BACKGROUNDCurrently, slightly more than 50% of bloodstream infections (BSIs) are hospital acquired. When these infections occur in patients in intensive care units, they are associated with a high mortality rate, additional hospital days and excess hospital costs. Because of multifactor of nosocomial BSIs, measurements of control nosocomial BSIs are wide variety and lead to some confusion in practice. The aim of this study was to explore special way in accordance with self-hospital base on common principle.

METHODSIn one ward of the Intensive Care Unit, Peking Union Medical College Hospital, at first, we divided the all operation about bloodstream way into three sections used as keypoints. By surveying keypoints respectively, some operation faults of blood way were discovered. For decreasing the mobidity of nosocomial BSIs, some intervention measurements were executed. The rate of nosocomial BSIs was analyzed by chi-square test.

RESULTSAccording to the statistics from January to June, we received and cured 618 patients in total; among them, there were 13 cases of nosocomial BSI and the average occurrence was 2.3 cases/month. After intervention measurements from July to December 2011, we received and cured 639 patients in total with seven cases of nosocomial BSI, and the average occurrence was 1.2 cases/month (P < 0.05). From January to April 2012, no nosocomial BSI occurred in the investigated ward.

CONCLUSIONRemoving the operation faults of bloodstream way might decrease the nosocomial BSI rapidly and efficiently by utilizing a key point survey.

Adult ; Aged ; Bacteremia ; etiology ; prevention & control ; therapy ; Cross Infection ; etiology ; prevention & control ; therapy ; Female ; Humans ; Male ; Middle Aged

Dysgonomonas capnocytophagoides is a gram-negative, facultatively anaerobic coccobacillus that was formerly designated CDC group dysgonic fermenter (DF)-3, occurring as a normal flora in human gut and rarely causing human infections such as bacteremia, abscess, diarrhea, and cholecystitis. In this study, we report a case of biliary sepsis caused by D. capnocytophagoides in a patient with biliary obstruction. A seventy four-year-old man, admitted to the hospital due to common bile-duct stone, also had cholangitis caused by D. capnocytophagoides and Enterococcus avium, which were isolated from his blood cultures. D. capnocytophagoides was initially identified as D. gadei by MALDI-TOF mass spectrometry, but later confirmed as D. capnocytophagoides by 16S rRNA gene sequencing. To the best of our knowledge, this is the first report of human infection by D. capnocytophagoides in Korea.
Abscess ; Bacteremia ; Centers for Disease Control and Prevention (U.S.) ; Cholangitis ; Cholecystitis ; Cholelithiasis ; Diarrhea ; Enterococcus ; Genes, rRNA ; Humans ; Korea ; Mass Spectrometry ; Sepsis

PURPOSE: Blood culture is the most important tool for detecting bacteremia in children with fever. However, blood culture contamination rates range from 0.6% to 6.0% in adults; rates for young children have been considered higher than these, although data are limited, especially in Korea. This study determined the contamination rate and risk factors in pediatric patients visiting the emergency room (ER) or being admitted to the ward. METHODS: We conducted a retrospective chart review of blood cultures obtained from children who visited Yonsei Severance Hospital, Korea between 2006 and 2010. Positive blood cultures were labeled as true bacteremia or contamination according to Centers for Disease Control and Prevention/National Healthcare Safety Network definitions for laboratory-confirmed bloodstream infection, after exclusion of cultures drawn from preexisting central lines only. RESULTS: Among 40,542 blood cultures, 610 were positive, of which 479 were contaminations and 131 were true bacteremia (overall contamination rate, 1.18%). The contamination rate in the ER was significantly higher than in the ward (1.32% vs. 0.66%, P<0.001). The rate was higher in younger children (2.07%, 0.94%, and 0.61% in children aged <1 year, 1-6 years, and >6 years, respectively). CONCLUSION: Overall, contamination rates were higher in younger children than in older children, given the difficulty of performing blood sampling in younger children. The contamination rates from the ER were higher than those from the ward, not accounted for only by overcrowding and lack of experience among personnel collecting samples. Further study to investigate other factors affecting contamination should be required.
Adult ; Bacteremia ; Centers for Disease Control and Prevention (U.S.) ; Child ; Delivery of Health Care ; Emergency Service, Hospital ; Fever ; Humans ; Korea ; Retrospective Studies ; Risk Factors

OBJECTIVETo analyze the clinical features of inhalation injury in children, with the aim of improving its management.

METHODSThe incidence of inhalation injury in 333 cases of burned children was analyzed in terms of burn area, shock, infection and prognosis.

RESULTSThe incidences of shock and bacteremia were 41.14% and 18.92%, and those of moderate and severe inhalation injury were 58.76% and 31.96% respectively in burned children with inhalation injury. Bacteremia developed in 24.82% of the patients with shock. Among 67 patients who ultimately died, 58.21% of them were complicated with bacteremia ending in 34.33% of mortality. Early tracheostomy was beneficial in that less fluids were required for resuscitation.

CONCLUSIONBurn infection was an important factor affecting the prognosis of inhalation injury. And inhalation injury and shock were major inducers of burn infection. Early application of wide spectrum antibiotics and shock management were helpful in lowering of burn infection rate. Early tracheostomy might be beneficial to burn shock management.

Anti-Bacterial Agents ; therapeutic use ; Bacteremia ; epidemiology ; etiology ; prevention & control ; Burns ; physiopathology ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Shock ; epidemiology ; etiology ; Smoke Inhalation Injury ; mortality ; physiopathology

We investigated the combined effect of glutamine (GLN) and growth hormone (GH) on bacterial translocation (BT) in sepsis. After single intraperitoneal injection of lipopolysaccharide (10 mg/kg), 48 rats were divided randomly into four groups of 12 animals each: the control group received chow orally; the GLN group received chow plus 10% GLN; GH group received chow plus GH; and the GLN/GH group received chow, 10% GLN, and GH. Twenty-four and 96 hr later, rats were sacrificed. Portal blood culture, bacterial colony counts of cultured mesenteric lymph nodes, mucosal thickness, malondialdehyde (MDA), and glutathione (GSH) levels in the gut mucosa were measured. There was no significant change of the rate of portal blood culture between all treatment groups at 24 and 96 hr. At 24 hr, the rats receiving combined treatment of GLN and GH showed lower bacterial colony counts and mucosal MDA levels than the control rats, and higher mucosal GSH levels than the control and GLN-treated rats. At 96 hr, rats treated with both GLN and GH exhibited lower bacterial colony counts and mucosal MDA levels, and higher mucosal thickness and GSH levels than control, GLN, or GH-treated rats. This study suggests that the combination of GLN and GH may synergistically reduce BT over time in sepsis.
Animals ; Bacteremia/etiology ; Bacteremia/microbiology ; Bacteremia/prevention & control ; Bacterial Translocation/drug effects* ; Comparative Study ; Drug Evaluation, Preclinical ; Drug Synergism ; Endotoxemia/drug therapy* ; Endotoxemia/microbiology ; Escherichia coli/isolation & purification* ; Glutamine/pharmacology* ; Glutamine/therapeutic use ; Glutathione/analysis ; Human Growth Hormone/pharmacology* ; Human Growth Hormone/therapeutic use ; Ileum/microbiology ; Ileum/pathology ; Intestinal Mucosa/microbiology ; Intestinal Mucosa/pathology ; Lipid Peroxidation/drug effects ; Lymph Nodes/microbiology ; Male ; Rats ; Rats, Sprague-Dawley ; Recombinant Proteins/pharmacology ; Recombinant Proteins/therapeutic use ; Sepsis/microbiology ; Sepsis/prevention & control* ; Specific Pathogen-Free Organisms

This study was performed to measure early changes in the serotype distribution of pneumococci isolated from children with invasive disease during the 3-year period following the introduction of 10- and 13-valent pneumococcal conjugate vaccines (PCVs) in Korea. From January 2011 to December 2013 at 25 hospitals located throughout Korea, pneumococci were isolated among children who had invasive pneumococcal disease (IPD). Serotypes were determined using the Quellung reaction, and the change in serotype distribution was analyzed. Seventy-five cases of IPD were included. Eighty percent of patients were aged 3-59 months, and 32% had a comorbidity that increased the risk of pneumococcal infection. The most common serotypes were 19A (32.0%), 10A (8.0%), and 15C (6.7%). The PCV7 serotypes (4, 6B, 9V, 14, 18C, 19F, 23F, and 6A) accounted for 14.7% of the total isolates and the PCV13 minus PCV7 types (1, 3, 5, 7F and 19A) accounted for 32.0% of the total isolates. Serotype 19A was the only serotype in the PCV13 minus PCV7 group. The proportion of serotype 19A showed decreasing tendency from 37.5% in 2011 to 22.2% in 2013 (P = 0.309), while the proportion of non-PCV13 types showed increasing tendency from 45.8% in 2011 to 72.2% in 2013 (P = 0.108). Shortly after the introduction of extended-valent PCVs in Korea, serotype 19A continued to be the most common serotype causing IPD in children. Subsequently, the proportion of 19A decreased, and non-vaccine serotypes emerged as an important cause of IPD. The impact of extended-valent vaccines must be continuously monitored.
Adolescent ; Bacteremia/complications/diagnosis ; Child ; Child, Preschool ; Female ; Hospitals ; Humans ; Infant ; Male ; Pneumococcal Infections/microbiology/*prevention & control ; Pneumococcal Vaccines/*immunology ; Republic of Korea ; Serotyping ; Streptococcus pneumoniae/*classification/isolation & purification ; Vaccines, Conjugate/*immunology

BACKGROUND: Hemodialysis patients are increasing every year and bloodstream infections (BSIs) are a major cause of morbidity and mortality in patients receiving hemodialysis. As the domestic studies have not explored the incidence of BSIs, the distribution and current situation of microorganism and so on this study was carried out to determine the incidence and epidemiological risk factors of the BSIs in hemodialysis patients. A distribution of pathogenic organism of the BSIs was investigated. METHODS: This study was carried out for those 275 patients with hemodialysis for 12 months the patients who underwent hemodialysis in the hemodialysis center within the university hospital. Data was collected by structural questionnaire, medical record review. The definition for BSIs was based on that of CDC. RESULTS: A total of 59 BSIs occurred during 123,502 dialysis sessions. The bloodstream infection rate per 1,000 dialysis sessions was 0.48 overall and varied markedly by the type of vascular access: 0.1 for arteriovenous fistulas, 0.54 for arteriovenous grafts. 2.57 for permanent catheters and 5.39 for temporary catheters. The most common pathogen isolated from the BSIs was MSSA and MRSA 18.0%, Streptococcus species 11.5%. In a logistic regression analysis, immunosuppressive therapy (OR=8.081, p=0.001), case of starting hemodialysis in the intensive care unit (OR=4.855, p=0.043) were associated independently with BSIs. CONCLUSION: Based on this study, continuous study and effort together with interest in BSIs, and the study on BSIs in hemodialysis patients should be further continued in the years to come. Surveillance for BSIs is recommended as a routine activity in hemodialysis center.
Arteriovenous Fistula ; Bacteremia ; Catheters ; Centers for Disease Control and Prevention (U.S.) ; Cross Infection ; Dialysis ; Humans ; Incidence ; Intensive Care Units ; Logistic Models ; Medical Records ; Methicillin-Resistant Staphylococcus aureus ; Mortality ; Renal Dialysis* ; Risk Factors ; Streptococcus ; Transplants ; Surveys and Questionnaires

OBJECTIVETo clarify the value of endotoxin determination in evaluating the infection risk and antibiotic prophylaxis during transrectal biopsy of the prostate.

METHODSForty-eight patients were divided into four groups randomly. Group A (12 patients) were not treated before biopsy. Group B (13 patients) received antibiotic prophylaxis therapy. Group C (12 patients) underwent clusis. Group D (11 patients) received combined treatment. Urine and blood samples of the patients were obtained before and after prostatic biopsy. All samples were cultured for bacteria and investigated for endotoxin concentration by limulus quantitative azo color test.

RESULTSNo significant difference in either serum endotoxin or blood bacterial cultures was noted before and after prostatic biopsy (P < 0.05) in all the groups. A significant increase was observed in urine endotoxin after biopsy compared with that before biopsy in Groups A and B (P < 0.05). There was no significant increase in urine endotoxin after biopsy compared with that before biopsy in Group C and D. The positive incidence of urine bacterial culture was significantly increased (P < 0.05) in patients of Group A and B.

CONCLUSIONCirculation infection risk following prostatic biopsy was low. Changes of urinary infection were fewer in patients who had undergone clusis and/or antibiotic prophylaxis than in those who had received no or only antibiotic prophylaxis therapy. Endotoxin determination in urine is a reliable, sensitive and simple method for diagnosis of bacterial infection in patients undergoing transrectal biopsy of the prostate.

Aged ; Aged, 80 and over ; Antibiotic Prophylaxis ; Bacteremia ; microbiology ; Bacterial Infections ; etiology ; prevention & control ; Bacteriuria ; microbiology ; Biopsy, Needle ; adverse effects ; Endotoxins ; analysis ; blood ; urine ; Humans ; Male ; Middle Aged ; Prostate ; pathology

Objective: To explore the feasibility and effectiveness of "one-puncture one-needle" transrectal ultrasound (TRUS)-guided prostate biopsy in the prevention of postoperative infections. METHODS: We retrospectively analyzed the clinical data about "one-puncture one-needle" (the observation group) and "one-person one-needle" (the control group) TRUS-guided prostate biopsy performed in the Second People's Hospital of Guangdong Province from January 2005 to December 2015, and compared the incidence rates of puncture-related infection between the two strategies. By "one-puncture one-needle", one needle was used for one biopsy puncture, while by "one-person one-needle", one needle was used for all biopsy punctures in one patient and the needle was sterilized with iodophor after each puncture. RESULTS: Totally, 120 patients received 6+1-core or 12+1-core "one-person one-needle" and 466 underwent 12+1-core "one-puncture one-needle" TRUS-guided prostate biopsy. There were no statistically significant differences between the two groups of patients in age, the prostate volume, the serum PSA level, or the detection rate of prostate cancer (P >0.05). Compared with the control group, the observation group showed remarkably lower incidence rates of puncture-related urinary tract infection (7.5% vs 0.9%, P <0.05), fever (5.0% vs 1.1%, P <0.05), bacteriuria (2.5% vs 0.2%, P <0.05), and total infections (16.7% vs 2.6%, P<0.05) postoperatively. Two cases of bacteremia or sepsis were found in each of the groups, with no significant difference between the two. CONCLUSIONS "One-puncture one-needle" TRUS-guided prostate biopsy can effectively prevent puncture-related infections.
Bacteremia ; etiology ; Biopsy, Fine-Needle ; adverse effects ; instrumentation ; methods ; Case-Control Studies ; Feasibility Studies ; Humans ; Male ; Prostate ; pathology ; Prostate-Specific Antigen ; blood ; Prostatic Neoplasms ; blood ; pathology ; Retrospective Studies ; Sterilization ; methods ; Ultrasonography, Interventional ; Urinary Tract Infections ; prevention & control