1.Recognition of a Pseudo-Outbreak of Cladosporium Species by Continuous Monitoring of Culture Results.
Soohun YOO ; Myung Sook KIM ; Hae Sun CHUNG ; Yangsoon LEE ; Dongeun YONG ; Seok Hoon JEONG ; Kyungwon LEE ; Yunsop CHONG
Korean Journal of Nosocomial Infection Control 2010;15(1):57-63
BACKGROUND: Cladosporium spp. are dematiaceous fungi that are commonly isolated from indoor and outdoor environments, including hospital air. This fungus is rarely pathogenic to humans, but has been reported to cause infections of the skin and toenails, as well as sinusitis and pulmonary infections. The monitoring of culture results was conducted to identify the outbreak of an unknown black fungal infection between January and March 2006 in a University hospital, and infection control activity was performed to identify the cause of the outbreak. METHODS: An epidemiological investigation of 22 patients with infections caused by an unknown black fungus was conducted. Microscopic examination and molecular analysis on the internal transcript spacer (ITS) region was performed to identify the black fungus. To detect the source of contamination, a culture of environmental specimens was performed, and then, disinfection of the laboratory was implemented. RESULTS: The patients with black fungi belonged to various departments and wards. No symptoms of fungal infection were recognized on the basis of the survey. The black fungus was identified as Cladosporium spp. on the basis of morphological features and ITS region sequencing. Culturing of environmental specimens was performed in the laboratory. Black fungi were isolated from a specimen from a rack and had the same morphological features with Cladosporium spp. from clinical specimens. After the rack was autoclaved, Cladosporium spp. from clinical specimens was no longer isolated. CONCLUSION: Epidemiological investigation, microscopic examination, and molecular analysis revealed that the sudden increase in the isolation rate of Cladosporium spp. from clinical specimens was the result of a pseudo-outbreak caused by the contamination of a rack. To our knowledge, this is the first report of a pseudo-outbreak of Cladosporium spp. Continuous monitoring of culture results is important to avoid unnecessary labor for nosocomial infection control.
Cladosporium
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Cross Infection
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Disinfection
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Fungi
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Humans
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Infection Control
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Nails
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Sinusitis
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Skin
2.Knowledge of and Attitude toward Acquired Immunodeficiency Syndrome among Korean Auxiliary Police.
Young PARK ; Jae Sim JEONG ; Haeng Mi SON ; Jun Hee WOO
Korean Journal of Nosocomial Infection Control 2010;15(1):48-56
BACKGROUND: The purpose of this study was to investigate AIDS-specific knowledge, attitudes, and behaviors of auxiliary police on duty in Seoul and to provide basic data for use in AIDS prevention education for auxiliary police. METHODS: In November 2008, we questioned 402 auxiliary police in the Mobile Police Force located in Seoul by using a self-administered questionnaire containing 39 items. RESULTS: Of the respondents, 98.5% were unmarried and scored, on average, 2.95+/-0.98 out of 4 with respect to their knowledge about the transmission routes of HIV infection. Approximately 70.6% of the respondents were sexually active in the past year and 6.3% were diagnosed with or treated for a venereal disease within the past year. Approximately 42.5% of the respondents had sex with someone other than their steady partner and 35.5% of these respondents did not use condom during sexual intercourse. Approximately 77% of the respondents were willing to be anonymously tested for HIV infection that may have been acquired because of unprotected sexual activity during the past year (P=0.018). CONCLUSION: Providing assertive education, as well as additional support and instructions, is necessary to raise awareness about the prevention of AIDS among auxiliary police.
Acquired Immunodeficiency Syndrome
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Anonyms and Pseudonyms
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Coitus
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Condoms
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Surveys and Questionnaires
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HIV Infections
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Humans
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Police
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Sexual Behavior
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Sexually Transmitted Diseases
;
Single Person
3.Needlestick/Sharps Injuries in Nursing Students in Korea: A Descriptive Survey.
Kyung Mi KIM ; Suk Jung HAN ; Sun Nam PARK
Korean Journal of Nosocomial Infection Control 2010;15(1):41-47
BACKGROUND: The purpose of this study was to examine the frequency and characteristics of needlestick/sharps injuries (NSIs) in nursing students in Korea. METHODS: The study was based on a survey of questionnaires completed by 341 nursing students who had sustained at least one NSI during clinical practice in hospitals. RESULTS: The NSI incidence rate was 36.4%. Approximately half of the students reported two to four NSIs. Most (90.2%) of the NSIs occurred on the fingertips and were caused by a hollow-bore needle (46.8%) or lancet (45.8%). Some students were exposed to used needles contaminated with unknown pathogens (37.3%), HBs Ag (2.3%), Venereal Disease Research Laboratory (VDRL) (0.8%), or HIV (0.6%). Students cited the reason for injury as carelessness, inexperience, hastiness, or recapping. Almost two-thirds of students who reported having experienced an NSI knew about post-exposure treatment. However, only one-third of the students with NSIs completed an official report. CONCLUSION: Korean nursing students lack knowledge about injury prevention, report procedures, and treatment after NSI. A revised educational approach with emphasis on occupational risk, skill development, and injury reporting is necessary to prevent NSI and to ensure that students obtain post-exposure prophylaxis.
Dietary Sucrose
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HIV
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Humans
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Incidence
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Korea
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Needles
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Needlestick Injuries
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Post-Exposure Prophylaxis
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Sexually Transmitted Diseases
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Students, Nursing
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Surveys and Questionnaires
4.Isolation of Healthcare-Associated Pathogens from Cellular Phones Used by Medical Personnel.
Jae Seok KIM ; Oh Kun KWON ; Wonkeun SONG ; Han Sung KIM ; Ji Young PARK ; Hyoun Chan CHO ; Kyu Man LEE ; Hae Ran LEE
Korean Journal of Nosocomial Infection Control 2010;15(1):36-40
BACKGROUND: Cellular phone has become a necessary device for communicating in hospitals. Cellular phones contaminated with bacteria may serve as a fomite in the transmission of pathogens by the hands of medical personnel. We investigated the bacterial contamination of cellular phones used by medical personnel in a tertiary hospital. METHODS: Culture swabs were obtained from 101 cellular phones and 99 anterior nasal cavities from medical personnel using cellular phones. The swabs were inoculated on blood agar, MacConkey agar, mannitol salt agar, and enterococcal broths containing 6microgram/mL vancomycin for 48 h at 37degrees C. The bacteria were identified on the basis of colony morphology, gram staining characteristics, catalase test, coagulase test, and DNase test; Microscan (Siemens, USA) was used for the identification of enterococci. RESULTS: Of the 101 cellular phones, 13 were contaminated with Staphylococcus aureus (including 4 methicillin-resistant S. aureus [MRSA]), 61 with coagulase-negative staphylococci (CoNS) (including 38 methicillin-resistant CoNS), 27 with Micrococcus spp., 11 with diphtheroids, 67 with Bacillus spp., and 4 with viridans streptococci. No gram-negative bacilli were isolated. Nasal swabs yielded 36 S. aureus, including 9 MRSA. Only 1 of 9 cellular phones used by the MRSA carriers was contaminated with MRSA. CONCLUSION: Cellular phones used by some medical personnel were contaminated with pathogens such as S. aureus or MRSA. Although, the clinical implications of pathogens isolated from cellular phones have not been fully investigated, pathogens could be transmitted by the hands of medical personnel who are cellular phone users.
Agar
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Bacillus
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Bacteria
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Catalase
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Cellular Phone
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Coagulase
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Deoxyribonucleases
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Disinfection
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Fomites
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Hand
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Hand Hygiene
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Mannitol
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Methicillin Resistance
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Methicillin-Resistant Staphylococcus aureus
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Micrococcus
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Nasal Cavity
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Staphylococcus aureus
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Tertiary Care Centers
;
Vancomycin
;
Viridans Streptococci
5.Post-Exposure Reporting of Needlestick and Sharp-Object Injuries among Nurses.
Jeong Min SEO ; Ihn Sook JEONG
Korean Journal of Nosocomial Infection Control 2010;15(1):26-35
BACKGROUND: Nurses are often exposed to needlestick and sharp-object injuries (NSIs). This study aimed to investigate the post-exposure reporting rate of NSIs among nurses. METHODS: The subjects were 84 nurses from 4 hospitals (3 hospitals with 300 or more beds and 1 hospital with less than 300 beds) who had experienced at least 1 NSI within a 6-month period. The instrument was a self-administered questionnaire, which was based on the EPINet report form and a questionnaire for NSIs among resident physicians, which was used by Choi et al. Data were collected between April 9 and June 15, 2009, and analyzed using descriptive statistics and the chi-square test, which was performed using SPSS with a significance level of 0.05. RESULTS: Among the 84 nurses who had experienced at least 1 NSI within 6 months, only 14.3% had reported the NSIs, and 58.4% of these subjects reported the NSI immediately after sustaining the injury. The most common reason for not reporting was "the patients were found out to be uninfectious" (81.9%) followed by "too busy" (65.3%). The incidence of post-exposure reporting was negatively related to the number of NSIs (chi-square=13.871, p<0.001) and positively related to assessments of infectivity of the patients (chi-square=4.248, P=0.039) and other persons' recommendations to report NSIs (chi-square=4.092, P=0.043). CONCLUSION: The post-exposure reporting rate was very low. The factors responsible for this low rate should be investigated in a more systematic manner, and more measures should be undertaken to increase the reporting rate among nurses.
Humans
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Incidence
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Needlestick Injuries
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Surveys and Questionnaires
6.Korean Nosocomial Infections Surveillance System, Intensive Care Unit Module Report: Data Summary from July 2008 through June 2009 and Analysis of 3-Year Results.
Yee Gyung KWAK ; Yong Kyun CHO ; Jin Yong KIM ; Sang Oh LEE ; Hyo Youl KIM ; Young Keun KIM ; Eun Suk PARK ; Hye Young JIN ; Hee Jung CHOI ; Sun Young JEONG ; Eu Suk KIM ; Hyun Kyun KI ; Sung Ran KIM ; Ji Young LEE ; Hae Kyung HONG ; Soonduck KIM ; Young UH ; Yeong Seon LEE ; Hee Bok OH ; Eui Chong KIM
Korean Journal of Nosocomial Infection Control 2010;15(1):14-25
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 2008 through June 2009. METHODS: We performed a prospective surveillance of nosocomial urinary tract infections (UTI), bloodstream infections (BSI), and pneumonia (PNEU) at 101 ICUs in 57 hospitals using KONIS. Nosocomial infection (NI) rates were calculated as the numbers of infections per 1,000 patient-days or device-days. RESULTS: We identified 3,287 NIs during the study period: 1,787 UTIs (1,772 cases were urinary catheter-associated), 917 BSIs (797 were central line-associated), and 583 PNEUs (335 were ventilator-associated). The rate of urinary catheter-associated UTIs was 4.80 cases per 1,000 device-days (95% confidence interval, 4.58-5.03) and urinary catheter utilization ratio was 0.85 (0.849-0.851). Although the urinary catheter utilization ratios were lower in the hospitals with 400-699 beds than in the hospitals with 700-899 beds and more than 900 beds, the rates of urinary catheter-associated UTIs were higher in hospitals with 400-699 beds than in the larger ones. The rate of central line-associated BSIs was 3.27 (3.05-3.51) and the utilization ratio was 0.56 (0.559-0.561). The rate of ventilator-associated PNEUs was 1.86 (1.67-2.07) and the utilization ratio was 0.41 (0.409-0.411). The rate of ventilator-associated PNEUs was lower in July 2008-June 2009 than in July 2007-June 2008 and July 2006-December 2006. CONCLUSION: It appears that the KONIS influences the reduction in the rate of device-associated infections, especially ventilator-associated PNEU; therefore, ongoing targeted surveillance and infection control strategies are needed to control device-associated infections.
Cross Infection
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Gossypol
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Infection Control
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Critical Care
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Intensive Care Units
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Pneumonia
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Urinary Catheters
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Urinary Tract Infections
7.Can We Overcome the Antimicrobial Resistance in Hospital?.
Korean Journal of Nosocomial Infection Control 2006;11(1):1-14
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
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Cephalosporins
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Cross Infection
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Education
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Enterococcus
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Infection Control
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Korea
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Methicillin-Resistant Staphylococcus aureus
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Prescriptions
;
Prevalence
8.Infection control program in Asan Medical Center.
Jae Shim JEONG ; Jeong Sil CHOI ; Chik Hyun PAI
Korean Journal of Nosocomial Infection Control 1997;2(2):145-154
No Abstract available.
Chungcheongnam-do*
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Infection Control*
9.Comparison of Nosocomial Infection Rates.
Korean Journal of Nosocomial Infection Control 1997;2(2):137-143
No Abstract available
Cross Infection*
10.Tuberculin skin test in newly employed Health Care Workers.
Sung Won YOON ; Og Son KIM ; Jae Hoon SONG
Korean Journal of Nosocomial Infection Control 1997;2(2):131-136
OBJECTIVES: Health care workers(HCWs) are more likely to become infected with tuberculosis from patients in the hospital. When HCWs have an active tuberculosis infection, it is possible that they also become a source of infections to other HCWs and patients. METHODS: Tuberculin tests were performed with mantoux method using 5 units of tuberculin by infection control practitioners on Feb. 21, and Mar. 7, 1997. A total of 138 newly employed HCWs including 44interns and 94 nurses were tested. Results of skin test were interpreted by themselves according to the instructions. RESULTS: Among 138 personels, skin tests were negative in 27 personels (19.6%); 4 interns (9.1%) and 23 nurses (24.5%). There were 3 persons (2.2%) who had a history of tuberculosis which had been treated. CONCLUSION: The study showed that approximately 20% of newly employed HCWs had negative tuberculin skin test. Given the possibility of being infected with tuberculosis in the hospital, regular follow up of tuberculin skin test is warranted to protect HCWs,
Delivery of Health Care*
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Humans
;
Infection Control Practitioners
;
Skin Tests*
;
Skin*
;
Tuberculin Test
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Tuberculin*
;
Tuberculosis