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 ; Cross Infection ; Disinfection ; Fungi ; Humans ; Infection Control ; Nails ; Sinusitis ; Skin

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 ; Anonyms and Pseudonyms ; Coitus ; Condoms ; Surveys and Questionnaires ; HIV Infections ; Humans ; Police ; Sexual Behavior ; Sexually Transmitted Diseases ; Single Person

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 ; HIV ; Humans ; Incidence ; Korea ; Needles ; Needlestick Injuries ; Post-Exposure Prophylaxis ; Sexually Transmitted Diseases ; Students, Nursing ; Surveys and Questionnaires

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 ; Bacillus ; Bacteria ; Catalase ; Cellular Phone ; Coagulase ; Deoxyribonucleases ; Disinfection ; Fomites ; Hand ; Hand Hygiene ; Mannitol ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Micrococcus ; Nasal Cavity ; Staphylococcus aureus ; Tertiary Care Centers ; Vancomycin ; Viridans Streptococci

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 ; Incidence ; Needlestick Injuries ; Surveys and Questionnaires

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 ; Gossypol ; Infection Control ; Critical Care ; Intensive Care Units ; Pneumonia ; Urinary Catheters ; Urinary Tract Infections

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

BACKGROUND: Urinary tract is the most common site of nosocomial infections, accounting for 35% of all nosocomial infections. About 80-90% of these urinary tract infections are associated with urethral catheter insertion. Recently, we experienced an outbreak of nosocomial UTI (urinary tract infection) caused by Candida spp. in the surgical ICU (SICU) and we investigated the cause of UTI outbreak. METHODS: We collected data from clinical records and observed the current methods of care of urethral catheters in the SlCU. During the outbreak, we investigated the current procedures and maintenance care of urethral catheter insertion and educated the staff on the correct methods of the catheter insertion and care. We performed surveillance cultures of unused new urine bags, RESULTS: Between May 2000 and June 2000, 17 Candida spp. strains were isolated from urines of 17 patients hospitalized in the SICU of National Health Insurance Corporation Ilsan Hospital. All infections were attributed to the care of urethral catheter insertion and contaminated bags. We identified that routine bladder irrigation and emptying urine to a common urinal have been done incorrectly during the outbreak period. Rodotorula spp. was isolated from 4 urine bags (50% contamination rate) out of 8 unused new urine bags by surveillance cultures. CONCLUSION: The causes of the UTI outbreak caused by Candida spp. was terminated by outbreak investigation and change of contaminated urine bag.
Candida* ; Catheters ; Cross Infection ; Humans ; National Health Programs ; Urinary Bladder ; Urinary Catheters ; Urinary Tract Infections* ; Urinary Tract*

BACKGROUND: Numerous disinfectants are available for disinfection and sterilization in the hospital environment but it is difficult to select an appropriate one. Biospot(R) is a chlorine-based disinfectant that consists of sodium dichloroisocyanurates. We evaluated the bactericidal effect of Biospot(R) against clinical isolates and compared it with that of other disinfectants. METHOD: Biospot(R), Wydex(R), HiCLO-S(R), Vipon(R), 70% ethanol, and 3% boric acid were evaluated. Clinical isolates were cultured from the patients in Kangnam St. Mary's hospital. There were two strains of Escherichia coli, methicillin-susceptible Staphylococcus aureus, methicillin-resistant Staphylococcus aureus, Klebsiella pneumoniae, vancomycin-resistant Enterococcus faecium, Pseudomonas aeruginosa, coagulase-negative staphylococcus, Streptococcus pneumoniae, and Bacillus subtilis. One strain of Candida albicans was included. Each strain was exposed to disinfectants for 0.5, 1, 2, 4, 8, and 15 minutes. RESULTS: All the non-spore forming bacteria were killed within 30 seconds in Biospot(R) (30 ppm of sodium dichloroisocyanurate). Wydex(R) (2% glutaraldehyde), HiCLO-S(R) (hypochlorous add 30ppm and electrolyzed oxidized water), Vipon(R) (50ppm of sodium hypochlorite), and 70% ethanol, but not in boric acid. Candida albicans were killed in 30 seconds with 100 ppm of BiOSpot(R) and all of disinfectants except boric acid. Bacillus subtilis, the spore forming bacteria, was killed in 4 minutes with 50 ppm, 2 minutes with 100 ppm of Btospot. Other disinfectants such as Vipon(R) killed Bacillus subtilis in 8 minutes. But Wydex(R), HiCLO-S(R), 70% ethanol, and boric acid could not kill the strain until 15 minutes. CONCLUSIONS: Biospot(R) was an effective and useful disinfectant against most common clinical isolates including fungus and spore forming bacteria.
Bacillus subtilis ; Bacteria ; Candida albicans ; Disinfectants ; Disinfection ; Enterococcus faecium ; Escherichia coli ; Ethanol ; Fungi ; Humans ; Klebsiella pneumoniae ; Methicillin-Resistant Staphylococcus aureus ; Pseudomonas aeruginosa ; Sodium ; Spores ; Staphylococcus ; Staphylococcus aureus ; Sterilization ; Streptococcus pneumoniae

BACKGROUND: Glutaraldehyde is used most commonly as a high-level disinfectant for semicritical patient-care equipments. However, its potential toxicity to healthcare workers and a long exposure time needed to kill mycobacteria can be problematic. Recently, Perasafe(R) (Antec International, UK) has been introduced in the market as a safe and very effective disinfectant. This study was to evaluate the efficacy of Perasafe(R) against not only bacteria and yeast but also mycobacteria and bacterial spores and compare it with glutaraldehyde. MATERIAL AND METHOD: Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Candida albicans, Mycobacterium tuberculosis, and Bacillus subtilis were used for the test. Perasafe(R) and Cidex(R) were used at the final concentration of 1.62% and 2.25%, respectively; the disinfectants were neutralized by Tween 80 (0.5%) in the mycobacterial test and by lecithin (0.75%) in all other tests. Bacterial suspensions were made in phosphate buffer with or without fetal bovine serum (1%) to simulate dirty or clean conditions, respectively. The disinfectants were tested at 0, 24 and 48 hr of preparation to check stability. An effective disinfectant activity was defined as a 5 log10 reduction in viable counts. RESULTS: E. coli, S. aureus, P. aeruginosa and C albicans were effectively disinfected in less than 5 min by both Perasafe(R) and Cidex(R) and the both disinfectants remained equally effective under the dirty conditions or at 48 hr of preparation. Perasafe(R) was effective in 1 min against B. subtilis spores compared to Cidex(R) which took 30 min for the same activity. M. tuberculosis was effectively disinfected in 10 min by Perasafe(R) and 20 min by Cidex(R). CONCLUSIONS: Perasafe(R) showed greater tuberculocidal and sporicidal activities than Cidex(R), although both disinfectants were equally effective against common bacterial and yeast pathogens. Perasafe(R) may be an outstanding high-level disinfectant for endoscopes and other semicritical medical equipment.
Bacillus subtilis ; Bacteria* ; Candida albicans ; Delivery of Health Care ; Disinfectants ; Endoscopes ; Escherichia coli ; Glutaral ; Lecithins ; Mycobacterium tuberculosis ; Polysorbates ; Pseudomonas aeruginosa ; Spores ; Spores, Bacterial* ; Staphylococcus aureus ; Suspensions ; Tuberculosis ; Yeasts*