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METHODS: We investigated and compared the epidemiologic characteristics of the E. cloacae isolation in the period of outbreak (April-June, 1998) with those in the control period (January-March, 1998). To identify the risk factors for E. cloacae sepsis, we retrospectively conducted a chart review for the patients who had E. cloacae sepsis during the period of outbreak. On the basis of these results, environmental culture was performed hospital wide. RESULTS: Ten clinical isolates E. cloacae were recovered from the blood of ten patients from April to June. 1998. Seven out of 10 patients recieved ERCP procedure just before E. cloacae sepsis. Hence, we performed surveillance study in the endoscopy room before and after the procedure. The survey showed that distilled water which was used for washing the endoscopy was contaminated with E. cloacae, which was suspected to be the common source of this outbreak. Therefore, we changed distilled water into sterilized distilled water on washing the endoscopy. After this correction was performed, the incidence of ERCP-associated E. cloacae sepsis declined markedly (P<0.011). CONCLUSION: We investigated an outbreak of ERCP-related E. cloacae sepsis and the outbreak was successfully controlled by removing the source of infection.
Cholangiopancreatography, Endoscopic Retrograde* ; Cloaca ; Endoscopy ; Enterobacter cloacae* ; Enterobacter* ; Humans ; Incidence ; Methods ; Retrospective Studies ; Risk Factors ; Sepsis* ; Water

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Can We Overcome the Antimicrobial Resistance in Hospital?.

Jin Hong YOO

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

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Investigation of Immune Status to Rubella Virus and Rubella Vaccination in Hospital Employees for Nosocomial Infection Control.

Tae Youn CHOI ; Won Bae KIM

Korean Journal of Nosocomial Infection Control.1997;2(2):97-103.

BACKGROUND: The risk of rubella infection is higher among hospital employees than others because of more exposure to rubella viruses. Because rubella infection during pregnancy can cause congenital rubella syndrome, special preventive measures should be taken for female employees in the hospital. METHODS: 309 employees in Soonchunhyang Kumi Hospital, aged from 18 to 45 years old, were included this study. Rubella IgG antibody was detected by the method of MEIA (microparticle enzyme immunoassay). And non-immunized employees were received by Wister RA 27/3 rubella vaccination and rechecked rubella antibody titers at 2 months later after vaccination. RESULTS: Among 309 subjects, 276(89.3%) were positive for rubella IgG antibody. The overall mean titer of rubella antibody was 72 IU/mL (SD: 67 IU/mL). The rubella antibody in titer decreased gradually with aging. The seroconversion rate after vaccination was 100%(28/28). CONCLUSIONS: The authors recommend that the employees susceptible to rubella or all employees in the hospital should be vaccinated for preventing rubella.
Aging ; Cross Infection* ; Female ; Gyeongsangbuk-do ; Humans ; Immunoglobulin G ; Middle Aged ; Pregnancy ; Rubella Syndrome, Congenital ; Rubella Vaccine ; Rubella virus* ; Rubella* ; Vaccination*

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Infection Control Activities in Korea University Medical Center.

Sun Ju CHOI ; Young Ja CHOI ; Hee Jung CHIN ; Hee Jin CHEONG ; Woo Joo KIM ; Min Ja KIM ; Seung Chull PARK

Korean Journal of Nosocomial Infection Control.1998;3(1):65-70.

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

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Current Status, Prevention and Control Strategy of Vancomycin-resistant Enterococci (VRE) in Korea.

Hee Jin CHEONG ; Woo Joo KIM

Korean Journal of Nosocomial Infection Control.1998;3(1):57-64.

No Abstract available.
Korea*

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A Retrospective Study of Funguria.

Hae Kyung LEE ; Yeonjoon PARK ; Yong Goo KIM ; Kyung Ja HAN ; Lee So MAENG ; Eun jung LEE ; Sang In SHIM

Korean Journal of Nosocomial Infection Control.1998;3(1):49-55.

BACKGROUND: The incidence of fungal urinary tract infections has increased in the immunocompromized patients. We analyzed urine culture results of St. Mary's Hospital during 28 month period between October 1993 and January 1996 to evaluate the frequency of yeast isolates and to survey the distribution of departments from where yeasts isolated. METHODS: We performed a retrospective analysis of urine culture results. Yeasts were identified by the examination of germ tube production in human serum at 37degrees C and API2OC (BioMerieux, France) yeast strip. RESULT: A total of 1,387 urine cultures were reviewed, of which 164 (11.8%) were isolated as fungi. Candida albicans occurred in 36.5% of the total yeast isolates, C. tropicalis in 35.3%, C. glabrata in 10.9% and Trichosporon beigelii in 0.6%. The incidence of urinary fungal infection increased in 1995 (13.0%) than 1994 (9.1%) (P=0.047). Fifty two percents (85/164) of urinary fungi were isolated from patients in Neurosurgery (NS), where isolation of C. tropicalis was significantly more increased than other departments. In four patients, candiduria progressed to candidemia, which were caused by C. albicans (three patients) and C. glabrata (1 patient). CONCLUSIONS: The isolation rate of yeast species was different in NS and non-NS department. The frequency of isolation of C. albicans increased in non-NS department than NS department, while the frequency of isolation of C. tropicalis increased in NS department than non-NS department. The most common organism was C. albicans and department was Neurosurgery.
Candida albicans ; Candidemia ; Fungemia ; Fungi ; Humans ; Incidence ; Neurosurgery ; Retrospective Studies* ; Trichosporon ; Urinary Tract Infections ; Yeasts

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