Corio-BioConcept, Belgium), EIA, and RT-PCR at the same time. Results : Of the 112 specimens tested, the number of children who showed positive results at RT-PCR and Respi-Strip were 45 and 42, respectively. The Respi-Strip rapid antigen test had a sensitivity of 88% and a specificity of 94%. The positive and negative predictive values were 90% and 92%, respectively. The agreement was 83%. Conclusion : In our study, the rapid antigen test had as much sensitivity as any method for detection of RSV. The test has many advantages such as easy performance, simple interpretation, and rapid results. If the rapid antigen test is widely applied in the clinical setting, the may be useful for diagnostic and epidemiological studies of RSV infection.

• 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.

• 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.