BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) continues to be a major cause of nosocomial infection and a molecular typing is necessary for proper epidemiologic investigations of sources and moles of spread in an outbreak. An nosocomial outbreak of MRSA in a neonatal intensive care unit at Ewha Womans University Mokdong Hospital was suspected. To investigate the clonality of isolates and control the spread of nosocomial outbreak, we performed plasmid restriction analysis of MRSA isolates from patients and medical staffs. METHODS: We studied 7 MRSA strains (umbilicus 4, blood 1, urine 1 and pus 1) from patients in a neonatal intensive care unit and the MRSA strains from nares and hands surveillance cultures of 26 medical staffs (4 medical doctors and 22 nurses). All MRSA strains were tested for antimicrobial susceptibility and plasmic analysis after EcoRI restriction. We analyzed the plasmid patterns of MRSA isolated from patients and compared with those from medical staffs. RESULTS: Ten MRSA strains (from 7 nares and 3 hands) were isolated from surveillance cultures of 26 medical staffs. Seven out of 10 MRSA strains from medical staffs revealed identical pattern of antibiogram which was the same pattern in all 7 MRSA strains from seven patients. Plasmid restriction patterns were classified 6 groups from A to F showing 2-10 bands. Six out of 7 MRSA strains from the patients showed group A(A1 5, A31) and 5 out of 10 MRSA strains from the medical staffs showed group A(A1 1, A21, A32, A41) and remainders showed different plasmid restriction analysis patterns. CONCLUSIONS: These results suggest that plasmid restriction analysis is a rapid, inexpensive, and good discriminating molecular typing of MRSA outbreak and is useful for the epidemiologic investigation of MRSA outbreaks in the clinical laboratory.
Cross Infection ; Disease Outbreaks ; Female ; Hand ; Humans ; Infant, Newborn ; Intensive Care, Neonatal ; Medical Staff ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Microbial Sensitivity Tests ; Molecular Epidemiology* ; Molecular Typing ; Plasmids* ; Suppuration

BACKGROUND: Approxinately 30%-70% of patients hospitalized receive intravenous(IV) therapy[l-4], It is generally believed that many hospitalized patients experienced IV therapy related complications-including infiltration(swelling), phlebitis, pain, suppurative phlebitis and bacterernia. These complications may be critical to ill children in the hopsital. This study was done to assess the IV therapy related complications and characteristics od the phlebitis of the hospitalized children. METHODS: We collected date prospectively from December 8, 1994 to December 14 at the tertiary care hospital in Seoul. The subhects of this study were children who got new IV catheters during that period. RESULTS: There were 306 new cases(176 children) that got IV therapy and which meant 63.8 per 100 discharge patients. Male(62.8%), pediatric surgery patients(70.6%) were more than female(37.2%) and pediatrucs(28.4%) respectively. The usually used IV sites were the upper extermities(71.3%). Among various purposes of IV therapy, the most common was to administer drugs(74.2%) including antibiotics, and next was to keep vein open (41.2%). By the way, 172 cases(56.3%) had IV related complications and 14 resulted in phlebitis. The most common IV related complication of hospitalized children was swelling(35.1%). The incidence of IV related complication of hospitalized children was swelling(35.1%). The incidence of IV phlebits was higher in pediaterics than in pediatrid surgery (P<0.05), over 12 years old than under that aged patients (P<0.01). CONCLUSION: This study revealed that many hospitalized children experienced the IV related complications. In order to decrease the IV related complications, reduce the incidence and thorough care is recommanded.
Anti-Bacterial Agents ; Catheters ; Child* ; Child, Hospitalized ; Humans ; Incidence ; Phlebitis ; Prospective Studies ; Seoul ; Tertiary Healthcare ; Veins

No abstract available.
Humans ; Twins*

No abstract available.
Brain* ; Child* ; Humans ; Seizures*

Injuries are important causes of death and disability. The purpose of this study was to determine how often preschoolers have injuries and what factors affect the injury occurrences. The sample consisted of 360 preschoolers who were registered at eight nurseries located in Sedaemoongu, Seoul. The data were analyzed using the SAS PC statistical package. The results of the study are as follows: During last 12 months 73.1% of 360 preschoolers had accidental injuries. In an analysis of the location where the injury took place, showed that the most places were in the nursery(17.3%) and around home(14.4%), and the most place inside home were in the bedroom(13.9%) and living room(13.9%). There were the diverse and injurious risks inside the home as well as around home. The most frequent type of injury was abrasion(27.5%) and most children injured their legs(28.3%). They were treated most frequently at home(52.8%) and usually emergency treatment was performed by family members with disinfection being the main type of first aid. To identify factors related to injury occurrence, multiple logistic regression was performed and the main factors were the age of child, active tendency, and mother's education level.
Cause of Death ; Child ; Disinfection ; Education ; Emergency Treatment ; First Aid ; Humans ; Logistic Models ; Nurseries ; Seoul ; Child Health

Injuries are important causes of death and disability. The purpose of this study was to determine how often preschoolers have injuries and what factors affect the injury occurrences. The sample consisted of 360 preschoolers who were registered at eight nurseries located in Sedaemoongu, Seoul. The data were analyzed using the SAS PC statistical package. The results of the study are as follows: During last 12 months 73.1% of 360 preschoolers had accidental injuries. In an analysis of the location where the injury took place, showed that the most places were in the nursery(17.3%) and around home(14.4%), and the most place inside home were in the bedroom(13.9%) and living room(13.9%). There were the diverse and injurious risks inside the home as well as around home. The most frequent type of injury was abrasion(27.5%) and most children injured their legs(28.3%). They were treated most frequently at home(52.8%) and usually emergency treatment was performed by family members with disinfection being the main type of first aid. To identify factors related to injury occurrence, multiple logistic regression was performed and the main factors were the age of child, active tendency, and mother's education level.
Cause of Death ; Child ; Disinfection ; Education ; Emergency Treatment ; First Aid ; Humans ; Logistic Models ; Nurseries ; Seoul ; Child Health

No abstract available.
Intestinal Obstruction*

Pleomorphic xanthoastrocytoma(PXA) is a benign brain tumor with favorable prognosis in spite of its marked pleomorphism. We report a case with review of the literature. An eight-year-old boy presented with headache and vomiting. Plain skull X-ray showed findings of increased intracranial pressure. The MR imaging demonstrated superficially located large cystic mass with a Iobulated mural nodule in the left frontal lobe. The mural nodule abutting leptomeninges showed intense enhancement on postcontrast Tl-weighted images, but the cyst wall was not enhanced. Preoperative diagnosis of PXA with the MRI findings could lead to avoidance of more aggressive brain resection and therefore more favorable neurological outcome
Brain ; Brain Neoplasms ; Child* ; Diagnosis ; Frontal Lobe ; Headache ; Humans ; Intracranial Pressure ; Magnetic Resonance Imaging ; Male ; Prognosis ; Skull ; Vomiting

PURPOSE: This retrospective study was done to evaluate the status of nosocomial urinary tract infections and to determine the risk factors andtransmission route of causal IRPA through molecular epidemiology. METHOD: Two hundred ninety-nine of 423 patients admitted to the internal medicine and surgery ICU at a university hospital incity B had a positiveurine culture. Twelve of the 299 patients who had a urinary tract infection had IRPA strains. The data was collected from November 1, 2004 to January 31, 2005. The following results were obtained after the data was analyzed using percentile and UPGMA. RESULT: The rate of nosocomial urinary tract infections in the ICU was 10.8%. Therewere 16.8 cases of infection based on the period of hospitalization. There were 16.9 cases of infection based on the use of a foley catheter. The rate of nosocomial urinary tract infection in the ICU and urinary tract infections related to IRPA were higher in patients with the following characteristics: men, old age, admission through the emergency room, longer than seven days admission, severity of admitting causes, disturbance of consciousness, hydration less than 300cc in 24hours, a long course of antibiotics, a long period of foley catheterization and perineal care. Most of the microorganisms that caused the urinary tract infection were gram negative bacilli, among which P. aeruginosa was found in 70 patients (18.5%) and IRPA in 12 (4.0%). Among the 12 IRPA strains that were tested with PFGE, eight showed a dice coefficient higher than 80%, suggesting a genetic relationship. They were related with the period of hospitalization in the same ICU. These patients all received direct care for a urinary tract infection. CONCLUSION: Through these results, IRPA can be consideredas a contributing factors to urinary tract infections thus, active preventative measures are needed by the medical staff.
Adult ; Aged ; Aged, 80 and over ; Anti-Bacterial Agents/*pharmacology ; Cross Infection/*epidemiology/etiology/microbiology ; Drug Resistance, Bacterial ; Female ; Humans ; Imipenem/*pharmacology ; Intensive Care Units ; Male ; Middle Aged ; Pseudomonas Infections/drug therapy/*epidemiology ; Pseudomonas aeruginosa/classification/drug effects/*genetics ; Retrospective Studies ; Risk Factors ; Urinary Catheterization ; Urinary Tract Infections/*epidemiology/etiology/microbiology

No abstract available.
Bacteria, Anaerobic*