Antimicrobial resistance in the hospital is the most important challenging issue in the field of nosocomial infection control. Several nationwide surveys performed so far revealed that various profiles of resistance were already stablished in Korea: the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) was more than 70%; vancomycin-resistant Enterococcus was around 15%; resistance to third generation cephalosporins and aminoglycosides were around 30%, and so on. Although there remains some controversy, association between the development of antimicrobial resistance and the adverse clinical outcome does exist as supported by many studies worldwide. Therefore, combating and overcoming the antimicrobial resistance in the hospital is the most urgent task to solve. For the purpose of eradicating the antimicrobial resistance, we should use a two-edged sword: antimicrobial stewardship and hospital infection control. Regulation of antimicrobials could prevent the emergence of resistance, While infection control and precaution could contain the further spread of resistant organisms. In addition to these, futher aggressive strategy could be used for some species, e.g., active surveillance and \lquote search and destroy\rquote decolonization for MRSA. In conclusion, continuous education of appropriate antimicrobial prescription, implementation of proper precautions, and systematic approach to the infection control via organization of specialized personnel are sine qua non in overcoming the antimicrobial resistance in the hospital.
Aminoglycosides ; Cephalosporins ; Cross Infection ; Education ; Enterococcus ; Infection Control ; Korea ; Methicillin-Resistant Staphylococcus aureus ; Prescriptions ; Prevalence

No abstract available.
Methicillin Resistance ; Staphylococcus

No abstract available.
Cross Infection*

No abstract available.
Disinfection*

Tracheal stenosis can be caused by various etiologies, such as infectious disease, trauma from previous prolonged incubation, airway surgery, or external blunt trauma, and neoplasm. Recently, the development of emergency and intensive care units leads to the primary cause of airway stenosis using airway devices. The stenotic lesions can be produced at any level between the vocal cord and the site of the tip of the tube. Laryngotracheal stenosis may be due to prolonged endotrachel intubation, especially with large tube, large tracheostomy stoma, too highly placed oacheostomy, erosion by local infection, the prying action of heavyweight equipment that connects the tracheostomy to the ventilator, excessive cuff pressure, or erosion by the tip of the tube. Prevention of tracheal stenosis is of key importance by understanding and attending to these causes. We experienced three cases of tracheal stenosis occurred after use of airway devices. In first and second cases, We performed end-to-end anastomosis artier resection of stenotic segment of the trachea in a 22-year-ol4 female and a 25-year-old male. They ha6 been treated with prolonged endotracheal incubation and emergency tracheostomy, respectively, for a ventilatory support for the respiratory failure after falling down from a height. The stenotic lesions occurred at the cuff site in the first case and at the stomal level in the second case. In third case, We performed one-stage laryngotracheoplastic procedure for subglottic stenosis in a 23-year-old male. He had been treated with emergence tracheostomy which had been placed too high for a ventilators support for the respiratory failure after traffic accident. The stenotic lesion occurred at the stomal level. The postoperative courses were uneventful.
Accidents, Traffic ; Adult ; Communicable Diseases ; Constriction, Pathologic ; Emergencies ; Female ; Humans ; Intensive Care Units ; Intubation ; Male ; Respiratory Insufficiency ; Trachea ; Tracheal Stenosis* ; Tracheostomy ; Ventilators, Mechanical ; Vocal Cords ; Young Adult