BACKGROUND: This study was aimed to identify the effect of oral care using 0.1% chlorhexidine gluconate (CHG) on ventilator-associated pneumonia (VAP) in the intensive care unit (lCU). METHODS: A total of 82 ventilated patient were enrolled in this prospective clinical trial performed during the 6-month period from October, 2005 through March, 2006. oral care was performed on the patients three times a day with 0.1% CHG for the study group and with 0.9% saline for the control group. To evaluate the colonization of potential pathogens, sputum cultures were taken on the first day of ventilation and followed on days 3, 5, 7, and 14. RESULTS: The overall incidence rate of YAP was 0.359 in the CHG-treated group compared to 0.116 in the NaCI-treated group (P=0.017). Likewise, 1000 device-day incidence rate of YAP was significantly lower in the CHG-treated group than in the NaCI-treated group (P=0.0396). However, among the patients whose initial sputrm cultures were positive , both the incidence rate (P=0.114) and 1000 device-day incidence rate (P=0.361) were not statistically significant. The average time from the day of ventilation to the onset of VAP among the patients whose initial sputrm cutures were positive was 14 days in the CHG-treated group and 9 days in the NaCI-treated group, but the difference was not statistically significant (P=0.169). CONCLUSION: An oral care with 0.1% CHG was helpful in controlling VAP in the ICU patients, but the effectiveness of CHG could not be confirmed in the patients whose initial sputrm cultures were positive.
Chlorhexidine* ; Colon ; Humans ; Incidence ; Intensive Care Units* ; Critical Care* ; Pneumonia, Ventilator-Associated* ; Prospective Studies ; Sputum ; Ventilation

BACKGROUND: THe Korean Society for Nosocomial Infection Control (KOSNIC) orfanized the Korean Nosocomial Infections Surveillance System (KONIS) to establish a nationwide database of Nosocomial infection (NI) rate in the intensive care units (ICUs) of Korean hospitals. This report is a summary of the data from July through September 2006. METHODS: The KONIS performed a prospective sruveillance for nosocomial urinary tract infections (UTI), bloodstream infections (BSI), and pneumonia (PNEU) at 76 ICUs in 44 hospitals. NI rates were calculated as the numbers of infections per 1,000 patient-days or device-days. RESULTS: A total of 846 nosocomial infections were fOlllld during the study period: 407 UTIs (397 cases were urinary catheter-associated), 204 BSIs (182 were central line-associated), and 235 PNEUs (161 were ventilator-associated). The rate of urinary catheter-associated UTIs was 4.61 cases per 1,000 device-days and urinary catheter utilization ratio was 0.83. The rate of central line-associated BSIs was 3.16 and the utilization ratio was 0.55. The rate of ventilator-associated PNEUs was 3.80 and the utilization ratio was 0.41. Although the ventilator utilization ratio was lower in the hospitals with 400-699 beds than in the hospitals with more than 900 beds, the rate of ventilator-associated pneumonia was higher in the smaller hospitals than in the larger ones. The rates of all three device-associated infections were the highest in the neurosurgical ICUs and the rates were the lowest in the surgical ICUs. CONCLUSION: This study may contribute to the development of effective strategies for NI control according to the size of hospital and the type of ICUs.
Cross Infection* ; Intensive Care Units ; Pneumonia ; Pneumonia, Ventilator-Associated ; Prospective Studies ; Urinary Catheters ; Urinary Tract Infections ; Ventilators, Mechanical

BACKGROUND: Korean Nosocomial Infections Surveillance System (KONIS) operating since July 2006 is the first nationwide monitoring system for nosocomial infections in the in the intensive care unit (lCU) with a standard protocol and web-based prompt response network in Korea. This report describes the characteristics of the KONIS hospitals compared with those of all Korean hospitals with 400 beds and over. METHODS: A survey was conducted for the 44 hospitals participating in KONIS 2006, and the data were rechecked by the KONIS hospitals through KONIS web-network. The survey form included questions about the size of the hospital, infection control personnel, nursing personnel, and the status of microbiologic laboratory. RESULTS: Compared to all Korean hospitals with 400 beds and over, the KONIS hospitals were larger in term of average number of beds (857 vs 654); the number of hospitals with 700 beds and over was over-represented in Seoul (P=0.01) and under-represented in the central/south area (P<0.001) The majority of the KONIS hospitals were major teaching university-affiliated (88,6%) and private (72.7%), but in the central/south area, public hospitals comprised up to 60%. The number of infection control professionals (ICP) averaged 1.6, hospital beds per ICP 531, and infectious disease physicians 1.3. Medical and medical combined ICUs were the major component (67,1%) of the KONIS ICUs, The lCU bed per nurse was 0.63. CONCLUSION: The KONIS 2006 hospitals were over-represented in the overall indicators in Seoul. Because no objective indicators were available regarding the patient quality, KONIS data must be interpreted in consideration of all indicators.
Communicable Diseases ; Cross Infection* ; Hospitals, Public ; Humans ; Infection Control ; Intensive Care Units ; Korea ; Nursing ; Seoul

BACKGROUND: Serratia marcescens proliferates well in a humid environment or soil and is recently considered as an important pathogen for the severe nosocomial infections. this organism is spreads easily by hand-to-hand transmission, and contaminates medical equipment used for invasive procedures, working environment, medications, and soap. METHODS: We investigated the source of an outbreak of bloodstream infections by S. marcescens isolated that occurred during the period from July to December, 2004, at a university hospital in Gyeonggi Province and attempted to intervene in the outbreak and control it. RESULTS: From July to December, 2004, S. marcescens grew from 296 blood culture from 283 patients. The medical charts of the patients were reviewed, and surveillance cultures were taken to identify the outbreak of nosocomial infections and risk factors. Only four cases of infection were identified and all remaining positive blood cultures were due to contamination. Nine isolates randomly selected from the 296 S. marcescens showed an identical pulsed-field gel electrophoresis pattern. To identify the source of infection, environmental culture and hand cultures of the related medical workers were carried out, but S. marcescens was not isolated. CONCLUSION: As the result of aggressive infection control activities, such as re-education on environmental management methods, hand washing techniques, and blood culture sampling techniques, no more S. marcescens had been grown in blood culture since January, 2005.
Cross Infection ; Electrophoresis, Gel, Pulsed-Field ; Gyeonggi-do ; Hand ; Hand Disinfection ; Humans ; Infection Control ; Risk Factors ; Serratia marcescens ; Serratia* ; Soaps ; Soil

BACKGROUND: The propose of this study was to identify the level of medical technologists' perception of and compliance with hospital infection control guidelines. METHODS: A questionnaire survey was conducted for 65 medical technologists working at three university hospitals in Seoul and Kyunggi areas. The questionnaire was composed of 34 questions on the general characteristics (14 items) of individual responders and about infection control guidelines (20 items). Their response was marked on the basis of 5 points for each question. RESULTS: The mean scores of the perception of and compliance with the infection control guidelines were 4.62+/-0.34 and 3.85+/-0.42, respectively. The female technologists scored significantly higher than did the male counterparts in the participation level of the infection control guidelines (P<0.05). The medical technologists who had participated in an infection control educational program were more likely than those who had not to show a higher compliance level on the infection control guidelines (P<0.05). CONCLUSION: The study demonstrated that the development of infection control educational programs for medical technologists and a supportive policy of the hospital administration should contribute to the prevention of nosocomial infections.
Compliance* ; Cross Infection* ; Female ; Gyeonggi-do ; Hospital Administration ; Hospitals, University ; Humans ; Infection Control ; Male ; Medical Laboratory Personnel ; Seoul ; Surveys and Questionnaires

BACKGROUND: Silver has been used for disinfection and sterilization. We aimed to confirm the in-vitro antibacterial effects of nanocrystalline silver-coated gauze. METHODS: Fourteen clinical isolates each of Escherichia coli and Acinetobacter baumannii were used. Bacterial suspensions made in tryptic soy broth were exposed to Ordinary and silver-coated gauze. Bacteria were then harvested from the gauze immediately and after 24 h incubation, cultured on blood agar plates and eunmerated for viable counts. The number of colonies was converted into common logarithms for comparison. RESULTS: The number of colonies recovered from silver-coated gauze was significantly lower than those recovered from ordinary gauze when harvested immediately after exposure (E. coli, 3.06 vs 1.73; A. baumannii, 3.13 vs 1.98; P<0.001). After 24 h incubation of exposed gauze, silver-coated gauze produced less than 1 CFU/mL, whereas ordinary gauze produced a number of colonies significantly higher than it did immediately after exposure (E. coli, 4.13; A. baumannii, 4.46; P<0.001). Conclusion: Compared with ordinary gauze, silver-coated gauze was shown to have 99.99% antibacterial effect.
Acinetobacter baumannii ; Agar ; Bacteria ; Disinfection ; Escherichia coli ; Silver ; Sterilization ; Suspensions

No Abstract available.
Infection Control*

BACKGROUND: This study aimed to assess central supply room nurses' knowledge on and educational needs for the sterilization process. METHODS: The participants were 88 nurses working at central supply rooms of hospitals in Busan, Ulsan, and Gyeong-nam. From August to September 2014, knowledge and educational needs of the sterilization process were measured by using self-reported questionnaires. Data were analyzed by descriptive statistics, t test or analysis of variance (ANOVA), Scheffe test, and repeated-measures ANOVA with the SPSS 21.0 program. RESULTS: The mean score for knowledge on the sterilization process was 39.58 out of 50 points and was highest in keeping sterilization (8.94 out of 10 points) and lowest in packing sterilization (6.82 out of 10 points). The mean score for knowledge was significantly higher in the nurses with postgraduate studies (F=3.35, P=0.040), in those with internal training (t=2.03, P=0.045), with three or more internal trainings (F=9.72, P<0.001), with external training (t=3.48, P=.001), with two or more external trainings (F=8.40, P=0.001), and in those working in hospitals with 700 beds or more (F=15.88, P<0.001). The mean score for educational need was 4.06 out of 5 points, ranging from 3.99 to 4.12 points. It was significantly higher in nurses aged 40 years and older (F=4.28, P=0.017) and in those working in hospitals with 700 beds or more (F=4.82, P=0.010). CONCLUSION: Nurses working in central supply rooms need education on the sterilization process. We recommend the development of a standardized textbook and an educational program based on the results of this study.
Busan ; Education ; Sterilization* ; Ulsan

BACKGROUND: Prevention of respiratory infection among workers in geriatric facilities is important because the workers can transmit these infections to the elderly. Therefore, this study intended to assess the knowledge and compliance of preventive behavior against respiratory tract infection among these workers. METHODS: Data were collected from 202 workers in geriatric facilities via a questionnaire-based survey from July 19 to August 8, 2014. Data were analyzed using the SPSS 21.0 program. RESULTS: Among the workers, 44.6% experienced respiratory tract infection in the last 1 year. The score for knowledge of respiratory tract infection prevention among the workers was 10.6 points out of 12. The average score for compliance of the preventive behavior against respiratory tract infection was 34.6 points out of 48. The correlation between preventive knowledge and compliance of the preventive behavior against respiratory tract infection was not verified (r=0.00, P=0.967). CONCLUSION: In this study, the level of knowledge of respiratory infection prevention among the workers in the elderly care facility was high. However, the level of compliance was not sufficiently high. In addition, no correlation was found between their preventive knowledge and compliance. Therefore, a preventive program that focuses on the compliance of respiratory infection prevention rather than on its knowledge needs to be developed.
Aged ; Compliance* ; Humans ; Respiratory System* ; Respiratory Tract Infections*

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 2013 through June 2014. METHODS: We performed a prospective surveillance of nosocomial urinary tract infections (UTIs), bloodstream infections (BSIs), and pneumonia (PNEU) in 166 ICUs of 94 hospitals using the KONIS. Nosocomial infection (NI) rate was defined as the number of infections per 1,000 patient-days or device-days. RESULTS: A total of 2,843 NIs were found during the study period: 861 UTIs (846 were urinary catheter-associated), 1,173 BSIs (1,021 were central line-associated), and 809 PNEUs (498 were ventilator-associated). The rate of urinary catheter-associated UTIs was 1.21 per 1,000 device-days (95% confidence interval [CI]=1.13-1.29), and the urinary catheter utilization ratio was 0.84 (95% CI=0.839-0.841). The rate of central line-associated BSIs was 2.33 per 1,000 device-days (95% CI=2.20-2.48), and the utilization ratio was 0.53 (95% CI=0.529-0.531). The rate of ventilatorassociated PNEUs (VAPs) was 1.46 per 1,000 device-days (95% CI=1.34-1.60), and the utilization ratio was 0.41 (95% CI=0.409-0.411). In hospitals with more than 900 beds, although the ventilator utilization ratio was highest, the rate of VAPs was lower than in hospitals with 300-699 or 700-899 beds. CONCLUSION: BSIs were the most commonly reported nosocomial infections. Although device utilization ratios had increased, nosocomial infection rates did not differ significantly from those during the previous period (July 2012 through June 2013).
Cross Infection* ; Intensive Care Units* ; Critical Care* ; Pneumonia ; Prospective Studies ; Urinary Catheters ; Urinary Tract Infections ; Ventilators, Mechanical