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Seroprevalence of Hepatitis A Virus Antibody and Vaccination among Healthcare Workers in a Teaching Hospital.

Hye Ran JEONG ; Bong Hee KIM ; Hyo You KIM ; Young Keun KIM ; Young UH ; Hei Kyung JIN

Korean Journal of Nosocomial Infection Control.2009;14(2):98-102.

BACKGROUND: Recently, the incidence of hepatitis A virus (HAV) infection has been increasing in Korea, and an outbreak among healthcare workers (HCWs) has also been reported. This study aims to evaluate the seroepidemiology of hepatitis A among HCWs at an 820-bed teaching hospital in Korea, thereby facilitating HAV vaccination for these HCWs. METHODS: In June 2009, we assessed the total immunoglobulins against the HAV in the serum samples of 907 HCWs by using VIDAS Anti-HAV Total (bioMerieux, France). RESULTS: Seropositivity for HAV significantly increased with age (P<0.001): 0% for < or =25 years, 9.4% for 26-30 years, 39.5% for 31-35 years, 66.7% for 36-40 years, 85.7% for 41-45 years, 96.0% for 46-50 years, 98.3% for 51-55 years, 95.8% for 56-60 years, and 100% for > or =61 years. CONCLUSION: Since HCWs aged 20-40 years show low seropositivity for HAV vaccination against hepatitis A should be considered in all these HCWs.
Aged ; Delivery of Health Care ; Hepatitis ; Hepatitis A ; Hepatitis A Antibodies ; Hepatitis A virus ; Hospitals, Teaching ; Humans ; Immunoglobulins ; Incidence ; Korea ; Seroepidemiologic Studies ; Vaccination

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Risk Factors for Neurosurgical Site Infections after Craniotomy: a Nationwide Prospective Multicenter Study in 2008.

Hyo Youl KIM ; Young Keun KIM ; Young UH ; Kum WHANG ; Hye Ran JEONG ; Hee Jung CHOI ; Hee Jung SON ; Hye Young JIN ; Soon Im CHOI ; Hong Bin KIM ; Eu Suk KIM ; Yoon Soo PARK ; Yong Kyun CHO ; Shin Yong PARK ; Young Goo SONG ; June Myung KIM

Korean Journal of Nosocomial Infection Control.2009;14(2):88-97.

BACKGROUND: Neurosurgical site infection may have serious sequelae, especially that occurring after craniotomy. A nationwide prospective multicenter study was performed in Korea to determine the incidence and risk factors for surgical site infections (SSI) after craniotomy. Methods: We collected demographic data, clinical and operative risk factors for SSI, and information regarding the antibiotics administered for the patients who underwent craniotomy in 17 hospitals between July and December of 2008. All the data were collected using a real-time web-based reporting system. RESULTS: Of the 1,020 patients who underwent craniotomy, 31 (3%) developed SSI, including 4 with superficial incisional SSI, 2 with deep incisional SSI, and 25 with organ/space SSI. The SSI rate was predicted on the basis of the National Nosocomial Infections Surveillance (NNIS) risk index. The SSI rate of 3.1%, 3.3%, and 1.8% were ascribed NNIS scores of 0, 1, and 2, respectively. The independent risk factors for SSI identified were postoperative cerebrospinal fluid leakage (odds ratio, 12.13; 95% confidence interval, 4.54-32.42) and preoperative Glasgow coma scales score < or =8 (odds ratio, 2.35; 95% confidence interval, 1.07-5.18). Third generation cephalosporins were the most frequently (in 65.6% of the cases) used for prophylaxis. CONCLUSION: A multicenter SSI surveillance system for craniotomy was first established in Korea. The NNIS risk index was not effective in identifying the patients at risk. We required to further analyze a large number of SSI cases to correctly identify the risk factors for SSI after craniotomy.
Anti-Bacterial Agents ; Antibiotic Prophylaxis ; Cephalosporins ; Coma ; Craniotomy ; Cross Infection ; Humans ; Incidence ; Korea ; Prospective Studies ; Risk Factors ; Weights and Measures

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Qualitative Fit Testing of High-Efficiency Particulate Respirators for Healthcare Personnel.

Hye Jin PARK ; Jae Sim JEONG ; Sang Ho CHOI ; Jun Hee WOO

Korean Journal of Nosocomial Infection Control.2009;14(2):79-87.

BACKGROUND: This study purposed to survey the fit rate of respirators by person and by product through conducting a qualitative fit test of high-efficiency respirators; moreover, this study also tests for differences in the fit rates determined by the qualitative fit tests with an increase in the number of the types of respirators tested. METHODS: The subjects of this study were 30 healthcare personnel who had passed a sensitivity test. The fit test of high-efficiency respirators was conducted using FT10 (3M Co., USA), an experimental tool used for performing the qualitative fit test of high-efficiency respirators, and three types of high-efficiency respirators - 1860, PFR95, and N7000 - were tested. RESULTS: The qualitative fit test was performed for the three types of high-efficiency respirators and the fit rate of the respirators that the subjects had been using previously was 43.3%; however, the probability that one or more of the three types of high-efficiency respirators would fit the subjects increased to 83.3%, and this increase was statistically significant (P<0.05). The difference in the fit rates of the three types of high-efficiency respirator types was not statistically significant; however, the differences in the satisfaction of and preference for the different respirator products were all statistically significant (P<0.05). CONCLUSION: Healthcare personnel are using ill-fitting respirators and a qualitative fit test should be performed to improve the fit of their respirator. In the qualitative fit test performed for the high-efficiency respirators, the fit rate increased with the increase in the variety of respirator types. Thus, a large variety of respirators should be made available to increase the fit rate of high-efficiency respirators for healthcare personnel.
Delivery of Health Care ; Humans ; Respiratory Protective Devices ; Ventilators, Mechanical

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The Analysis of Risk Factor and Infection Control of Carbapenem-Resistant Acinetobacter baumannii in a Medical Intensive Care Unit.

Song Mi MOON ; Jun Seong SON ; Hee Joo LEE ; Hee Kyung CHUN ; Mee La KIM ; Mi Suk LEE

Korean Journal of Nosocomial Infection Control.2009;14(2):72-78.

BACKGROUND: An epidemiologic study was performed after the outbreak of carbapenem-resistant Acinetobacter baumannii (CRAB) in the medical intensive care unit (MICU) from December 2006 to May 2007. METHODS: A retrospective case-control study was performed using the medical records of the patients. The case and control patients were compared for age, gender, total length of stay in MICU, prior carbapenem use, Acute Physiology and Chronic Health Evaluation II (APACH II) score, presence of central line, effect of mechanical ventilation, and sputum suction. Environmental and hand-washing studies were performed during the outbreak. RESULTS: Ten CRAB-affected patients and 29 controls were enrolled in this study. Univariate analysis showed that the age, total length of stay in MICU, presence of central line, and prior carbapenem use were associated with the CRAB outbreak. However, multivariate analysis showed that only prior carbapenem use was associated with the CRAB outbreak (odd ratio: 8.67, P=0.01). The outbreak disappeared after implementing a combined infection control strategy, including the sequential disinfection of MICU and strict compliance with cross-transmission prevention protocols. CONCLUSION: The use of carbapenem was associated with an increased risk of CRAB infection. This study suggests that the MICU contamination and infection transmission by health-care workers played a major role in the CRAB outbreak. Novel strategies such as restricted use of broad-spectrum antibiotics, strict hand hygiene, strict isolation of the patients, and MICU disinfection may be required to prevent the CRAB outbreak.
Acinetobacter ; Acinetobacter baumannii ; Anti-Bacterial Agents ; APACHE ; Case-Control Studies ; Compliance ; Disease Transmission, Infectious ; Disinfection ; Epidemiologic Studies ; Hand Hygiene ; Humans ; Infection Control ; Critical Care ; Intensive Care Units ; Length of Stay ; Medical Records ; Multivariate Analysis ; Respiration, Artificial ; Retrospective Studies ; Risk Factors ; Sputum ; Suction

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Needs for Hepatitis A Virus Immunization in Healthcare Personnel.

Youn Hee PARK ; Tae Hyong KIM ; Eun Jung LEE ; Tae Youn CHOI ; Hee Bong SHIN ; Eun Ju CHOO ; Min Hyeok JEON ; Hye Kyung JUNG ; Ji Yeon KWON

Korean Journal of Nosocomial Infection Control.2009;14(2):66-71.

BACKGROUND: Currently, the incidence of hepatitis A is on the increase in Korea. Although there is emphasis on contact precautions, the nosocomial outbreak of hepatitis A virus (HAV) in healthcare personnel has increased within endemic areas because these workers inevitably come in close contact with patients and work under suboptimal hygiene conditions. In this study, we evaluated the necessity of immunization against HAV for healthcare personnel. METHODS: We investigated the seropositivity of serum immunoglobulin G (IgG) anti-HAV antibody (Ab) in 672 healthcare personnel on the basis of their age-group, sex, and occupation in Soon Chun Hyang University Hospital and Soon Chun Hyang University Bucheon Hospital. RESULTS: The subjects were divided into 6 groups on the basis of their ages to identify differences among the various age groups in the number of cases with HAV Ab seropositivity. Significant intergroup differences were noted in this respect: 21-25 years, 2/152 (1.3%); 26-30 years, 33/245 (13.5%); 31-35 years, 70/148 (47.3%); 36-40 years, 52/79 (65.8%); >40 years, 44/48 (91.7%). CONCLUSION: The number of seropositive cases was low among young healthy personnel: low seropositivity is an emerging risk for vulnerable population. With the increase in the incidence of hepatitis A, healthcare personnel have become a risk population for hepatitis A, as are community residents. Therefore, for healthcare personnel working in hospitals, immunization against HAV should be recommended for personnel younger than 30 years, and serological testing for older personnel.
Delivery of Health Care ; Hepatitis ; Hepatitis A ; Hepatitis A Antibodies ; Hepatitis A Vaccines ; Hepatitis A virus ; Humans ; Hygiene ; Immunization ; Immunoglobulin G ; Incidence ; Korea ; Occupations ; Serologic Tests ; Vulnerable Populations

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Evaluation of the Contaminant Bacteria Isolated from Humidifiers Used in the Intensive Care Unit.

Mi Hyang LEE ; Kyoung Ho ROH ; Yeon A KIM

Korean Journal of Nosocomial Infection Control.2009;14(2):61-65.

BACKGROUND: This study aims to obtain basic data regarding the proper maintenance and potential role of humidifiers in the development of nosocomial pneumonia. We investigated into a spectrum of bacteria that grew after disinfection in humidifiers that were used in intensive care units (ICUs). The bacteria were isolated at different time points after disinfection. METHODS: We randomly selected 6 humidifiers that were used in an ICU and conducted a series of bacterial culture studies at 24 hr, 48 hr, 72 hr and 168 hr after disinfecting the six humidifiers. The fluid from the humidifider was cultured in the same manner as the dialysate. RESULTS: No bacteria were isolated in most of the 6 humidifiers 24 hr after the disinfection of the instruments. Gram-negative bacilli such as Acinetobacter baumannii, Burkholderia cepacia, and Stenotrophomonas maltophilia were cultured at 48 hr after disinfection. CONCLUSION: Regular and thorough disinfection of humidifiers is necessary to prevent possible spread of infection via humidifiers in the ICU.
Acinetobacter baumannii ; Bacteria ; Burkholderia cepacia ; Disinfection ; Critical Care ; Intensive Care Units ; Pneumonia ; Stenotrophomonas maltophilia

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Infection Control Activities in Dong-A University Hospital.

Kyung Suh KIM ; Hyuck LEE

Korean Journal of Nosocomial Infection Control.2003;8(2):103-109.

No abstract available.
Infection Control*

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Epidemiologic Study of Phlebitis Associated with Short-term Intravenous Catheter: Focused on 6 hospital on Seoul or Gyonggo-do, Korea.

Jeong Sil CHOI ; Eun Suk PARK ; Hye Young JIN ; Sun Young JUNG ; Mi Ra PARK ; Jung Eun KIM ; Keum Soom KIM

Korean Journal of Nosocomial Infection Control.2003;8(2):95-102.

Purpose : The purpose of this study was to obtain epidemiologic data and overall risk of complications of short term peripheral intravenous catheters. METHODS: The data was collected prospectively from August 19 to september 13, 2002. The subjects of this study were 350 adult patients hospitalized to the internal medicine a surgical general ward. Catheter sites were inspected daily from insertion to removal by infection control nurses, and characteristics of patients and catheters were recorded. Phlebitis was defined as one of the followings along the course of the vein: erythema, warmth. swelling or tenderness. RESULTS: Overall incidence of the phlebitis associated with short-term catheter was 23.7%. Catheters were removed when routine catheter replacement (every 72 hours) was occurred in 24.9%, phlebitis 23.7%. discharge of patients 13.1%, change of heparin cap 9.7%, others 28.6%. There were no significant differences in the incidence of the phlebitis by sex, age, the type of dressing, the duration of catheter placement insertion site, the type of hospitalized ward' and the size of cannula. The incidence of phlebitis was the highest (36.1%) within 48-72 hours after insertion. There was significant difference in the incidence of phlebitis according to the types of infusate. 75 of 83 phlebitis cases (90.4%) were received chemical infusates. Especially glucose/aminoacid, TPN and intralipose were attributed to major risk factor of phlebitis associated with short-term catheter (P<0.05). CONCLUSION: The incidence rate of phlebitis associated with short-term catheter was 23.7%. In this study, the type of infusate was the significant risk. factor related to phlebitis. Consequently, in order to prevent and detect the phlebitis associated with short-term catheter early, a consistent, organized assessment and evaluation of the above factors during the intravenous therapy is needed.
Adult ; Bandages ; Catheters* ; Epidemiologic Studies* ; Erythema ; Heparin ; Humans ; Incidence ; Infection Control ; Internal Medicine ; Korea* ; Patients' Rooms ; Phlebitis* ; Prospective Studies ; Risk Factors ; Seoul* ; Veins

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Molecular Characterization of Extended-spectrum beta-lactamase(ESBL) in Clinical Isolates of Klebsiella pneumoniae.

Seong Heon WIE ; Soo Young KIM ; Sang Il KIM ; Yang Ree KIM ; Jin Hong YOO ; Wan Shik SHIN ; Moon Won KANG

Korean Journal of Nosocomial Infection Control.2003;8(2):83-93.

BACKGROUND: ESBL-producing Klebsiella spp. are increasing worldwide, and infections with ESBL-producing organisms are usually hospital-acquired and common infections with ESBL-producing organisms include urinary tract infections, peritonitis, cholangitis, intraabdominal abscesses and nosocomial pneumonia. We studied the phenotypic and genotypic characteristics of ESBL-producing K. pneumoniae, which were isolated from the patients in St. Vincent Hospital. METHODS: Susceptibility to antibiotic was determined by standard disk diffusion and agar dilution methods for all 22 strains of K. pneumoniae. PCR amplifications were performed with primers specific for TEM. SHY, and CMY-1 genes, and the DNA of the amplified products were sequenced. Total DNA was extracted from the isolates restricted with XbaI, and fingerprinted using pulsed-field gel electrophoresis. Crude preparations of beta-lactamase were obtained by sonications and used for characterization of beta-lactamase by isoelectric focusing. RESULTS: The MIC90 values for ceftazidime and aztreonam were 128 microgram/mL and 64 microgram/mL, respectively. The MIC90 values for cefotaxime and sulperazon were 8 microgram/mL and 4microgram/mL, respectively, and that for cefoxitin was 1.0 microgram/mL, which is much lower than the value for third-generation cephalosporins. The MICs for ciprofloxacin. cefepime, and imipenem were less than 1 microgram/mL for all organisms, which is within the susceptible range. Isoelectric focusing studies demonstrated three beta-lactamases with pls of 5.. (TEM-1), 7.6 (SHV-2a), and 8.2 (SHV-12). The presence of blaSHV and blaTEM genes was confirmed by specific PCRs and DNA sequencing analysis. but blaCMY-1 genes were not found. According to DNA sequencing analysis, 21 K. pneumoniae strains produced SHV-12 ESBL and one strain produced SHV-2a ESBL. CONCLUSIONS: Our results suggest that the resistance of K. pneumoniae from clinical isolates to extended spectrum beta-lactam antibiotics may be due to the production of SHY-type ESBL. This approach in detecting and characterizing ESBL will be valuable for the control of infection and antibiotics use in medical institution.
Abscess ; Agar ; Anti-Bacterial Agents ; Aztreonam ; beta-Lactamases ; Cefotaxime ; Cefoxitin ; Ceftazidime ; Cephalosporins ; Cholangitis ; Ciprofloxacin ; Dermatoglyphics ; Diffusion ; DNA ; Electrophoresis, Gel, Pulsed-Field ; Humans ; Imipenem ; Isoelectric Focusing ; Klebsiella pneumoniae* ; Klebsiella* ; Peritonitis ; Pneumonia ; Polymerase Chain Reaction ; Sequence Analysis, DNA ; Sonication ; Urinary Tract Infections

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Molecular Epidemiology and Risk Factors of Staphylococcus epidermidis Isolated from Patients with Acute Leukemia.

Kyung Mi KIM ; Dong Gun LEE ; Sang Il KIM ; Jung Hyun CHOI ; Sung Suk HAN ; Wan Shik SHIN

Korean Journal of Nosocomial Infection Control.2003;8(2):71-82.

BACKGROUND: The purpose of this study is to define the risk factors of S. epidermidis acquisition and the epidemiology of strain variation in acute leukemia patients. METHODS: The participants were 155 patients of acute leukemia admitted in a University hospital for 11 months. 83 patients are the isolated group who had isolated S. epidermidis from body sites (blood, oral cavity, nares, rectum) and 72 patients are the not isolated group who had not isolated S. epidermidis. Isolates were analysed by CHEF and cluster analysis with dendrogram. Differences In proportions were tested with the Chi-square and Fisher's exact test. RESULTS: Ninety-one S. epidermidis were obtained from blood, oral cavity, nares, and rectum. The major proportion of positive culture was 81.3% from nares. Eight-nine S. epidermidis were isolated from healthcare workers. There were significant development of bacteremia in patients with S. epidermidis from nares. Resistance rate of S. epidermidis was 75.8% to methicillin, 86.3% to erythromycin, 81.l% to gentamicin, 68.9% to ciprofloxacin, 0% on vancomycin. There was significant difference on resistance rate between patients and healthcare workers' group. There was no relation between the strain of patients and those of healthcare workers. Sex age, diagnosis, length of stay, type of chemotherapy, duration of chemotherapy, Type of central venous catheter. duration of central venous catheter, prior antibiotic therapy, number of antibiotics, site of nosocomial infection, neutropenic period were not significantly different between S. epidermidis isolated group and not isolated group. Significant risk factors included duration of central venous catheter. hyper-alimentation, and folliculitis. CONCLUSION: Our result suggests that S. epidermidis in nares can be a risk factor of bacteremia. This research would be helpful for decreasing the S. epidermidis of immunocompromised patients.
Anti-Bacterial Agents ; Bacteremia ; Central Venous Catheters ; Ciprofloxacin ; Cross Infection ; Delivery of Health Care ; Diagnosis ; Drug Therapy ; Epidemiology ; Erythromycin ; Folliculitis ; Gentamicins ; Humans ; Immunocompromised Host ; Length of Stay ; Leukemia* ; Methicillin ; Molecular Epidemiology* ; Mouth ; Rectum ; Risk Factors* ; Staphylococcus epidermidis* ; Staphylococcus* ; Vancomycin

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