• Pediatric Infection and Vaccine
• /
• v.29 no.3
• /
• pp.141-146
• /
• 2022

Purpose: Congenital tuberculosis (TB) is difficult to diagnose owing to its non-specific symptoms. Delayed diagnosis increases the risk of nosocomial infections. We examined the TB status of infants and healthcare workers who were in proximity to preterm twins diagnosed with congenital TB 63 days after birth and 48 days after admission to the neonatal intensive care unit (NICU). Methods: Contact investigations were conducted on 24 staff members and 35 infants who had contact with the twins with congenital TB. Results: Two of the exposed infants, both of whom had received the Bacille Calmette-Guérin vaccine, had positive tuberculin skin test results. Four of the 24 exposed staff members had positive interferon-gamma release assay (IGRA) test results before exposure and were not re-tested after exposure; the remaining 20 had negative IGRA test results. All exposed staff members and infants had normal chest radiographic findings. Conclusions: Although transmission of TB in the NICU is unusual, it can occur. These results support the need for a systematic investigation of the TB status of exposed infants, their family members, and healthcare workers.

• Clinical and Experimental Pediatrics
• /
• v.48 no.9
• /
• pp.946-952
• /
• 2005

Purpose : Vancomycin-resistant enterococci(VRE) are now nosocomial pathogens in Korea. But little is known about the prevalence of stool colonization with VRE in neonates in Korea. So we studied the prevalence and risk factors of VRE colonization in the Neonatal Intensive Care Unit(NICU). Methods : From January 2000 to December 2004, the medical records of 294 neonates(127 cases of VRE group and 167 cases of non-VRE group, according to the results of stool culture) were reviewed retrospectively. We studied the annual prevalence of VRE and risk factors of VRE colonization in neonates. Results : From 2000 to 2003, the prevalence rate of VRE in NICU increased. After preventing VRE transmission, the prevalence rate of VRE has decreased. Conclusion : VRE colonization increased recently. Risk factors of VRE colonization were prematurity, lower birth weight, longer hospitalization and use of vancomycin or 3rd generation cephalosporin, compared with the non-VRE group. To prevent VRE transmission among newborns, aggressive infection control strategies by NICU staffs must be implemented immediately for all babies.

• Tuberculosis and Respiratory Diseases
• /
• v.60 no.3
• /
• pp.277-284
• /
• 2006

Background : Delayed treatment of pulmonary tuberculosis is an important problem because it results in greater mortality and the nosocomial transmission of tuberculosis. This study was conducted to analyze the factors that contribute to the delayed treatment of pulmonary tuberculosis in a university hospital and we wanted to provide basic data for instituting an effective management program for tuberculosis. Methods : we retrospectively reviewed the medical records of 155 patients with smear-positive or culture-positive pulmonary tuberculosis and who were treated between May 1999 and October 1999. A case-control study was performed to analyze the factors. We then tried to follow up the patients in delayed treatment group via telephone for the purpose of assessing the therapeutic interventions. Results : Among 150 patients, 55 (37%) were included in the delayed treatment group. The factors associated with delayed treatment on the univariate analysis included age (61 vs 40 years old; p <0.001), a smear-negative sputum test for acid-fast bacilli (AFB) (85% vs 55%; p <0.001) and no visits to a private clinic before the patient presented to the university hospital (56% vs 36%; p = 0.014). Multivariate analysis revealed that old age (p = 0.001), a smear-negative sputum for AFB (p = 0.001), and lower lobe infiltrate on chest X-ray (p = 0.041) were the independent predictors of delayed treatment. Of the 22 patients who did not receive any treatment, 20 of them 91%) consented to our suggestion of revisiting the hospital. Conclusion : Delayed treatment of patients with pulmonary tuberculosis is not uncommon in a university hospital. Old age, smear-negative for AFB, and lower lobe infiltrate on chest X-ray are the risk factors for delayed treatment. A more systematic management system is required for achieving better control of tuberculosis.