BACKGROUND: This study aimed to examine the underreporting rate and related factors after needlestick injuries among healthcare workers (HCWs) in small- or medium-sized hospitals. METHODS: Convenience sampling was conducted for 1,100 HCWs in 12 small- or medium-sized hospitals with less than 500 beds. From October 1 to November 30, 2010, data were collected using self-report questionnaire that was developed by researcher. The response rate for the study was 98.3% (982 HCWs). Data were analyzed using Statistical Package for the Social Sciences (SPSS) Win 12.0. RESULTS: The reports showed that 239 HCWs (24.3%) sustained needlestick injuries within the last year. The under-reporting rate after a needlestick injury was 67.4% (161/239), and underreporting rates varied across the hospitals and ranged from 46.2% to 85.7%. The major reasons for underreporting after needlestick injuries were the assumption that no blood-borne pathogens existed in the source patient (62.8%), annoyance (17.9%), and no knowledge about the reporting procedure (6.0%). Multiple logistic regression analysis showed that the suggestion by colleagues to report the injury, the number of needlestick injuries, and the needle type were independently related to the underreporting of needlestick injuries. CONCLUSION: The underreporting rate of needlestick injuries in small- or medium-sized hospitals was similar to that in large-sized hospitals, and this finding confirmed that the suggestion by colleagues to report the injury was the most significant factor influencing the injury-report rate. Thus, creating an environment that encourages HCWs to report injuries is considered the most important method to decrease the underreporting rate of needlestick injuries in small- and medium-sized hospitals.
Blood-Borne Pathogens ; Delivery of Health Care ; Humans ; Logistic Models ; Needles ; Needlestick Injuries ; Occupational Exposure ; Risk Management ; Social Sciences ; Surveys and Questionnaires

BACKGROUND: Hospital-wide surveillance showed an up to 9% increase in the incidence rate of the nasal transmission of methicillin-resistant Staphylococcus aureus (MRSA) among health care workers (HCWs) in a tertiary care hospital where MRSA is endemic. The purpose of this study was to investigate the knowledge of and attitude towards nasal transmission of MRSA and hand-washing practice among HCWs and determine the behavioral factors associated with the nasal transmission of MRSA. METHODS: In a 750-bed tertiary care hospital, nasal swabs from HCWs were obtained, and questionnaires with 25 questions were distributed to HCWs who were divided into 2 different groups: MRSA carriers and non-carriers. The questionnaires focused on the HCWs' knowledge about the mode of MRSA transmission and precautions against MRSA infection and their self-reported compliance for hand hygiene. RESULTS: The total number of respondents for the surveillance culture and survey were 253 (51 MRSA carriers and 202 non-carriers). There was significant difference between the 2 groups on the knowledge of precautionary measures used for the MRSA patients in the hospital (P=0.026). Compared to the MRSA carriers, the non-carriers washed their hands significantly more frequently after ventilator care (P=0.004) and used more alcohol sanitizers (P=0.023). However, no significant difference was observed in hand-washing practices of both the groups before the medical procedures, their knowledge about the mode of transmission of MRSA, and the duration of hand washing. CONCLUSION: Non-carriers replied more accurately to the questions on knowledge about the management and treatment of MRSA, and they considered interventions such as surveillance cultures and questionnaires to be an effective method in lowering the incidence of nosocomial infections. Compared to the MRSA carriers, the non-carriers showed higher hand-washing compliance.
Compliance ; Cross Infection ; Cross-Sectional Studies ; Surveys and Questionnaires ; Delivery of Health Care ; Drug Resistance ; Hand ; Hand Disinfection ; Humans ; Incidence ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Tertiary Healthcare ; Ventilators, Mechanical

BACKGROUND: Clostridium difficile infection (CDI) is the predominant cause of hospital-acquired diarrhea. This study evaluated the sporicidal activities of several disinfectants against C. difficile spores. METHODS: We used toxigenic C. difficile strains with different ribotypes for our study. We compared the sporicidal activities of Cavicide (Metrex Research Corporation, USA), Cidex OPA (Advanced Sterilization Products, USA), 1% Rely+On Virkon (Dupont, UK), 0.25% Surfanios (Laboratoires Anios, France), sodium hypochlorite (Yuhan Clorox, Korea), and 70% ethyl alcohol (Duksan, Korea) by using dilution-neutralization method. The sporicidal activity of the disinfecting agents was considered to be the inactivation factor (IF). The IF was calculated as the log10 colony forming unit (CFU) reduction of the viable count from the initial inoculums. Disinfectants were considered to be sporicidal if they showed an IF> or =4. RESULTS: Cavicide, 70% ethyl alcohol, Rely+On Virkon, and Surfanios showed no reduction in spore counts at all exposure time. Solutions of sodium hypochlorite diluted 1:100 (> or =400 ppm available chlorine), 1:50, and 1:20 were sporicidal after 5 min, 2 min, and 30 s, respectively. Cidex OPA showed sporicidal activity after 30 min. CONCLUSION: To prevent the transmission of CDI, at least 1,000 ppm sodium hypochlorite solution should be used to disinfect the hospital environment. Contaminated endoscopes should be disinfected with Cidex OPA for more than 30 min.
Chlorophenols ; Clostridium ; Clostridium difficile ; Colony Count, Microbial ; Diarrhea ; Disinfectants ; Endoscopes ; Ethanol ; Glutaral ; Peroxides ; Ribotyping ; Sodium Hypochlorite ; Spores ; Stem Cells ; Sterilization ; Sulfuric Acids

BACKGROUND: In this report, we present the annual data of the intensive care unit (ICU) module of the Korean Nosocomial Infections Surveillance System (KONIS) from July 2009 through June 2010. METHODS: We performed a prospective surveillance of nosocomial urinary tract infections (UTIs), bloodstream infections (BSIs), and pneumonia (PNEU) at 116 ICUs in 63 hospitals by using KONIS. Nosocomial infection (NI) rates were calculated as the number of infections per 1,000 patient-days or device-days. RESULTS: We identified 3,965 NIs during the study period: 2,156 cases of UTIs (2,119 were urinary catheter-associated), 1,110 cases of BSIs (948 were central line-associated), and 699 cases of PNEU (410 were ventilator-associated). The rate of urinary catheter-associated UTIs (CAUTIs) was 4.75 cases per 1,000 device-days (95% confidence interval, 4.55-4.95), and urinary catheter utilization ratio was 0.86 (range, 0.859-0.861). The rate of central line-associated BSIs was 3.28 (range, 3.07-3.49), and the utilization ratio was 0.56 (range, 0.559-0.561). The rate of ventilator-associated PNEUs (VAPs) was 1.95 (range, 1.77-2.15), and the utilization ratio was 0.41 (range, 0.409-0.411). Although ventilator utilization ratio was lower in the hospitals with 400-699 beds than in the hospitals with 700-899 beds and more than 900 beds, the rate of VAPs were higher in the hospitals with 400-699 beds than in hospitals with 700-899 beds and more than 900 beds. The incidence of infections due to imipenem-resistant Acinetobacter baumannii increased from 43.6% to 82.5% since July 2006. CONCLUSION: The risk of acquiring VAP and CAUTI is highest in the ICUs of hospitals with 400-699 beds than that in hospitals with more beds. Imipenem-resistant A. baumannii was identified as an emerging gram-negative pathogen of nosocomial infections.
Acinetobacter baumannii ; Cross Infection ; Incidence ; Critical Care ; Intensive Care Units ; Pneumonia ; Urinary Catheters ; Urinary Tract Infections ; Ventilators, Mechanical

No Abstract available.
Infection Control*

No Abstract available.
Cross Infection*

No Abstract available.
Chungcheongnam-do* ; Infection Control*

No Abstract available
Cross Infection*

OBJECTIVES: Health care workers(HCWs) are more likely to become infected with tuberculosis from patients in the hospital. When HCWs have an active tuberculosis infection, it is possible that they also become a source of infections to other HCWs and patients. METHODS: Tuberculin tests were performed with mantoux method using 5 units of tuberculin by infection control practitioners on Feb. 21, and Mar. 7, 1997. A total of 138 newly employed HCWs including 44interns and 94 nurses were tested. Results of skin test were interpreted by themselves according to the instructions. RESULTS: Among 138 personels, skin tests were negative in 27 personels (19.6%); 4 interns (9.1%) and 23 nurses (24.5%). There were 3 persons (2.2%) who had a history of tuberculosis which had been treated. CONCLUSION: The study showed that approximately 20% of newly employed HCWs had negative tuberculin skin test. Given the possibility of being infected with tuberculosis in the hospital, regular follow up of tuberculin skin test is warranted to protect HCWs,
Delivery of Health Care* ; Humans ; Infection Control Practitioners ; Skin Tests* ; Skin* ; Tuberculin Test ; Tuberculin* ; Tuberculosis

BACKGROUND: With increase of antibiotics use and invasive procedures, infections caused by multi-resistant Acinetobacter baumannii (MRAB) are increasing. Recently, we experienced the outbreak of- nosocomial infections caused by MRAB resistant to imipenem and cefoperazone/sulbactam in intensive care units (ICU) and general ward. We analyzed the clinical characteristics of the infected patients and antibiotic susceptibility of the organisms. And surveillance cultures and IRS-PCR were performed to find out the transmission route. METHODS: We collected data from physical examination and clinical records. We performed surveillance cultures of environment, patients not infected with MRAB in ICU, and hands of health care workers. RESULTS: Between November 1996 and June 1997, 49 strains of MRAB were isolated from the 26 patients hospitalized in Kangnam St. Mary' s Hospital. The lower respiratory infection (13 cases) was the most common infection and sputum was the most common sources (47.1%). All strains of MRAB showed the same genotype. In disk diffusion test, all strains were resistant to piperacillin, gentamicin, amikacin, ceftazidime, cefoperazone/sulbactam, aztreonam, imipencm, ciprofloxacin. From the surveillance cultures, the genotypically identical strains were isolated from ventilator Y-piece, the floor of ICU, and hands of health care workers. It suggested that this strain was transmitted through ventilatory device or hands of health care workers. We instructed all the health care workers to wash hands, to disinfect hospital environment completely. Since July 1997, no further case has occurred. CONCLUSIONS: Since A. baumannii could be transmitted through ventilatory devices and the hands of health care workers, it is important to wash hands and to disinfect hospital environment completely.
Acinetobacter baumannii* ; Acinetobacter* ; Amikacin ; Anti-Bacterial Agents ; Aztreonam ; Ceftazidime ; Ciprofloxacin ; Cross Infection* ; Delivery of Health Care ; Diffusion ; Genotype ; Gentamicins ; Hand ; Humans ; Imipenem* ; Critical Care Units ; Patients' Rooms ; Physical Examination ; Piperacillin ; Sputum ; Ventilators, Mechanical