No abstract available.
Humans

We have reviewed 9009 pediatric age group patiests visiting the emergency room in Busan National University Hospital during the last 8 years and 8 months period from Jan. 1st., 1970 to Aug. 31st.,1978. The clincal and statistical results were obtained in this stydy as following: 1. Of the total 40406 patients visiting the emergency room, the patients under 15years of age occupied 22.3%, with the sex ratio male to female,3:2. 2. The yearly distribution of patients showed little significant change until 1975 because of dconomic stagnation. There after the incidence began to increase and a mareakly sudden increase from 1977 due to medical insurance and medical protection. The monthly distribution revealed a sightly higher incidence in Summer seasin(June. July and August). 3. Preschool childres between one year anad six years of age occupied 42% of all pediatric patients. The most popular rime 27.0% of all pediatric patients were seen. 4. The most common disease was accident (24.2%), the second common was respiratory disease (16.3%), which was followde by vernous disease (13.4%), gastroinestinal disease (8.8%), infectious disease (6.3%), poisonings (5.4%), neonatal disease(4.4%), and surgical disease (4.3%) and the like in order of frequency. 5. The admission rate through the emrgency room was 43.2% of total pediatric emergency patieats.
Busan ; Communicable Diseases ; Emergencies* ; Emergency Service, Hospital* ; Humans ; Incidence ; Insurance ; Male ; Poisoning ; Sex Ratio ; Statistics as Topic*

We have observed clinically 57 cases of diphtheria, admitted to Dept. of Pediatrics and E. N. T. of College of Medicine, Busan National University during a period of past 4 years from Jan. 1973 to Dec. 1976. The following results were obtained from this observation: 1. The yearly prevalence rate seemed not to be reduced throughout 4 years. 2. The seasonal incidence was highest from Oct. to next Feb when 77.5% of cases was de-veloped. Most of cases (82.5%) was below the age 8 years with the sex ratio of male to female, 1.5:1. 3. About one half of cases gad been resided in the rural area. 4. Concerning the degree of the immunization status of diphtheria, 48.3% of cases was never taken, 17.5% unknown, 33.4% inadequate, and 5.3% was adequate. 5. The sites of occurence of dephtheria were pharynx (33.3%) larynx (47.4%) and both (19.3%) 6. 77.2% of cases was found diphtheria organism, which was detected on smear (63.2%) and culture (52.6%) individually. 7. The chief clinical symptoms and signs on admission were dyspnea (77.2%) pseudomemb-rane (77.2%) prostration (75.4%) fever (72.0%) hoarseness (54.4%) cough (50.9%) and the like in order of frequency. 8. Anemia was found in 77.2% leukocytosis in 84.2% of cases. 9. 54.5% of cases had complications, of which myocarditis (22.4%) pneumonia (21.0%)bull neck (14.0%) nephritis (12.2%) and nerve palsy (10.5%) were developed. 10. The onest of myocarditis was the 3th-8th day of depheheria and the most common abnormal ECG finding was the changes of S-T segment and T wave. 11. The morality rate was 12.3% of the total cases (45.5% of mixed type the and 7.4% of laryngeal type were expired). The causes of death were myocarditis (its mortality rate, 46. 1%) and paralysis of diapgragm.
Anemia ; Busan ; Cause of Death ; Cough ; Diphtheria* ; Dyspnea ; Electrocardiography ; Female ; Fever ; Hoarseness ; Humans ; Immunization ; Incidence ; Larynx ; Leukocytosis ; Male ; Morals ; Mortality ; Myocarditis ; Neck ; Nephritis ; Paralysis ; Pediatrics ; Pharynx ; Pneumonia ; Prevalence ; Seasons ; Sex Ratio

30 cases of methemoglobinemia who had been admitted in pediatric department of Busan National University Hospital from Jan. 1970 to Jun. 1976 were clinically studied, and the results were summerized as followings: 1. The incidence of methemoglobinemia was corresponding to 0.5% of all pediatric in patients, and 16.7% of all acute poisoning during same period. 2. The sex ratio of male to female was 2:1 and the peak age group was 1 to 3 years of age. 3. The prevalent incidence in a year was shown in August and in Summer season. 4. The most frequent causative substances of methemoglobinemia was D.D.S(26 cases) and then phenacetine( 2 cases). The motive of poisoning was mianly accidental causes(23 cases) 5. Clinical features of methemoglobinemia was relatively good and this patient was treated with methylene blue and ascorbic acid.
Ascorbic Acid ; Busan ; Child* ; Female ; Humans ; Incidence ; Male ; Methemoglobinemia* ; Methylene Blue ; Poisoning ; Seasons ; Sex Ratio

BACKGROUND: Enterococci have become increasingly predominant as causative agents of nosocomial infections. Infections due to multi-drug resistant enterococci have drawn increasing attention during the past two decades. The purpose of the present study was to evaluate the occurrence of virulence factors and antimicrobial resistance in enterococci isolated from patients with bacteremia or urinary tract infection. METHODS: A total of 209 strains of enterococi (102 Enterococcus faecalis and 107 E. facium) isolated during 8 months of 2005 were collected from 10 university hospitals in Korea. Disk diffusion susceptibility tests were performed using Mueller-Hinton agar. The antimicrobial resistance genes and virulence factors were determined using PCR. RESULTS: In E. faecalis, the rate of resistance to ciprofloxacin, tetracycline, and quinupristindalfopristin was 27.4%, 83.3%, and 85.2%, respectively; no isolates were resistant to ampicillin, vancomycin, teicoplanin, or linezolid. In E. faecium, the rate of resistance to ampicillin, ciprofloxacin, tetracycline, vancomycin, and teicoplanin was 86.9%, 87.9%, 8.4%, 19.6%, and 6.5%, respectively; no strains were resistant to quinupristin-dalfopristin or linezolid. All the E. faecalis strains tested were found to harbor multiple virulence factors, but E. faecium strains were generally without virulence factors except esp. The prevalence of the esp gene was significantly higher in enterococci isolated from urinary tract infection than in those from bacteremia. CONCLUSION: A similar pattern of resistance to antimicrobial agents and prevalence of virulence factors was observed in both the enterococci isolated from bacteremia and urinary tract infection. Our study indicates that host factors are more likely than bacterial properties to influence the development of bacteremia.
Agar ; Ampicillin ; Anti-Infective Agents ; Bacteremia* ; Ciprofloxacin ; Cross Infection ; Diffusion ; Enterococcus faecalis ; Hospitals, University ; Humans ; Korea ; Polymerase Chain Reaction ; Prevalence ; Teicoplanin ; Tetracycline ; Urinary Tract Infections* ; Urinary Tract* ; Vancomycin ; Virulence Factors* ; Virulence* ; Linezolid

A nationwide antimicrobial resistance surveillance has been conducted since 1997 in Korea. In this study, susceptibility test data generated in 2004 by KONSAR group hospitals were analyzed and compared to those at a commercial laboratory. In hospitals, the rank orders of organisms in 2004 were identical to those in 2003. The most prevalent species was Staphylococcus aureus (20.2%) in hospitals, but Escherichia coli (29.7%) in the commercial laboratory. The proportions of Enterococcus faecium to all isolates of Enterococcus faecalis plus E. faecium were 47.2% in hospitals and 24.9% in the commercial laboratory. The mean resistance rates of significant antimicrobial-organism combinations in hospitals were: oxacillin-resistant S. aureus (68%), oxacillin-resistant (penicillin- nonsusceptible) Streptococcus pneumoniae (68%), vancomycin-resistant E. faecium (25%), cefotaxime-resistant E. coli (14%), ceftazidime- and cefoxitin-resistant Klebsiella pneumoniae (34% and 32%, respectively), and imipenem-resistant Acinetobacter spp. and Pseudomonas aeruginosa (17% and 24%, respectively). In conclusion, oxacillin-resistant staphylococci, expanded-spectrum cephalosporin-resistant K. pneumoniae, and imipenem-resistant Acinetobacter spp. and P. aeruginosa were prevalent in 2004. Increasing trends were observed for vancomycin-resistant E. faecium, cefoxitin- resistant E. coli and K. pneumoniae, and imipenem-resistant Acinetobacter spp. and P. aeruginosa. Certain antimicrobial- organism combinations were also prevalent among the commercial laboratory-tested strains.
Pseudomonas aeruginosa/drug effects/isolation & purification ; Microbial Sensitivity Tests ; Laboratories ; Korea ; Klebsiella pneumoniae/drug effects/isolation & purification ; Imipenem/*pharmacology ; Hospitals ; Gammaproteobacteria/*drug effects/isolation & purification ; Drug Resistance, Multiple, Bacterial ; Ceftazidime/*pharmacology ; Anti-Bacterial Agents/*pharmacology ; Acinetobacter/drug effects/isolation & purification

BACKGROUND: A web-based surveillance of surgical-site infections (SSIs) in Korean Nosocomial Infections Surveillance System (KONIS) was performed to determine the incidence of SSIs after 15 operative procedures. METHODS: Forty-three hospitals participated in the surveillance system for 15 operative procedures. A year-round observation was carried out, and the duration of participation was shortened for 3 months unit. All data were collected using a real-time web-based reporting system. RESULTS: From July 2010 through June 2011, SSI surveillance data of 18,644 cases were collected from 43 hospitals. SSIs were found to occur in 2.10% of the total cases. The SSI rates after various surgeries were as follows: 4.49%, rectal surgery; 4.41%, colon surgery; 3.50%, gastric surgery; 3.12%, craniotomy; 1.25%, abdominal hysterectomy; 0.93%, laminectomy; 0.63%, cesarean section; 0.62%, gallbladder surgery; and 0.54%, vaginal hysterectomy. The interim results of implant-related surgery are given below as SSI rates: 3.78%, ventricular shunt operation; 3.23%, coronary artery bypass graft; 2.20%, cardiac surgery; 1.31%, spinal fusion; 0.96%, knee prosthesis; and 0.88%, hip prosthesis. CONCLUSION: The SSI rate was found to be 2.10% by the KONIS 2010. The maintenance of a surveillance system for SSI is very important, as it will help in decreasing SSIs via feedback to the involved surgeons and infection-control personnel.
Colon ; Coronary Artery Bypass ; Cross Infection ; Female ; Gallbladder ; Hip ; Hysterectomy, Vaginal ; Incidence ; Knee ; Surgical Procedures, Operative

BACKGROUND: A nationwide prospective multicenter study was performed in Korea to determine the incidence and risk factors for surgical site infections (SSI) after craniotomies (CRAN), ventricular shunt operations (VS), gastric operations (GAST), colon operations (COLO), rectal operations (RECT), hip joint replacements (HJR), and knee joint replacements (KJR). METHODS: We collected data regarding demographics, clinical and operative risk factors for SSI, and antibiotics administered to the patients who underwent CRAN in 18 hospitals, VS in 19 hospitals, GAST in 19 hospitals, COLO in 19 hospitals, RECT in 19 hospitals, HJR in 24 hospitals, and KJR in 23 hospitals between January and December 2009. All the data were collected using a real-time web-based reporting system. RESULTS: The SSI rate of CRAN, VS, GAST, COLO, RECT, HJR, and KJR was 3.68 (22/1,169), 5.96 (14/235), 4.25 (75/1,763), 3.37 (22/653), 5.83 (27/463), 1.93 (23/1,190), and 2.63 (30/1,139), respectively, per 100 operations. The only significant risk factor for SSI after CRAN was postoperative cerebrospinal fluid leakage. The independent risk factors for SSI after GAST were multiple procedure, reoperation, infection of other sites, and transfusion. In HJR, the duration of preoperative hospital stay and operation time were longer, and the need for general anesthesia, transfusion, and steroid use and the incidence of contaminated/dirty wound, obesity, and infection of other sites were significantly increased in the infected group. In KJR, the duration of preoperative hospital stay was longer and the need for reoperation was significantly higher in the infected group, and in addition, the incidence of SSI was higher among males. CONCLUSION: The maintenance of surveillance on SSI is very important because surveillance provides valuable information to the surgeon and infection control personnel, which in turn helps decrease the incidence of SSI.
Anesthesia, General ; Anti-Bacterial Agents ; Colon ; Craniotomy ; Demography ; Hip Joint ; Humans ; Incidence ; Infection Control ; Knee Joint ; Korea ; Length of Stay ; Male ; Obesity ; Reoperation ; Risk Factors

BACKGROUND: The aim of this study was to determine a nation-wide prevalence of Ambler class A and D extended-spectrum-lactamases (ESBL) in Klebsiella pneumoniae isolates in Korea. METHODS: During the period of April to May 2005, 189 isolates of K.pneumoniae were collected from 11 Korean hospitals. Antimicrobial susceptibilities to ceftazidime and cefotaxime were tested by the disk diffusion method, and ESBL production was determined by double-disk synergy test. Determinants of ceftazidime or cefotaxime-resistance were transferred to Escherichia coli J53 (azide-resistant) by transconjugation. Genotypes of class A and D ESBL genes were determined by PCR amplification and sequencing. RESULTS: One hundred-sixty isolates of K.pneumoniae showed positive results in double-disk synergy test. The most prevalent ESBL was SHV-12 (n=148). Also detected were genes encoding ESBLs including TEM-52 (n=1), SHV-2a (n=2), CTX-M-3 (n=15), CTX-M-9 (n=6), CTX-M-12 (n=2), CTX-M-14 (n=9), CTX-M-15 (n=1), PER-1 (n=1), GES-5 (n=3), and OXA-30 (n=2) beta-lactamases. CONCLUSION: With the emergence of CTX-M-12, PER-1, and OXA-30 beta-lactamases, the ESBLs in K.pneumoniae isolates are becoming more diverse in Korea.
beta-Lactamases ; Cefotaxime ; Ceftazidime ; Diffusion ; Escherichia coli ; Genotype ; Klebsiella pneumoniae* ; Klebsiella* ; Korea ; Polymerase Chain Reaction ; Prevalence

BACKGROUND: A rapid increase in antimicrobial-resistant bacteria has become a serious problem in many countries including Korea, but the rate and pattern of antimicrobial resistance may vary significantly depending on countries and even on hospitals. The aim of this study was to determine the nationwide prevalence of resistance among frequently isolated bacterial pathogens in Korea. METHODS: Routine susceptibility data for medically important bacterial pathogens from 12 university hospital and general hospital laboratories in Korea were analysed by patient group. These pathogens had been isolated during the period from April to November in 2004. RESULTS: The proportion of methicillin-resistant Staphylococcus aureus (MRSA) was 67%. Van-comycin-resistance rate of Enterococcus faecalis was 1% and that of E.faecium was 20%. The resistance rates of Streptococcus pneumoniae to penicillin and Haemophilus influenzae to ampicillin were 70% and 54%, respectively. The resistant rates of Escherichia coli and Klebsiella pneumoniae were 7-10% and 26-31% to the 3rd generation cephalosporin, respectively. The resistance rates to 3rd generation cephalosporin were 22-30% in Citrobacter freundii, 35-44% in Enterobacter cloacae and 15-22 % in Serratia marcescens. Imipenem resistance rates of Pseudomonas aeruginosa and Acinetobacter baumannii were 26% and 17%. Cotrimoxazole and levofloxacin resistance rates of Stenotrophomonas maltophilia were 46% and 44%, respectively. CONCLUSION: Antimicrobial resistance rates of clinically important pathogens in Korea were still high and were generally higher among the bacteria isolated from the intensive care unit patients. Strict infection control and continuous nationwide surveillance program will be required to manage the antimicrobial resistance problem.
Acinetobacter baumannii ; Ampicillin ; Bacteria* ; Citrobacter freundii ; Enterobacter cloacae ; Enterococcus faecalis ; Escherichia coli ; Haemophilus influenzae ; Hospitals, General ; Humans ; Imipenem ; Infection Control ; Intensive Care Units ; Klebsiella pneumoniae ; Korea* ; Levofloxacin ; Methicillin-Resistant Staphylococcus aureus ; Penicillins ; Prevalence ; Pseudomonas aeruginosa ; Serratia marcescens ; Stenotrophomonas maltophilia ; Streptococcus pneumoniae ; Trimethoprim, Sulfamethoxazole Drug Combination