Although acute occupational poisonings are very rare officially, it seems that there are a considerable number of unreported cases seen from non-intentional poisoning cases of the national injury and poisoning survey on discharged patients. Establishing a proper national surveillance system for acute occupational poisonings is needed. It is difficult for clinical physicians to diagnose acute occupational poisonings appropriately because the victims who usually are not mentally alert can not provide the information on the workplace hazard. Consulting a specialist of occupational and environmental medicine may help to reveal the cause of poisoning. Furthermore, reporting to the public organization such as workers health center and Korea occupational safety and health is helpful to prevent additional injuries.
Environmental Medicine ; Humans ; Korea* ; Occupational Health ; Poisoning* ; Specialization

Septic arthritis is rarely caused by anaerobic bacteria, which is mostly secondary to hematogenous dissemination among the immunocompromised host. We report a patient of septic arthritis on the right knee joint caused by Bacteroides thetaiotaomicron. To the best of knowledge, this is the first report of septic arthritis caused by Bacteroides spp. in Korea.
Arthritis, Infectious* ; Bacteremia* ; Bacteria, Anaerobic ; Bacteroides* ; Humans ; Immunocompromised Host ; Knee Joint ; Korea ; Multiple Myeloma*

Previous exposure to antimicrobials is a major risk factor for Clostridioides difficile infection (CDI). Antibiotic prescription and C. difficile toxin assay records of patients admitted to a tertiary hospital in Korea from 2009 to 2013 were collected to investigate the association between antibiotic consumption and CDI incidence. A Spearman's correlation analysis between CDI incidence (positive result of toxin assay/10,000 admissions) and antibiotic consumption (defined daily dose/1,000 patient-days) was performed on a monthly basis. Using the matched month approach, we found a significant correlation between CDI rate and moxifloxacin consumption (Spearman's r = 0.351, P < 0.001). Furthermore, using the onemonth delay approach, we found that the consumption of clindamycin (Spearman's r = 0.272, P = 0.037) and moxifloxacin (Spearman's r = 0.297, P = 0.022) was significantly correlated with CDI incidence. Extended-spectrum cephalosporins did not have any effect on CDI incidence.

Background: Clostridioides difficile infection (CDI) is one of the most common hospitalacquired infections, with its incidence and disease burden increasing markedly worldwide over the past decade. Methods: To assess the attributable costs of CDI in Korea, the expenses related to hospital management of CDI cases were computed. This analysis used data from the National Health Insurance Service–National Sample Cohort spanning a decade (2010–2019). The annual national burden of CDI was determined by combining the attributable cost per CDI case with the number of patients with CDI obtained from the Health Insurance Review and Assessment Service data. Results: The attributable costs of CDI were determined based on variations in the length of hospital stay and medical costs between patients with CDI and control patients. The mean length of hospital stay was significantly longer for patients with CDI than that for control patients: 43.06 vs. 14.76 days (a difference of 28.30 days, P < 0.001). The adjusted medical costs (2019 = 100) for cases of CDI and controls were 11,162 USD and 3,318 USD, respectively, with a significant difference of 7,843 USD (P < 0.001). The cost of CDI per case exhibited a noticeable annual increase from 2010 to 2019, despite an annual decreasing trend in length of hospital stay. The estimated national cost attributed to CDI was $28.9 million in 2010; however, it increased gradually each year, reaching $205.6 million in 2019 (a 600% increase over 10 years). Conclusion CDI is associated with substantial healthcare costs in Korea. The economic burden of CDI has gradually increased in South Korea.

Background: Clostridioides difficile infection (CDI) is one of the most common hospitalacquired infections, with its incidence and disease burden increasing markedly worldwide over the past decade. Methods: To assess the attributable costs of CDI in Korea, the expenses related to hospital management of CDI cases were computed. This analysis used data from the National Health Insurance Service–National Sample Cohort spanning a decade (2010–2019). The annual national burden of CDI was determined by combining the attributable cost per CDI case with the number of patients with CDI obtained from the Health Insurance Review and Assessment Service data. Results: The attributable costs of CDI were determined based on variations in the length of hospital stay and medical costs between patients with CDI and control patients. The mean length of hospital stay was significantly longer for patients with CDI than that for control patients: 43.06 vs. 14.76 days (a difference of 28.30 days, P < 0.001). The adjusted medical costs (2019 = 100) for cases of CDI and controls were 11,162 USD and 3,318 USD, respectively, with a significant difference of 7,843 USD (P < 0.001). The cost of CDI per case exhibited a noticeable annual increase from 2010 to 2019, despite an annual decreasing trend in length of hospital stay. The estimated national cost attributed to CDI was $28.9 million in 2010; however, it increased gradually each year, reaching $205.6 million in 2019 (a 600% increase over 10 years). Conclusion CDI is associated with substantial healthcare costs in Korea. The economic burden of CDI has gradually increased in South Korea.

Background: Clostridioides difficile infection (CDI) is one of the most common hospitalacquired infections, with its incidence and disease burden increasing markedly worldwide over the past decade. Methods: To assess the attributable costs of CDI in Korea, the expenses related to hospital management of CDI cases were computed. This analysis used data from the National Health Insurance Service–National Sample Cohort spanning a decade (2010–2019). The annual national burden of CDI was determined by combining the attributable cost per CDI case with the number of patients with CDI obtained from the Health Insurance Review and Assessment Service data. Results: The attributable costs of CDI were determined based on variations in the length of hospital stay and medical costs between patients with CDI and control patients. The mean length of hospital stay was significantly longer for patients with CDI than that for control patients: 43.06 vs. 14.76 days (a difference of 28.30 days, P < 0.001). The adjusted medical costs (2019 = 100) for cases of CDI and controls were 11,162 USD and 3,318 USD, respectively, with a significant difference of 7,843 USD (P < 0.001). The cost of CDI per case exhibited a noticeable annual increase from 2010 to 2019, despite an annual decreasing trend in length of hospital stay. The estimated national cost attributed to CDI was $28.9 million in 2010; however, it increased gradually each year, reaching $205.6 million in 2019 (a 600% increase over 10 years). Conclusion CDI is associated with substantial healthcare costs in Korea. The economic burden of CDI has gradually increased in South Korea.

Background: Clostridioides difficile infection (CDI) is one of the most common hospitalacquired infections, with its incidence and disease burden increasing markedly worldwide over the past decade. Methods: To assess the attributable costs of CDI in Korea, the expenses related to hospital management of CDI cases were computed. This analysis used data from the National Health Insurance Service–National Sample Cohort spanning a decade (2010–2019). The annual national burden of CDI was determined by combining the attributable cost per CDI case with the number of patients with CDI obtained from the Health Insurance Review and Assessment Service data. Results: The attributable costs of CDI were determined based on variations in the length of hospital stay and medical costs between patients with CDI and control patients. The mean length of hospital stay was significantly longer for patients with CDI than that for control patients: 43.06 vs. 14.76 days (a difference of 28.30 days, P < 0.001). The adjusted medical costs (2019 = 100) for cases of CDI and controls were 11,162 USD and 3,318 USD, respectively, with a significant difference of 7,843 USD (P < 0.001). The cost of CDI per case exhibited a noticeable annual increase from 2010 to 2019, despite an annual decreasing trend in length of hospital stay. The estimated national cost attributed to CDI was $28.9 million in 2010; however, it increased gradually each year, reaching $205.6 million in 2019 (a 600% increase over 10 years). Conclusion CDI is associated with substantial healthcare costs in Korea. The economic burden of CDI has gradually increased in South Korea.

BACKGROUND: Recently, new plasmid-mediated extended-spectrum beta-lactamases have been reported. These are not derived from TEM or SHV enzymes but are related to cephalosporins of Enterobacteriaceae (AmpCenzymes), that confer to all cephalosporins including cefoxitin. METHODS: Fifteen clinical isolates of cefoxitin-resistant Klebsiella pneumoniae were charaterized. Antimicroilutin method. Crude beta-lactamases were prepared by sonication and isoelectric focusing of the enzyme preparations was performed in polyacrylamide gel. The transmissibility of resistance was tested by mating to E. coli J53. We performed PCR and hybridization for further characterization of the AmpC-type beta-lactamse. RESULTS: Seven strains were found to have the plasmid-mediated AmpC type beta-lactamase as a pI of 8.0 and this was confirmed to be cmy-1 beta-lactamase by PCR and hybridization analysis. These strains were resistant to ampicillin and piperacillin with MICs above 128microgram/ml. Cefoxitin resistance could be transferred from 4 strains via a large plasmi with molecular sizes approximately 77 or 130 kb. The molecular weight of CMY-1 enzyme is approximately 38kDa. We analyzed the OMP of six cefoxitin-resistance K. pneumoniae. Two of six strains were lacking a major OMP of approximately 40 kDa, but four of them showed another 39 kDa sized band just below the 40 kDa major OMP, which were thought to be a modified 40 kDa OMP. CONCLUSION: With these results, we conclude that resistance to cefoxitin in K. pneumoniae isolated from Korean patients is either associated with the productin of CMY-a, a plasmid-mediated AmpC type beta-lactamase, of altered expressin of an outer membrane protein.
Ampicillin ; beta-Lactamases* ; beta-Lactams ; Cefoxitin ; Cephalosporins ; Enterobacteriaceae ; Humans ; Isoelectric Focusing ; Klebsiella pneumoniae* ; Klebsiella* ; Membrane Proteins ; Molecular Weight ; Piperacillin ; Pneumonia ; Polymerase Chain Reaction ; Sonication

PURPOSE: This study was conducted to explore the mediating effect of self-efficacy in the relationship between internalized stigma and treatment adherence among community dwelling patient with mental illness. METHODS: A cross-sectional study design was employed. Participants were 145 people with mental illness who were enrolled at one of 11 community mental health institutions in Busan, South Korea. Internalized stigma of mental illness, self-efficacy, treatment adherence, and socio-demographic data were examined. Data were collected using self-report questionnaires and analyzed using Baron and Kenny method. RESULTS: Internalized stigma had a significant negative correlation with self-efficacy and treatment adherence. Self-efficacy had a significant positive correlation with treatment adherence. In addition, self-efficacy had a full mediating effect in the relationship between internalized stigma and treatment adherence. CONCLUSION: The results suggest that self-efficacy plays an important role in promoting treatment adherence among patients with mental illness who have high levels of internalized stigma. Therefore, mental health professionals should focus on reducing internalized stigma and also enhancing self-efficacy to increase treatment adherence for persons with mental illness living in the community.
Busan ; Cross-Sectional Studies ; Humans ; Korea ; Mental Health ; Mentally Ill Persons ; Negotiating* ; Patient Compliance

BACKGROUND: The aims of the study are to investigate the present state of occupational health management (OHM) in small enterprises, to explore the related factors, and to provide the information for effective policy of OHM in those enterprises. METHODS: The study subjects were 155 small enterprises that had referred the measurement of workplace hazards to a hospital at the East Seoul, Korea. Self-administered questionnaire survey was conducted by Fax. The contents of the survey were present state of OHM and related factors. RESULTS: 1. The characteristics of OHM in charge were as follows; among the health manager (1) 81.9% had the high authority, (2) 63.2% could explain workplace hazard, (3) 52.9% had outside professional education, (4) 49.7% recognized the need for occupational health, and (5) 67.7% had pragmatic perspective on workers' health protection. 2. The occupational health activities that showed higher performance rate were as follows; periodic health examination (86.5%), measurement of workplace hazard (92.9%). The occupational health activities that showed lower performance rate were as follows; appointment of emergency hospital (26.5%), replacement health examination (18.1%), health education (30.0%), health promotion (23.3%), preparation of health statistics (14.8%), planning health management (9.7%) 3. As results of multiple logistic regression analysis, the factors associated with the higher activity of occupational health were longer duration(more than 5 years) of health manager in charge(OR=2.41), pragmatic perspective on workers' health protection (OR=3.79), experience of outside professional education (OR=2.40), repair of automobiles(OR=3.31), workplace that employed more than 10 workers (OR=4.02), history of workers' compensation (OR=8.05), employers' high concern (OR=4.61). CONCLUSION: These results suggest that interest of employers and appointment of suitable health manager in charge were important, and minimum regulations and the development of occupational health program integrated with promoting productivity are required to activate occupational health in small enterprise
Education, Professional ; Efficiency ; Emergencies ; Health Education ; Health Promotion ; Korea ; Logistic Models ; Occupational Health ; Seoul ; Social Control, Formal ; Workers' Compensation ; Surveys and Questionnaires