BACKGROUND: This study was to evaluate a nationwide nosocomial infection rate and antimicrobial resistance in intensive care units(ICUs) in Korea. METHODS: The study was carried out at 16 university-affiliated teaching hospitals from July through October 2004. We performed a prospective multicenter study to investigate nosocomial infection rates, device-associated infection rated, and causative pathogens and their antimicrobial resistance. RESULTS: The urinary tract was the most commonly involved site. Nosocomial infection rate was 12.48 in medical. ICU (MICU), 9.59 in medical surgical ICU (MSICU), 14.76 in surgical ICU (MSICU), and 11.60 in other lCU. Device-associated infection rates were as follow: 1) rates of urinary catheter-associated urinary tract infection were 4.26 in MICU, 3.17 in SICU, 4.88 in MSICU, and 5.87 in other ICU; 2) rates of central line-associated bloodstream infection were 3.24 in MICU, 1.56 in SlCU, 2.36 in MSICU, and 1.78 in other ICU; 3) rates of ventilator-associated pneumonia were 3.61 in MlCU, 13.05 in SICU, 1.68 in MSICU, and 4.84 in other lCU. Staphylococcus aureus was the most frequently identified microorganism in this study; 93% of S. aurues were resistant to methicillin; 17% of Pseudomonas aeruginosa isolated were resistant to imipenem; 11% of Enterococcus faecium and 18% of Enterococcus faecalis showed resistance to vancomycin. Over a half of Acinetobacter spp, Stenotrophomonas maltophilia, Klebsiella pneumoniae, and Escherichia coli showed resistant to fluoroquinolone. Conclusion: This study shows the seriousness of antimicrobial resistance and the importance of infection control in the lCU in Korea. This study should provide a theoretical strategy to enforce the infection control.
Acinetobacter ; Cross Infection* ; Enterococcus faecalis ; Enterococcus faecium ; Escherichia coli ; Hospitals, Teaching ; Hospitals, University* ; Imipenem ; Infection Control ; Intensive Care Units* ; Critical Care* ; Klebsiella pneumoniae ; Korea* ; Methicillin ; Pneumonia, Ventilator-Associated ; Prospective Studies ; Pseudomonas aeruginosa ; Staphylococcus aureus ; Stenotrophomonas maltophilia ; Urinary Tract ; Urinary Tract Infections ; Vancomycin

Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most prevalent nosocomial pathogens in Korea. The prevalence of MRSA is nearly 70% of clinical isolates of S. aureus, and the importance of infection control has increased. Many DNA-based molecular techniques have been introduced to type MRSA strains, but no single method of molecular techniques is universally applicable. This review summarizes the molecular techniques in epidemiological analyses of MRSA, describing some practical applicatiais of these techniques.
Epidemiologic Methods* ; Infection Control ; Korea ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Prevalence

PURPOSE: This study was conducted to analyse the activities and status of infection control nurses (ICNs) and the trends of them since the first full-time ICN had been appointed in 1991. METHODS: Questionaries were mailed to 164 general hospitals with more than 300 beds. 85 hospitals were responded (51.8%) from 17June to 11 November 2003. RESULT: Full-time ICN was employed in 37.5%, 88.8% hospitals employed only one ICN regardless full-time or part-time ICN. ICNs spent time on surveillance (40.7%), teaching (29.4%), and meeting et al (30.3%). Surveillance was practice (67.5%), but surgical site surveillance was done in 12.1%. Personal characteristics and IC activities were significantly different between full-time and part-time ICNs. No of ICNs were increased by the national regulation and policy making. ICNs have improved the efficacy of infection control (IC) and abolished many wasteful ICs, The intensity of surveillance and the number of hospitals keep on hospital environmental control guidelines were increased. CONCLUSION: The number of ICNs was lower than 1980s' recommendation. The regulation on the ratio of ICN to beds should be added. The general features and activities of ICNs have been improved since 1991. However, to step up IC, the reward and support systems for ICN should be established.
Cross Infection ; Hospitals, General* ; Humans ; Infection Control* ; Policy Making ; Postal Service ; Reward

BACKGROUND: Hemodialysis patients are increasing every year and bloodstream infections (BSIs) are a major cause of morbidity and mortality in patients receiving hemodialysis. As the domestic studies have not explored the incidence of BSIs, the distribution and current situation of microorganism and so on this study was carried out to determine the incidence and epidemiological risk factors of the BSIs in hemodialysis patients. A distribution of pathogenic organism of the BSIs was investigated. METHODS: This study was carried out for those 275 patients with hemodialysis for 12 months the patients who underwent hemodialysis in the hemodialysis center within the university hospital. Data was collected by structural questionnaire, medical record review. The definition for BSIs was based on that of CDC. RESULTS: A total of 59 BSIs occurred during 123,502 dialysis sessions. The bloodstream infection rate per 1,000 dialysis sessions was 0.48 overall and varied markedly by the type of vascular access: 0.1 for arteriovenous fistulas, 0.54 for arteriovenous grafts. 2.57 for permanent catheters and 5.39 for temporary catheters. The most common pathogen isolated from the BSIs was MSSA and MRSA 18.0%, Streptococcus species 11.5%. In a logistic regression analysis, immunosuppressive therapy (OR=8.081, p=0.001), case of starting hemodialysis in the intensive care unit (OR=4.855, p=0.043) were associated independently with BSIs. CONCLUSION: Based on this study, continuous study and effort together with interest in BSIs, and the study on BSIs in hemodialysis patients should be further continued in the years to come. Surveillance for BSIs is recommended as a routine activity in hemodialysis center.
Arteriovenous Fistula ; Bacteremia ; Catheters ; Centers for Disease Control and Prevention (U.S.) ; Cross Infection ; Dialysis ; Humans ; Incidence ; Intensive Care Units ; Logistic Models ; Medical Records ; Methicillin-Resistant Staphylococcus aureus ; Mortality ; Renal Dialysis* ; Risk Factors ; Streptococcus ; Transplants ; Surveys and Questionnaires

Background: Reporting rate of notifiable communicable diseases has been assumed to be low in Korea. To encourage timely reporting of notifiable communicable diseases and to improve the reporting process by the Infection Control Unit, a disease code-based electronic surveillance and in-house electronic reporting system was developed and implemented in February 2003. We evaluated the reporting rates of notifiable communicable diseases before and after the implementation of the electronic reporting- system. METHODS: The electronic reporting system, which was integrated to the computerized physician order entry system, was designed to monitor KCD-4 codes at the time of every order entry. Whenever the system recognized the predetermined codes of notifiable communicable diseases, it generated an alert box to recommend reporting: and then a physician could fill up an electronic report form, which was collected and faxed to the local public health authority by the Infection Control Unit. Reporting rate of notifiable communicable diseases in 2002, when the conventional paper-based reporting system was used, was assumed comparing the number of cases reported actually and that of cases identified to be reported by reviewing the medical records and electronic database. RESULTS: From March to July 2003, 181 cases with tuberculosis and 14 with other communicable diseases were reported whereas 106 and 9 cases were reported respectively for the same 5-month period in 2002. Reporting rate using the conventional reporting system in 2002 was assumed to be 61% and 39% respectively. Conclusions: Using a disease code-based electronic reporting system, reporting of notifiable communicable diseases could be improved compared with conventional paper-based reporting system.
Communicable Diseases* ; Disease Notification ; Infection Control ; Korea ; Medical Informatics Applications ; Medical Order Entry Systems ; Medical Records ; Public Health ; Tuberculosis

PURPOSE: This study was conducted to investigate the epidemic pyrogenic reactions that occurred hospital-widely in 51 patients on 30-31 Mar. 1995 at a tertiary, educational, and acute care hospital. METHODS: The remained intravenous (IV) drugs and IV fluids that were infused to patients (N=51) who developed pyrogenic reactions were cultured and tested pyrogenic matter. Pyrogenic test was done by Limulus Amebocyte Lysate (PyrotellRMA,USA). RESULTS: IV normal saline 50 cc bottles (AAXSAT and AAX5AV) those were collected being used from case patients, and new bottles stocked in the drug storage were positive to pyrogenic test. Used normal saline collected from case patients were cultured coagulase-negative Staphylococus. Moreover the company, manufacturer of these fluids reported the positive pyrogenic test on these IV fluids (AAXSAT and AAX5AV). CONCLUSION: This epidemic was a pyrogenic reaction for infused the intrinsic contaminated fluid with pyrogen. We could prevent not the additional pyrogenic reactions in study hospital but national wide epidemics to apply the rapid and well-designed epidemic investigation and infection control.
Bacteremia ; Cross Infection ; Drug Storage ; Horseshoe Crabs ; Humans ; Infection Control

BACKGROUND: Nursing students may be exposed to patients with infectious diseases such as hepatitis B and hepatitis A through needle stick injuries or close contact during their clinical practice. This study surveyed the presence of antihepatitis B virus (anti-HBV), anti-hepatitis A virus (anti-HAV), and anti-varicella zoster virus antibodies in nursing students before the initiation of their clinical practice to help prevent subsequent infections. METHODS: From 2009 to 2013, the junior students of a nursing college in Jeollabuk-do were tested for antibodies against the hepatitis B, hepatitis A, and varicella zoster viruses before the initiation of their clinical practice. RESULTS: The students tested positive for anti-HBV (46.2-57.1%), anti-HAV (0-10.5%), and anti-varicella zoster antibodies (80.2-90.2%). No significant differences in the positivity rates were observed with respect to the year of their enrollment. CONCLUSION: This study was a survey of the seroprevalence of anti-HBV, anti-HAV, and anti-varicella zoster antibodies in nursing students before they started their clinical practice. The positivity rate of anti-HAV was lower than 10%. In order to prevent infection, it is necessary to test nursing students for the presence of antibodies against hepatitis B, hepatitis A, varicella, measles, mumps, and rubella, and check their vaccination history as recommended in the adult immunization schedule. Vaccination must be recommended for students who test negative for the respective antibodies.
Adult ; Antibodies* ; Chickenpox ; Communicable Diseases ; Hepatitis A ; Hepatitis A Antibodies ; Hepatitis B ; Hepatitis B Antibodies ; Herpes Zoster* ; Herpesvirus 1, Cercopithecine* ; Herpesvirus 3, Human ; Humans ; Immunization Schedule ; Jeollabuk-do ; Measles ; Mumps ; Needlestick Injuries ; Nursing* ; Rubella ; Seroepidemiologic Studies* ; Students, Nursing* ; Vaccination

No abstract available.
Busan* ; Infection Control*

No Abstract available.
Academic Medical Centers* ; Infection Control* ; Korea*

No Abstract available.
Korea*