• Title/Summary/Keyword: staphylococci

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Analysis of Central Line-associated Bloodstream Infection among Infants in the Neonatal Intensive Care Unit: A Single Center Study

  • Kim, Minhye;Choi, Sujin;Jung, Young Hwa;Choi, Chang Won;Shin, Myoung-jin;Kim, Eu Suk;Lee, Hyunju
    • Pediatric Infection and Vaccine
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    • v.28 no.3
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    • pp.133-143
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    • 2021
  • Purpose: This study aimed to determine the incidence of central line-associated bloodstream infection (CLABSI) in the neonatal intensive care unit (NICU), evaluate the patients' clinical characteristics, and identify the etiologic agents for guidance in prevention and treatment. Methods: A retrospective chart review study of infants classified as having CLABSI was conducted at the NICU of Seoul National University Bundang Hospital from January 2016 to December 2020. Results: Of the 45 infants, 53 had CLABSIs within a follow-up period of 18,622 catheter days. The incidence of CLABSIs was 2.85 per 1,000 catheter days. The most common catheter type was a peripherally inserted central catheter (n=47, 81%). A total of 57 pathogens were isolated, of which 57.9% (n=33) were Gram-positive bacteria, 36.8% (n=21) were Gram-negative bacteria, and 5.3% (n=3) were Candida spp. The most common pathogens were Staphylococcus aureus (n=12, 21%) and coagulase-negative staphylococci (n=12, 21%), followed by Klebsiella aerogenes (n=8, 14%). The median duration of bacteremia was 2 days, and 19 episodes showed bacteremia for 3 days or more. The mortality rate of infants within 14 days of CLABSI was 13.3% (n=6). Conclusions: This study analyzed the incidence of CLABSI and the distribution of pathogens in the NICU. Continuous monitoring of CLABSI based on active surveillance serves as guidance for empiric antibiotic use and also serves as a tool to assess the necessity for implementation of prevention strategies and their impact.

The Evaluation of Teicoplanin Usage in a University Hospital (대학병원에서의 Teicoplanin의 사용 현황 조사 및 실태 평가)

  • Kim, Eun A;Oh, Jung Mi
    • Korean Journal of Clinical Pharmacy
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    • v.11 no.1
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    • pp.19-29
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    • 2001
  • Teicoplanin, a glycopeptide antibiotic, has potential for use as an alternative to vancomycin in the treatment of gram-positive bacterial infections. However, unlike vancomycin, there is a lack of study on teicoplanin's efficacy and safety and the guideline for its use is not available, yet. The objective of this study was to investigate and evaluate the pattern of teicoplanin usage in a university hospital. A retrospective study was performed on 72 adult patients, who took teicoplanin for 3 continuous days at D. University hospital from 1 January 1999 to 30 June 2000. The microorganisms treated with teicoplanin were methicillin-resistant Staphylocorcus aureus $(69\%)$, coagulase-negative Staphylococci $(12\%)$, Enterococcus $(4\%)$, vancomycin-resistant Enterococci $(2\%)$, Streptococci $(2\%)$, and Bacillus $(1\%)$. The types of infection treated with teicoplanin were surgical wound infection $(58\%)$, lower respiratory infection $(11\%)$, bactremia $(7\%)$, urinary tract infection $(5\%)$, pleural fluid infection $(4\%)$, and peritoneal fluid infection $(2\%)$. The mean duration of teicoplanin usage was 16.5 days and teicoplanin was used with 1.4 other antibiotics, which were aminoglycosides (isepamicin, amikacin, netilmicin, astromicin) or quinolones (ciprofloxacin, tosufloxacin) or the third generation cephalosporin (ceftazidime). Only 24 cases $(28.6\%)$ met with the criteria for the justification of use, and the rest of 60 cases $(71.4\%)$ did not meet the criteria. In 84 cases $(100\%)$, blood culture tests were performed prior to the initial dose of teicoplanin. In 83 cases $(99\%)$, serum creatinine were conducted before the initial doses. In 45 cases $(53.6\%)$, serum creatinine was monitored at least twice weekly. In 55 cases $(65.5\%)$, WBC was tested at least twice weekly. In 84 cases $(100\%)$, body temperature was monitored at least once per nursing shift. In 15 cases out of 56 cases, maximum temperature decreased at least 1 degree within 3 days of teicoplanin use. In 15 case out of 35 cases, WBC values were within the normal range after treatment. In 23 cases $(27.4\%)$, dosage regimen was appropriate. Drug-related adverse effects were reported in 13 cases. Nephrotoxicity (progressively increasing SCr. or sustained SCr increase of $\geq$0.5 mg/dl from baseline) was noted in five cases. Neutropenia (absolute neutrophil count <1,500 $cells/mm^3$) was noted in one case and eosinophilia (total eosinophil count >350 $cells/mm^3$) was noted in seven cases. A more strict control on use of teicoplanin is required, considering that teicoplanin is categorized as one of restricted antibiotics.

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Environmental Microbial Assessment of Food Services at Elementary Schools in Western Gyeongnam Pyovince (서부 경남 지역 초등학교 급식소에서의 환경미생물 평가)

  • 박선자;하광수;심원보;박민경;정덕화
    • Journal of Food Hygiene and Safety
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    • v.18 no.1
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    • pp.14-24
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    • 2003
  • Two aims of the present study were the evaluation of hygienic, microbial safety on food services of elementary schools in Western Gyeongnam province, and then, the construction of database for the SSOP (Sanitation Standard Operation Procedures) practice. A total of 98 samples were collected from drinking water, waterworks, kitchen utensils, kitchen equipments, employees and cooked foods. Total bacteria was counted and pathogenic bacteria such E. coli, salmonella, yersinia, vibrio parahaemolyticus and staphylococcus were identified based on the biochemical analysis. Following are the results: the number of bacteria showed from 1.0x10$^2$CFU/ mL to 1.0x10$^{6}$ CFU/mL in most samples, which the level exceeds normal range. Over 1.0x10$^{5}$ CFU/ml bacteria were observed from the kimchi in 4 places (B, C, D, E), because cooked food such as kimchi had not been heated. As a rule, the bacterium level in place B was higher than that in any of the other places. E-coli were isolated from kitchen knives (C, E) and Kimchi (E): staphylococci were isolated from drinking water (A), hands (D), refrigerator (E) and apron (E). But, salmonella, vibrio and yersinia were not detected in anywhere. In conclusion, the presence of bacteria and pathogenic agents in school food service was closely related to hygienic practice. For that reason, it is necessary to have more systematic and efficient management in order to enhance the food safety.

Effect of PSE Pork on Physiochemical and Microbiological Properties of European Style Fermented Sausages during Ripening (원료육질이 발효소세지의 이화학적인 성상과 미생물 특성에 미치는 영향)

  • Chin, Ku-Bok;Ji, Seung-Taek;Seo, Seon-Woo;Shin, Heuyn-Kil
    • Korean Journal of Food Science and Technology
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    • v.23 no.6
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    • pp.661-666
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    • 1991
  • European style fermented sausages were made with normal pork, PSE and a 50 : 50 mixture, inoculated with Lactobacillus plantarum 1-74 and Staphylococcus simulans MIII and ripened for 21 days following commercial manufacturing procedures. In all treatments, pH droped sharply between 0 and 3 days during ripening. PSE sausages showed the lowest pH and Aw at the end of ripening than other treatment groups. Protein solubility, hardness, cohesiveness and chewiness were significantly (P<0.05) low for PSE sausages. Springiness was the highest for normal sausages but the other two treatment were not different. PSE sausages had poor texture low redness value during the ripening. The added sugars apparently dropped the pH fast in PSE sausages. Total bacterial count and lactobacilli increased from 0 day to the third day of ripening. The number of Staphylococcus sp. decreased in normal sausages by the end of the ripening period. Fermented sausages with PSE meat could be produced if the mixture had lower (<50%) amounts of PSE meat. In addition, added sugar must be reduced to prevent lowering the pH to a level that will affect processing and quality attributes of fermented sausages.

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Photodynamic effect of Photofrin and Radachlorin against Staphylococcus aureus and Staphylococcus epidermidis (황색포도알균과 표피포도알균에 대한 포토프린과 라다클로린의 광역학 효과)

  • Seo, Choong-Won;Ryu, Jae-Gi;Kwon, Pil-Seung
    • Journal of Digital Convergence
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    • v.12 no.6
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    • pp.407-414
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    • 2014
  • The aim of this study was to evaluate the photodynamic therapy effects against staphylococci using Photofrin and Radachlorin with Light emitting diode(LED). Experimental methods, The bacterial suspensions containing Staphylococcus aureus and Staphylococcus epidermidis at $1{\times}10^5$ were prepared and diluted to different concentrations of photosensitizer, Photofrin or Radachlorin, on 1.25, 2. 5,5 and $10{\mu}g/ml$. The bacterial suspensions were exposed to 630 and 670 nm LED light at the energy density of 14.4 and $19.8J/cm^2$, respectively. The CFU results of S. aureus and S. epidermidis were showed 33 and 50 colony forming at $5{\mu}g/ml$ of Photofrin, respectively and both of them perfectely were dead at $5{\mu}g/ml$ of Radachlorin. The fluorescent intensity by flow cytometry was showed the increase in the dead cells than the normal cells. In the TEM photograph, the damage of bacterial membrane and the distortion of cell morphology were observed. These results suggest that photodynamic therapy combine with Photofrin and Radachlorin can be applied a new modality for antibacterial therapy.

Study on the Amendment of Standard Regulations of Food Additives and Contaminants for Infant Formulas in Korea (우리나라 영.유아용 조제식의 식품첨가물과 오염물질 기준 개선방안 연구)

  • Moon, Ji-Hea;Lee, Heon-Ok;Shim, Jae-Young;Kim, In-Hye;Shin, Hye-Seoung;Won, Sun-Im;Paik, Min-Kyoung;Shin, Hyoung-Soo;Om, Ae-Son
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.37 no.9
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    • pp.1214-1221
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    • 2008
  • The aim of this study is to propose suggestions for establishing Korean regulatory standards of infant formula. Accordingly, the regulatory standards for food contaminants and additives in Korean infant formulas were compared and analyzed with those in CODEX, EU, Australia and New Zealand. Several suggestions for regulations were found from different countries. Firstly, it is advisable that additives for nutrient supplement of infant formula be classified as types of nutrients. Secondly, it is proposed that guidelines should be set on the maximum amount of additives in infant formula. Thirdly, pathogens such as Staphylococci and Salmonella of infant formula should be regulated. Finally, present regulations need to establish the maximum permissible levels of some pesticides, Pb and Al, that other countries are already regulating. These proposed recommendations would broaden the scope of infant formula regulatory standards needed for infants' health.

Antibiotic Susceptibility to Isolated Bacteria and Fungi from the Indoor-air (실내 공기중에서 세균 및 진균의 분포와 분리균의 항생물질 감수성)

  • 장명웅;장태호;박인달;김광혁
    • Journal of Life Science
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    • v.8 no.5
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    • pp.537-549
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    • 1998
  • This investigation was performed to isloate and identify the total bacteria, Staphylococcus spp. and fungi from the indoor air exposed for 30 minutes on the blood agar plate at the 27 places in a hospital. Antibiotic susceptibility tests of the isolated bacteria were also studied. The mean numbers of total bacteria, Staphylococci spp. and fungi were 26, 17, and 2 in the summer and 19, 8, and 2 in the winter, respectively. Staphylococcus epidermidis was the most common isolated bacteria, and the next was Staphylococcus aureus, Aerococcus spp., Micrococcus spp., and Bacillus spp. from the indoor-air of hospital. Aspergillus spp., Cephalosporum spp., Curvularia spp., penicillium spp., and Phialophora spp. was frequently isolated from the indoor-air of hospital. The 109 strains of isolated Staphylococcus epidermidis sho-wed resistance to tetracycline(45.0%), methicillin(40.2%), erythromycin(31.2%), and kanamycin(24.8%). The 76 strains of isolated Staphylococcus aureus showed resistance to erythromycin(71.7%), methicillin(63.2%), kanamycin (44.7%), tetracycline(39.5%), and ampicillin(32.9). The 67 strains of isolated Aerococcus spp. showed resistance to erythromycin(26.9%), methicillin(25.4%), kanamycin(22%), and tetracycline(22.4%). The 48 strains of isolated Micrococus spp. showed resistance to tetracycline(27.0%), methicillin(22.9%), erythromycin(22.9%), and kanamycin(20.8%).

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Risk Factors for Complications after Reconstructive Surgery for Sternal Wound Infection

  • Hashimoto, Ichiro;Takaku, Mitsuru;Matsuo, Shinji;Abe, Yoshiro;Harada, Hiroshi;Nagae, Hiroaki;Fujioka, Yusuke;Anraku, Kuniaki;Inagawa, Kiichi;Nakanishi, Hideki
    • Archives of Plastic Surgery
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    • v.41 no.3
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    • pp.253-257
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    • 2014
  • Background Although the utility of flaps for the treatment of sternal wound infections following median sternotomy has been reported for 30 years, there have been few reports on the risk factors for complications after reconstruction. The objective of this investigation was to identify factors related to complications after the reconstruction of sternal wound infections. Methods A retrospective analysis of 74 patients with reconstructive surgery after sternal wound infection over a 5-year period was performed. Clinical data including age, sex, body mass index (BMI), comorbidities, bacterial culture, previous cardiac surgery, wound depth, mortality rate, type of reconstructive procedure, and complication rate were collected. Results The patients' BMI ranged from 15.2 to $33.6kg/m^2$ (mean, $23.1{\pm}3.74kg/m^2$). Wound closure complications after reconstructive surgery were observed in 36.5% of the cases. The mortality rate was 2.7%. Diabetes mellitus significantly affected the rate of wound closure complications (P=0.041). A significant difference in the number of complications was seen between Staphylococcus aureus (S. aureus) and coagulase-negative Staphylococci (P=0.011). There was a correlation between harvesting of the internal thoracic artery and postoperative complications (P=0.048). The complication rates of the pectoralis major flap, rectus abdominis flap, omentum flap, a combination of pectoralis major flap and rectus abdominis flap, and direct closure were 23.3%, 33.3%, 100%, 37.5%, and 35.7%, respectively. Conclusions Diabetes mellitus, S. aureus, harvesting of the internal thoracic artery, and omentum flap were significant factors for complications after reconstruction. The omentum flap volume may be related to the complications associated with the omentum flap transfer in the present study.

Clinical Features of Brain Abscesses in Neonates and Children: A Single Center Experience from 1997 to 2006 (단일기관에서 조사한 소아 뇌농양의 임상양상(1997-2006))

  • Lee, Teak Jin;Chu, Jin-Kyong;Kim, Ki Hwan;Kim, Khi Joo;Kim, Dong Soo
    • Pediatric Infection and Vaccine
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    • v.15 no.1
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    • pp.30-35
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    • 2008
  • Purpose : We evaluated clinical presentations of brain abscesses, including predisposing factors, causative organisms, and mortality rate in neonates and children. Methods : We retrospectively reviewed the medical charts of neonates and children with brain abscesses treated at Severance Hospital from January 1997 through December 2006. Results : Among 27 neonates and children with brain abscesses, overall mortality was 22 % and 38% of survivors developed neurologic sequelae. The mortality rate was 38% in 8 infants with brain abscesses. The most common location of brain abscesses were frontal and parietal lobes, followed by temporal lobe. There were 7 cases with multiple brain abscesses. Streptococci (33%), Staphylococci (27%), and Gram-negative enterics (20%) were commonly isolated. The common predisposing conditions were neurosurgical procedure (30 %), cyanotic congenital heart disease (15%), and sinusitis/otitis (7%). Fever (74%), headache (37%), nausea/vomiting (33%), and altered mental status (33%) occurred commonly. Compared with children older than 1 year of age, infants were associated with multiple brain abscesses (63%, P=0.011) and high rates of death or neurologic sequelae (88%, P= 0.033). Conclusion : We should have a high index of suspicion in order to recognize the condition as early as possible, especially in infancy with brain abscesses who presents vague or nonspecific symptoms and signs.

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Microbiological Evaluation of Chilled Freshes Raw-fish Manufacturers before and after HACCP System Establishment (싱싱회류 생산업체의 HACCP 시스템 구축 전 후의 미생물학적 평가)

  • 박완희;이성학;정덕화
    • Journal of Food Hygiene and Safety
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    • v.19 no.2
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    • pp.74-83
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    • 2004
  • Raw-fish food contains a lot of moisture and is a high-protein food. It is a first-stage processed food taking a lot of manual work. Therefore, it is classified as a PHF food, very liable to cause a bacterial food-poisoning. But its manufacturers are usually small-sized and a systematic sanitation management is difficult to expect. But the manufacturer participating in this study produces chilled fresh raw-fish food. Fish are sliced into two fillets, which are packaged under vacuum, kept and distributed in refrigerators, and sold within a day. It is a newly-developed kind of raw-fish food, and a more improved kind of raw-fish food making possible a systematic sanitation management. The HACCP (Hazard Analysis and Critical Control Point) is a systematic and continuous process-control method which is very efficient for controling food sanitation and reducing the expenses. A new HACCP model has been developed to be applied to a large-sized chilled fresh raw-fish food manufacturer. To ascertain its efficiency, the baterial examination was done to its workplace and products. The significance test was done on its data by "SPSS 12.0 for Window" and "Mann-Whitney U Test". The numbers of bacteria on its final products were significantly different in flatfish and porgy. The number of bacteria tended to decrease in each time-differential sampling (P<.00l). The final food products showed no food-poisoning bacteria in all the time-differential tests and in all the samplings, which proves that the CCP of the HACCP system is under control. After the SSOP program was applied, no pathogenic bacteria were found in the work-place, and the kinds and numbers of bacteria decreased. The numbers of general bacteria and colon bacilli also showed a significant difference from those before the SSOP program in the filleting board (P<.05), in the skinning board (P<.0l), in the neck-removing knife (P<.05), and in the filleting knife (P<.01). The working equipments, periodically disinfected, also showed a significant difference in sanitary conditions (in the dehydrator, P<.05). The number of bacteria found on the food-touching surface was within the standard (below 500/l00 cm$^2$) After the SSOP program was applied, the general bacteria and colon bacilli were not found. The quality of water used in the food processing was also within the standard. The numbers of bacteria falling from the air in the work-place were negligible in all the samplings (<30CFU/l000ι). The staphylococci and fungi were not found.