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Effects of 0.12% Chlorhexidine Gluconate on the Oral Hygiene of Endotracheal Intubation Patients at Intensive Care Units.

Jin Hee PARK ; Hye Soo LEE ; Jeong Soo KIM

Korean Journal of Nosocomial Infection Control.2012;17(2):79-86.

BACKGROUND: This study tested the efficacy of 0.12% chlorhexidine gluconate for improving oral hygiene in intubated intensive care patients. METHODS: In a group of 57 ventilated patients, 29 received normal saline (NS) for oral hygiene, and 28 were treated with chlorhexidine gluconate (CHG). Data on oral bacterial colonization was collected for 11 months from October 2005 to August 2006. Tests of oral hygiene and oral microorganism culture were performed on the day of the ventilation, and repeated on days 4, 8, and 12. RESULTS: Oral hygiene was significantly improved in the CHG group compared to that in the NS group (P<.001). Further, all patients (100%) in the NS group tested positive for Staphylococcus aureus on the 12th day after the endotracheal intubation, whereas only 42.9% (P=0.026) of the CHG group were positive. The NS group also had higher isolation rates of Pseudomonas aeruginosa at 66.7% on the 8th day after intubation and 87.5% on the 12th day. At these same intervals, the CHG group had isolation rates of 29.4% (P=.028) and 14.3% (P=.010) respectively. CONCLUSION: The longer the period of endotracheal intubation, the more effective the 0.12% CHG treatment was for improved oral hygiene and reduction of S. aureus and P. aeruginosa colonization when compared to treatment with NS.
Chlorhexidine ; Colon ; Humans ; Critical Care ; Intensive Care Units ; Intubation ; Intubation, Intratracheal ; Oral Hygiene ; Pseudomonas aeruginosa ; Sodium Chloride ; Staphylococcus aureus ; Ventilation

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Fecal Bacteriotherapy for Recurrent Clostridium difficile Infection: A Systematic Literature Review.

Jahyun KANG

Korean Journal of Nosocomial Infection Control.2012;17(2):70-78.

BACKGROUND: Over the past several years, Clostridium difficile has become a major healthcare-associated pathogen. Fecal bacteriotherapy has been reported as an effective intervention for treating recurrent C. difficile infection by restoring the normal intestinal microbiota. METHODS: Articles on fecal bacteriotherapy were collected through PubMed, CINAHL, Cochrane Library, and Web of Science databases using the keywords "Clostridium difficile," "feces," "fecal transplantation," "fecal microbiota transplantation," and "fecal bacteriotherapy." Using a systematic literature review, variables of interest from articles that met the inclusion criteria were extracted and summarized. RESULTS: Among 141 articles that were published in English from January 1, 2000 to August 31, 2012, 8 studies were selected for analysis after assessing the titles, abstracts, and full contents. Fecal bacteriotherapy procedures varied with respect to donor selection, screening, infusion route, and preparation of the suspension. Donors were mostly family members or relatives, and donor screening included tests for blood borne and stool pathogens. Selected infusion routes were colonoscopy (62.5%), nasogastric tube (25%), and enema (12.5%). The success rate was reported to be 73-100%. There was a lack of a standard procedure for fecal bacteriotherapy in all of the selected studies. CONCLUSION: Fecal bacteriotherapy is an effective intervention for combating C. difficile infection that has a high success rate and no adverse effects. This therapy would be helpful for infection control in hospital settings by facilitating early eradication of C. difficile infection.
Clostridium ; Clostridium difficile ; Colonoscopy ; Donor Selection ; Enema ; Feces ; Humans ; Infection Control ; Mass Screening ; Metagenome ; Tissue Donors

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Knowledge of and Compliance with Cough Etiquette among Nursing and Allied Health College Students.

Og Son KIM ; Jin Hwan OH ; Kyung Mi KIM

Korean Journal of Nosocomial Infection Control.2012;17(2):61-69.

BACKGROUND: This study aims to examine the knowledge of nursing and allied health-college students on cough etiquette and their actual compliance to it. METHODS: For data collection, a structured questionnaire was created and handed out to students from 3 colleges from November 9 to November 18, 2011. The questionnaires were distributed to 300 students, and responses from 253 students were used for data analysis. RESULTS: In total, 54.85% students provided correct answers to questions regarding their knowledge on cough etiquette. The compliance score was 34.39 (compliance rate: 61.41%). There was a positive association between knowledge of proper cough etiquette and compliance with those procedures. CONCLUSION: It can be concluded that college student's knowledge of cough etiquette is low, and subsequently that their compliance with the proper procedures of cough etiquette was low. Therefore, it is necessary to develop a program to build knowledge of proper cough etiquette amongst these students.
Compliance ; Cough ; Data Collection ; Hand ; Humans ; Surveys and Questionnaires

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A Three-Year Study of the Effectiveness of Hand-Hygiene Protocol Implementation at a University Hospital.

Oh Mee KWEON ; Eunsuk PARK ; Dongsuk LEE ; Ju Hyun LEE ; Eun Jin HA ; Dongeun YONG ; Jun Yong CHOI ; Ki Hwan KIM ; Chul LEE ; Kyungwon LEE

Korean Journal of Nosocomial Infection Control.2012;17(2):53-60.

BACKGROUND: Compliance with hand hygiene protocols is one of the simplest ways to prevent healthcare-associated infections (HAIs). Hand hygiene is influenced by individual habits and beliefs, as well as by local organizational culture practices. This study was performed in order to increase the rate of compliance to hand hygiene through changes in the organizational culture. METHODS: From 2009 through 2011, this study was performed in a 2,000-bed tertiary-care university hospital with more than 6,000 employees. The program was implemented mainly by team activities, and the leadership and hand hygiene steering committee members supported them. Goals for planning, intervention, and evaluation of the compliance rate for hand hygiene were made annually in the hospital. RESULTS: The rate of compliance to hand hygiene increased significantly each year (43.8% in 2008, 75.3% in 2009, 80.7% in 2010, and 83.2% in 2011). The detection rate of vancomycin-resistant Enterococcus (VRE) and the incidence of healthcare-associated Staphylococcus aureus bacteremia decreased. CONCLUSION: The rate of compliance to hand hygiene was remarkably improved, and it continuously increased through systematic and continuous changes in the organizational culture. In addition, the detection rate of VRE and incidence of S. aureus bacteremia decreased. These results show that hand hygiene is an important factor for preventing HAIs.
Bacteremia ; Committee Membership ; Compliance ; Enterococcus ; Hand Hygiene ; Incidence ; Organizational Culture ; Staphylococcus aureus

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Development of Infection Control Guideline for Postpartum Care Centers.

Ihn Sook JEONG ; Su Jin LEE ; Jae Sim JEONG ; Sung Won YOON ; Sun Young JEONG ; Jin HA ; Ju Yeon SONG ; Yeon Hee LEE

Korean Journal of Nosocomial Infection Control.2013;18(2):57-88. doi:10.14192/kjnic.2013.18.2.57

BACKGROUND: This study aimed to develop feasible and detailed infection control guidelines (ICG) and audit protocols for health care workers and auditors in postpartum care centers (PCC). METHODS: PCC ICG and audit protocols were developed in several steps: 1) review of previous ICG for PCCs; 2) establishment of frameworks for updating guidelines and audit protocols; 3) review of new ICG, regulations, etc.; 4) drafting of PCC ICG and audit protocols and revision based on feedback from the research committee; 5) Delphi survey to solicit opinions from infection control, infant care, and maternal care professionals as well as PCC health care workers; 6) re-revision after discussion with the research committee; and 7) finalization of PCC ICG and audit protocols. RESULTS: We developed ICG with 4 categories and 26 sub-categories, and internal and external audit protocols with 163 and 85 items, respectively. CONCLUSION: The ICG and audit protocols are valid and feasible; we recommend their utilization as auditing tools, baseline data for the development of national infection control policies, and as educational materials for PCC healthcare workers.
Checklist ; Delivery of Health Care ; Humans ; Infant ; Infant Care ; Infection Control* ; Postnatal Care* ; Postpartum Period* ; Social Control, Formal

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Nasal Colonization and Molecular Characterization of Methicillin-Resistant Staphylococcus aureus among Hemodialysis Patients in 7 Korean Hospitals.

Jae Seok KIM ; Sun Hwa LEE ; Joseph JEONG ; Kyoung Ho ROH ; Hae Kyung LEE ; Sook Jin JANG ; Hye Soo LEE ; Jeong Uk KIM ; Sung Hee LEE ; Joon Sup YEOM ; Sang Oh LEE ; Jeong Sil CHOI ; So Yeon YOO ; Jae Sim JEONG ; Mi Na KIM

Korean Journal of Nosocomial Infection Control.2013;18(2):51-56. doi:10.14192/kjnic.2013.18.2.51

BACKGROUND: Staphylococcus aureus is a major bacteremia-causing pathogen in hemodialysis patients, frequently colonizing patient skin and mucosa. Active infection control is necessary to prevent methicillin-resistant S. aureus (MRSA) infection in hospitals; however, the spread of community-associated MRSA has recently become a concern for MRSA infection control. We evaluated the nasal colonization of MRSA among hemodialysis patients and the molecular characterization of the MRSA isolates. METHODS: Nasal swabs were obtained from 482 hemodialysis patients in 7 nationwide hospitals in November 2009, and cultured for MRSA colonization. Swabs were inoculated and cultured in 6.5% NaCl tryptic soy broth, then subcultured on MRSASelect medium (Bio-Rad, Hercules, CA) for 20-24 h. Multiplex PCR was performed to analyze staphylococcal cassette chromosome mec (SCCmec) types of MRSA isolates. RESULTS: Of 482 hemodialysis patients, 57 (11.8%) carried MRSA, ranging from 6.7% to 19.0%. Among the 57 MRSA isolates, we identified 3 (5.3%) SCCmec II, 1 (1.8%) SCCmec IIA, 30 (52.6%) SCCmec IIB, 1 (1.8%) SCCmec III, 6 (10.5%) SCCmec IV, and 16 (28.1%) SCCmec IVA subtypes. CONCLUSION: The MRSA carriage rate (11.8%) of hemodialysis patients in this study was high. The SCCmec IIB subtype, a healthcare-associated strain, was the predominant strain, although SCCmec IV isolates, typically found in community-associated MRSA infections, were also frequently observed. To prevent healthcare-associated MRSA infections in hemodialysis patients, standardized infection control measures should be performed, and efforts to reduce MRSA carriage rates should be considered.
Colon* ; Humans ; Infection Control ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Mucous Membrane ; Multiplex Polymerase Chain Reaction ; Renal Dialysis* ; Skin ; Staphylococcus aureus

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Trends in Antibiotic Use in a Single University Hospital.

Kang Il JUN ; Hei Lim KOO ; Min Kyung KIM ; Chang Kyung KANG ; Min Jae KIM ; Shin Hye CHUN ; Jung Sook SONG ; Hyang Sook KIM ; Nam Joong KIM ; Eui Chong KIM ; Myoung Don OH

Korean Journal of Nosocomial Infection Control.2013;18(2):44-50. doi:10.14192/kjnic.2013.18.2.44

BACKGROUND: The aim of this study was to evaluate antibiotic consumption by adult patients at a single university hospital in Korea between 2001 and 2012. METHODS: We used the 2004 World Health Organization Anatomical Therapeutic Chemical Classification System definition of defined daily doses (DDD) per 1,000 patient-days to calculate the annual antibiotic consumption for 18 antibiotic groups. Chi-square linear-by-linear analysis was performed to evaluate antibiotic consumption trends for each group. RESULTS: Average annual antibiotic consumption during 2001-2012 was 644.6 DDD/1,000 patient-days (standard deviation, 33.3 DDD/1,000 patient-days). Although no statistically significant change was observed during the study period, consumption of first- and second-generation cephalosporins, and aminoglycosides was significantly decreased, while that of beta-lactam/beta-lactamase inhibitors, fourth-generation cephalosporins, carbapenem, glycopeptide, linezolid, colistin, and quinolone increased significantly. CONCLUSION: The total amount of prescribed antibiotics did not change, but the use of broad-spectrum antibiotics increased during the study period.
Adult ; Aminoglycosides ; Anti-Bacterial Agents ; Cephalosporins ; Classification ; Colistin ; Hospitals, University ; Humans ; Korea ; World Health Organization ; Linezolid

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Communication of Infectious Diseases Consultant.

Tae Hyong KIM ; Hee Jin KIM

Korean Journal of Nosocomial Infection Control.2013;18(2):39-43. doi:10.14192/kjnic.2013.18.2.39

Infectious disease consultation contributes to optimal antibiotic use as well as improved treatment outcomes in many infectious diseases, especially severe infections like bacteremia. However, communication and language matter in consultations between clinicians. Communication barriers are even more complex among professionals who speak Korean, since there are significant challenges for practicing medicine while relying on language translations. This review aims to address some of the components that should be included in infectious diseases consultations for Korean-speaking specialists.
Bacteremia ; Communicable Diseases* ; Communication Barriers ; Consultants* ; Humans ; Referral and Consultation ; Specialization ; Translations

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Comprehensive Approach to Prevention of Central Line-Associated Bloodstream Infection.

Pyoeng Gyun CHOE ; Hong Bin KIM

Korean Journal of Nosocomial Infection Control.2013;18(2):33-38. doi:10.14192/kjnic.2013.18.2.33

Central lines are indispensable in hospital care. The main complication resulting from their use is central line-associated bloodstream infection (CLABSI). CLABSI is one of the most frequent healthcare-associated infections associated with high costs, morbidity, and potential lethality. Recent studies on CLABSI prevention show that a multifaceted approach to improving central line insertion and maintenance practices results in decreased CLABSI rates. The question today, then, is not 'what to do,' but 'how to do it.'
Catheter-Related Infections ; Central Venous Catheters ; Comprehensive Health Care

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A Case of Ochrobactrum anthropi Bacteremia.

Seung Soon LEE ; Kyo Sang YOO ; Jae Hyun CHO ; Han Sung KIM ; Tae Seok KIM ; Chae Ok HA ; Jae Seok KIM ; Hee Jung KANG

Korean Journal of Nosocomial Infection Control.2007;12(1):65-68.

Ochrobactrum anthropi, a rarely encountered organism in humans, is usually associated with infections in immunocompromised hosts and patients with indwelling catheters. We report a case of bacteremia associated with O. anthropi in a 80-year-old male with intrahepatic duct carcinoma. After insertion of biliary stent with endoscopic retrograde cholangiopancreatography, fever and neutrophilic leukocytosis developed in the patient. Blood cultures were performed three times, and O. anthropi was isolated from an aerobic bottle. Although the patient did not receive effective antibiotic treatment, fever and neutrophilic leukocytosis were improved.
Aged, 80 and over ; Bacteremia* ; Catheters, Indwelling ; Cholangiopancreatography, Endoscopic Retrograde ; Fever ; Humans ; Immunocompromised Host ; Leukocytosis ; Male ; Neutrophils ; Ochrobactrum anthropi* ; Ochrobactrum* ; Stents

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