Ventilator-Associated Peneumonia.
Korean Journal of Nosocomial Infection Control.2002;7(1):1-12.
No abstract available.
Korean Journal of Nosocomial Infection Control
1996 to Present ISSN: 1226-2382
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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 ; Cephalosporins ; Cross Infection ; Education ; Enterococcus ; Infection Control ; Korea ; Methicillin-Resistant Staphylococcus aureus ; Prescriptions ; Prevalence
Aminoglycosides ; Cephalosporins ; Cross Infection ; Education ; Enterococcus ; Infection Control ; Korea ; Methicillin-Resistant Staphylococcus aureus ; Prescriptions ; Prevalence
Korean Journal of Nosocomial Infection Control.2009;14(1):51-59.
BACKGROUND: This is a retrospective, descriptive study, evaluating the observed agreement between 1996 & 2002 Centers for Disease Control and Prevention (CDC) definitions of nosocomial pneumonia (NP) for medical intensive care unit (MICU) and surgical intensive care unit (SICU) patients. METHODS: A total of 476 adult patients who were over 15 years of age and had been admitted to the MICU & SICU of a university hospital between August 1, 2005 and August 1, 2007 were enrolled. Data were collected from electronic medical records according to the 1996 & 2002 CDC definitions of NP. RESULTS: According to the 1996 CDC definitions of NP, there were a total of 116 NP cases and incidence rate was 11.6 per 1,000 patient-days; when analyzed with the 2002 CDC definitions of NP, 75 cases met the criteria and the incidence rate was 7.5 per 1,000 patient-days. Kappa value measuring agreement between the two definitions was 0.67 (95% confidence interval 0.601-0.706). When 1996 CDC definitions were compared with 2002 CDC definitions, sensitivity, specificity, positive predictive value, and negative predictive value were 93.3, 88.5, 60.3, and 98.6%, respectively. CONCLUSION: Even though the aforementioned NP criteria had been applied to the same study population, the number of patients that met the definitions changed depending on which criteria had been used. Therefore, it is necessary to consider the differences when making a comparison.
Adult ; Centers for Disease Control and Prevention (U.S.) ; Electronic Health Records ; Humans ; Incidence ; Critical Care ; Intensive Care Units ; Pneumonia ; Retrospective Studies ; Sensitivity and Specificity
Adult ; Centers for Disease Control and Prevention (U.S.) ; Electronic Health Records ; Humans ; Incidence ; Critical Care ; Intensive Care Units ; Pneumonia ; Retrospective Studies ; Sensitivity and Specificity
Investigation on the Hemodialysis System Contaminated with Ralstonia Pickettii.
Korean Journal of Nosocomial Infection Control.2009;14(1):43-50.
INTRODUCTION: To prevent hemodialysis-related infections, it is important to maintain hemodialysis system without microbial contamination. In May 2003, routine surveillance showed that dialysis water from dialysis port was contaminated with bacteria. To identify the causes of the contamination, we conducted an investigation as follows. METHODS: Patients undergoing dialysis were carefully monitored to see whether evidences of pyrogenic reactions or infections were present. Factors that could have influence on bacterial contamination in hemodialysis systems were thoroughly examined. In addition, microbiologic surveillances were done 7 times in 1 month. RESULTS: Although pyrogenic reactions or bacteremia did not occur, R. pickettii was repeatedly isolated above the Association for the Advancement of Medical Instrumentation (AAMI) standards from almost all dialysis units. Bacterial counts of specimens were higher in the proximal part of the water supply tube than the other parts in all dialysis machines. The colony count of R. pickettii exceeded the maximum level of technical limit in the specimens collected from the dialysis machines in the early morning after intermission of 48 hours. The structure of the supply tube was suspected as the origin of the colonization because stagnant water is a reservoir for bacterial multiplication. After remodeling the structure of the water supply tube, neither R. pickettii nor any other bacteria were isolated. CONCLUSION: Our investigation successfully identified the source of R. pickettii contamination of reverse osmosis water. Appropriate corrective measures for water distribution systems of hemodialysis center could prevent outbreak of dialysis-associated illnesses.
Bacteremia ; Bacteria ; Bacterial Load ; Colon ; Dialysis ; Humans ; Osmosis ; Ralstonia ; Ralstonia pickettii ; Renal Dialysis ; Water ; Water Supply
Bacteremia ; Bacteria ; Bacterial Load ; Colon ; Dialysis ; Humans ; Osmosis ; Ralstonia ; Ralstonia pickettii ; Renal Dialysis ; Water ; Water Supply
Korean Journal of Nosocomial Infection Control.2009;14(1):36-42.
BACKGROUND: Norwegian scabies is a highly infectious disease characterized by crust formation, different from ordinary scabies, and is caused by Sarcoptes scabiei. After the patient in our case was diagnosed with Norwegian scabies, active measures were taken to prevent its transmission within the hospital. Methods: A 66-year-old female patient was admitted to the general ward of a university hospital on January 23rd, 2008 and 6 days later, she was found to have been infected with Norwegian scabies all over the body. For epidemiological investigation, those who had been in contact with the patient were identified and interviewed. The patient was advised to follow the contact precaution, and linen the patient used was cleaned thoroughly. The surrounding environment was decontaminated by applying surface disinfectant. Preventive cream against the Norwegian scabies was distributed to staff members and patients who had been exposed to the patient, and appointed a dermatologist to educate them on how to use of medicine, what the mechanism of the disease is, what cautions must be taken, and how to write an ex post facto report. RESULTS: After the confirmation of the 1st case, no additional cases have been reported in the hospital during the ensuing 2 months. Therefore, prompt prevention and infection control activities against Norwegian scabies can be thought to have been successful. CONCLUSION: Whena patient with an uncertain skin disease is admitted, pertinent measures must be taken from the moment the patient is admitted and contact precaution should be applied both to the patients and the staff members. When a scabies patient is detected in an institution, the medical staff must enforce as much active preventive measures as possible, and by doing so, there will be a better chance to prevent the outbreak of scabies in the hospital.
Aged ; Bedding and Linens ; Communicable Diseases ; Cross Infection ; Female ; Humans ; Infection Control ; Medical Staff ; Patients' Rooms ; Sarcoptes scabiei ; Scabies ; Skin Diseases
Aged ; Bedding and Linens ; Communicable Diseases ; Cross Infection ; Female ; Humans ; Infection Control ; Medical Staff ; Patients' Rooms ; Sarcoptes scabiei ; Scabies ; Skin Diseases
Korean Journal of Nosocomial Infection Control.2009;14(1):24-35.
BACKGROUND: This study evaluated the clinical characteristics and risk factors associated with community and hospital onset MRSA isolated from patients admitted to a tertiary care teaching hospital. METHODS: The study was carried out on MRSA isolated from clinical specimens of patients admitted into the wards and the intensive care unit in a 2,200-bed tertiary care teaching hospital from January 1st through December 31st, 2007. In order to identify the risk factors associated with MRSA acquisition, the medical records were reviewed. All statistics were computed using SPSS version 14.0. RESULTS: Of the 835 MRSA isolates, 179 (21.4%) were CO-MRSA and 656 (78.6%) were HO-MRSA. Of the 179 CO-MRSA isolates, 6 (3.4%) were CA-MRSA. Multiple logistic regression analysis showed that a history of using medical device or antibiotics within 1 year before the isolation of MRSA were significant risk factors for HO-MRSA, and a history of hospitalization within 1 year before the isolation of MRSA was a significant risk factor for CO-MRSA. Analysis on the antibiotics administered within 1 year before the isolation of MRSA showed that levofloxacin, macrolides, 1st generation cephalosporins, 3rd generation cephalosporins, 4th generation cephalosporins, vancomycin, metronidazole, and carbapenem were all significant risk factors for HO-MRSA and that TMP/SMX was a significant risk factor for CO-MRSA. Of the 6 (3.4%) CA-MRSA isolates, 1 (16.7%) was the pathogen responsible for soft tissue infection. No patients died from the CA-MRSA infection. CONCLUSION: MRSA isolated from clinical specimens of patients admitted into the wards and the ICU in a tertiary care teaching hospital was usually HO-MRSA, CO-MRSA and HO-MRSA usually had at least one of the risk factors associated with MRSA acquisition, and CO-MRSA was mainly HACO-MRSA.
Anti-Bacterial Agents ; Cephalosporins ; Hospitalization ; Hospitals, Teaching ; Humans ; Intensive Care Units ; Logistic Models ; Macrolides ; Medical Records ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Metronidazole ; Ofloxacin ; Risk Factors ; Soft Tissue Infections ; Tertiary Healthcare ; Vancomycin
Anti-Bacterial Agents ; Cephalosporins ; Hospitalization ; Hospitals, Teaching ; Humans ; Intensive Care Units ; Logistic Models ; Macrolides ; Medical Records ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Metronidazole ; Ofloxacin ; Risk Factors ; Soft Tissue Infections ; Tertiary Healthcare ; Vancomycin
Prevention of Intravascular Catheter-Related Infections.
Korean Journal of Nosocomial Infection Control.2009;14(1):15-23.
Catheter-related infections (CRIs) are one of the most frequent healthcare-associated infections and are costly, morbid, and potentially lethal. A series of studies has confirmed that a comprehensive bundle approach based on known guidelines was successful in reducing catheter-related bloodstream infections in intensive care units. In this review, I'll summarize the previous recommendations made in 2002 on preventing CRIs and highlight recent advances and the evidences supporting novel methods of CRIs prevention published in research articles.
Catheter-Related Infections ; Intensive Care Units
Catheter-Related Infections ; Intensive Care Units
Korean Journal of Nosocomial Infection Control.2009;14(1):8-14.
Active Surveillance Culture for Methicillin Resistant Staphylococcus Aureus.
Korean Journal of Nosocomial Infection Control.2009;14(1):1-7.
No abstract available.
Methicillin ; Methicillin Resistance ; Staphylococcus ; Staphylococcus aureus
Methicillin ; Methicillin Resistance ; Staphylococcus ; Staphylococcus aureus
Korean Journal of Nosocomial Infection Control.2011;16(1):29-36.
BACKGROUND: This study aimed to examine the underreporting rate and related factors after needlestick injuries among healthcare workers (HCWs) in small- or medium-sized hospitals. METHODS: Convenience sampling was conducted for 1,100 HCWs in 12 small- or medium-sized hospitals with less than 500 beds. From October 1 to November 30, 2010, data were collected using self-report questionnaire that was developed by researcher. The response rate for the study was 98.3% (982 HCWs). Data were analyzed using Statistical Package for the Social Sciences (SPSS) Win 12.0. RESULTS: The reports showed that 239 HCWs (24.3%) sustained needlestick injuries within the last year. The under-reporting rate after a needlestick injury was 67.4% (161/239), and underreporting rates varied across the hospitals and ranged from 46.2% to 85.7%. The major reasons for underreporting after needlestick injuries were the assumption that no blood-borne pathogens existed in the source patient (62.8%), annoyance (17.9%), and no knowledge about the reporting procedure (6.0%). Multiple logistic regression analysis showed that the suggestion by colleagues to report the injury, the number of needlestick injuries, and the needle type were independently related to the underreporting of needlestick injuries. CONCLUSION: The underreporting rate of needlestick injuries in small- or medium-sized hospitals was similar to that in large-sized hospitals, and this finding confirmed that the suggestion by colleagues to report the injury was the most significant factor influencing the injury-report rate. Thus, creating an environment that encourages HCWs to report injuries is considered the most important method to decrease the underreporting rate of needlestick injuries in small- and medium-sized hospitals.
Blood-Borne Pathogens ; Delivery of Health Care ; Humans ; Logistic Models ; Needles ; Needlestick Injuries ; Occupational Exposure ; Risk Management ; Social Sciences ; Surveys and Questionnaires
Blood-Borne Pathogens ; Delivery of Health Care ; Humans ; Logistic Models ; Needles ; Needlestick Injuries ; Occupational Exposure ; Risk Management ; Social Sciences ; Surveys and Questionnaires
Country
Republic of Korea
Publisher
Korean Society for Healthcare-associated Infection Control and Prevention
ElectronicLinks
http://www.kosnic.orgEditor-in-chief
Abbreviation
Korean Journal of Nosocomial Infection Control
Vernacular Journal Title
병원감염관리
ISSN
1226-2382
EISSN
Year Approved
2007
Current Indexing Status
Currently Indexed
Start Year
1996
Description
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