1.Effects of Cessation of Single-Room Isolation on Transmission of Vancomycin-Resistant Enterococcus in a Hospital
Si-Ho KIM ; Yu Jin LEE ; Ji Hong PARK ; Seran CHEON ; Jeong Seon RYU ; Jung Min SHIN ; Nam Sun HONG ; Yi-Rang JEONG ; Cheon Hoo JEON ; Yu Mi WI
Journal of Korean Medical Science 2024;40(5):e11-
Background:
Single room isolation with contact precautions is widely regarded as a fundamental strategy to prevent the transmission of multidrug-resistant organisms (MDROs). However, its implementation demands substantial resources, limiting its universal application to all MDROs. In this study, we assessed the effect of discontinuing single room isolation for vancomycin-resistant Enterococcus (VRE).
Methods:
This is a retrospective, observational study conducted at a single 750-bed tertiary center. We conducted an interrupted time series analysis to compare incidence rates and trends of new-onset VRE colonization and bacteremia during the one year before and after the strategy change on January 1, 2023.
Results:
Single-room occupancy decreased from 79.7% pre-intervention to 23.6% postintervention (P < 0.001). The incidence rate of new-onset VRE colonization was 0.452 and 0.535 per 1,000 patient-days in the pre- and post-intervention periods, respectively, with no statistically significant difference (P = 0.202). However, there was a slightly increasing trend (0.036 [95% confidence interval, −0.002, 0.074] increase per month, P = 0.066). The new-onset VRE bacteremia incidence rate was not differed in incidence (0.060 and 0.055, P= 0.571) or trend (P = 0.720).
Conclusion
Our study suggests that discontinuing single-room isolation for VRE patients may not affect the incidence of new-onset VRE bacteremia, but caution is needed due to the potential increase in colonization.
2.Effects of Cessation of Single-Room Isolation on Transmission of Vancomycin-Resistant Enterococcus in a Hospital
Si-Ho KIM ; Yu Jin LEE ; Ji Hong PARK ; Seran CHEON ; Jeong Seon RYU ; Jung Min SHIN ; Nam Sun HONG ; Yi-Rang JEONG ; Cheon Hoo JEON ; Yu Mi WI
Journal of Korean Medical Science 2024;40(5):e11-
Background:
Single room isolation with contact precautions is widely regarded as a fundamental strategy to prevent the transmission of multidrug-resistant organisms (MDROs). However, its implementation demands substantial resources, limiting its universal application to all MDROs. In this study, we assessed the effect of discontinuing single room isolation for vancomycin-resistant Enterococcus (VRE).
Methods:
This is a retrospective, observational study conducted at a single 750-bed tertiary center. We conducted an interrupted time series analysis to compare incidence rates and trends of new-onset VRE colonization and bacteremia during the one year before and after the strategy change on January 1, 2023.
Results:
Single-room occupancy decreased from 79.7% pre-intervention to 23.6% postintervention (P < 0.001). The incidence rate of new-onset VRE colonization was 0.452 and 0.535 per 1,000 patient-days in the pre- and post-intervention periods, respectively, with no statistically significant difference (P = 0.202). However, there was a slightly increasing trend (0.036 [95% confidence interval, −0.002, 0.074] increase per month, P = 0.066). The new-onset VRE bacteremia incidence rate was not differed in incidence (0.060 and 0.055, P= 0.571) or trend (P = 0.720).
Conclusion
Our study suggests that discontinuing single-room isolation for VRE patients may not affect the incidence of new-onset VRE bacteremia, but caution is needed due to the potential increase in colonization.
3.Effects of Cessation of Single-Room Isolation on Transmission of Vancomycin-Resistant Enterococcus in a Hospital
Si-Ho KIM ; Yu Jin LEE ; Ji Hong PARK ; Seran CHEON ; Jeong Seon RYU ; Jung Min SHIN ; Nam Sun HONG ; Yi-Rang JEONG ; Cheon Hoo JEON ; Yu Mi WI
Journal of Korean Medical Science 2024;40(5):e11-
Background:
Single room isolation with contact precautions is widely regarded as a fundamental strategy to prevent the transmission of multidrug-resistant organisms (MDROs). However, its implementation demands substantial resources, limiting its universal application to all MDROs. In this study, we assessed the effect of discontinuing single room isolation for vancomycin-resistant Enterococcus (VRE).
Methods:
This is a retrospective, observational study conducted at a single 750-bed tertiary center. We conducted an interrupted time series analysis to compare incidence rates and trends of new-onset VRE colonization and bacteremia during the one year before and after the strategy change on January 1, 2023.
Results:
Single-room occupancy decreased from 79.7% pre-intervention to 23.6% postintervention (P < 0.001). The incidence rate of new-onset VRE colonization was 0.452 and 0.535 per 1,000 patient-days in the pre- and post-intervention periods, respectively, with no statistically significant difference (P = 0.202). However, there was a slightly increasing trend (0.036 [95% confidence interval, −0.002, 0.074] increase per month, P = 0.066). The new-onset VRE bacteremia incidence rate was not differed in incidence (0.060 and 0.055, P= 0.571) or trend (P = 0.720).
Conclusion
Our study suggests that discontinuing single-room isolation for VRE patients may not affect the incidence of new-onset VRE bacteremia, but caution is needed due to the potential increase in colonization.
4.Effects of Cessation of Single-Room Isolation on Transmission of Vancomycin-Resistant Enterococcus in a Hospital
Si-Ho KIM ; Yu Jin LEE ; Ji Hong PARK ; Seran CHEON ; Jeong Seon RYU ; Jung Min SHIN ; Nam Sun HONG ; Yi-Rang JEONG ; Cheon Hoo JEON ; Yu Mi WI
Journal of Korean Medical Science 2024;40(5):e11-
Background:
Single room isolation with contact precautions is widely regarded as a fundamental strategy to prevent the transmission of multidrug-resistant organisms (MDROs). However, its implementation demands substantial resources, limiting its universal application to all MDROs. In this study, we assessed the effect of discontinuing single room isolation for vancomycin-resistant Enterococcus (VRE).
Methods:
This is a retrospective, observational study conducted at a single 750-bed tertiary center. We conducted an interrupted time series analysis to compare incidence rates and trends of new-onset VRE colonization and bacteremia during the one year before and after the strategy change on January 1, 2023.
Results:
Single-room occupancy decreased from 79.7% pre-intervention to 23.6% postintervention (P < 0.001). The incidence rate of new-onset VRE colonization was 0.452 and 0.535 per 1,000 patient-days in the pre- and post-intervention periods, respectively, with no statistically significant difference (P = 0.202). However, there was a slightly increasing trend (0.036 [95% confidence interval, −0.002, 0.074] increase per month, P = 0.066). The new-onset VRE bacteremia incidence rate was not differed in incidence (0.060 and 0.055, P= 0.571) or trend (P = 0.720).
Conclusion
Our study suggests that discontinuing single-room isolation for VRE patients may not affect the incidence of new-onset VRE bacteremia, but caution is needed due to the potential increase in colonization.
5.Rehabilitation Program for Improved Musculoskeletal Pain in Gastrointestinal Endoscopists: Multicenter Prospective Cohort Study
Su Youn NAM ; Kwangwoo NAM ; Ki-Nam SHIM ; Seoyon YANG ; Chung Hyun TAE ; Junwoo JO ; Nayoung KIM ; Seon Mi PARK ; Young Sook PARK ; Seun Ja PARK ; Sung-Ae JUNG
Gut and Liver 2023;17(6):853-862
Background/Aims:
This study aimed to develop a rehabilitation program for musculoskeletal pain experienced by gastrointestinal endoscopists and to investigate its usefulness.
Methods:
This was a multicenter cohort study. During the first 2 weeks, a questionnaire regarding daily workload and musculoskeletal symptoms was administered. Then, a rehabilitation program including equipment/posture correction and stretching was conducted during the remaining 6 weeks. Follow-up daily workload and musculoskeletal symptom surveys were distributed during the last 2 weeks. The program satisfaction survey was performed at the 6th and 8th weeks.
Results:
Among 118 participants (69 men), 94% (n=111) complained of musculoskeletal pain at baseline. Various hospital activities at baseline were associated with multisite musculoskeletal pain, whereas only a few workloads were correlated with musculoskeletal pain after the rehabilitation program. Follow-up musculoskeletal pain was negatively correlated with equipment/ posture program performance; arm/elbow pain was negatively correlated with elbow (R=–0.307) and wrist (R=–0.205) posture; leg/foot pain was negatively correlated with monitor position, shoulder, elbow, wrist, leg, and foot posture. Higher performance in the scope position (86.8% in the improvement vs 71.3% in the aggravation group, p=0.054) and table height (94.1% vs 79.1%, p=0.054) were associated with pain improvement. An increased number of colonoscopy procedures (6.27 in the aggravation vs 0.02 in the improvement group, p=0.017) was associated with pain aggravation. Most participants reported being average (32%) or satisfied (67%) with the program at the end of the study.
Conclusions
Our rehabilitation program is easily applicable, satisfactory, and helpful for improving the musculoskeletal pain experienced by gastrointestinal endoscopists.
6.Korean Guidelines for Postpolypectomy Colonoscopic Surveillance: 2022 revised edition
Su Young KIM ; Min Seob KWAK ; Soon Man YOON ; Yunho JUNG ; Jong Wook KIM ; Sun-Jin BOO ; Eun Hye OH ; Seong Ran JEON ; Seung-Joo NAM ; Seon-Young PARK ; Soo-Kyung PARK ; Jaeyoung CHUN ; Dong Hoon BAEK ; Mi-Young CHOI ; Suyeon PARK ; Jeong-Sik BYEON ; Hyung Kil KIM ; Joo Young CHO ; Moon Sung LEE ; Oh Young LEE ; ; ;
Intestinal Research 2023;21(1):20-42
Colonoscopic polypectomy is effective in decreasing the incidence and mortality of colorectal cancer (CRC). Premalignant polyps discovered during colonoscopy are associated with the risk of metachronous advanced neoplasia. Postpolypectomy surveillance is the most important method for managing advanced metachronous neoplasia. A more efficient and evidence-based guideline for postpolypectomy surveillance is required because of the limited medical resources and concerns regarding colonoscopy complications. In these consensus guidelines, an analytic approach was used to address all reliable evidence to interpret the predictors of CRC or advanced neoplasia during surveillance colonoscopy. The key recommendations state that the high-risk findings for metachronous CRC following polypectomy are as follows: adenoma ≥10 mm in size; 3 to 5 (or more) adenomas; tubulovillous or villous adenoma; adenoma containing high-grade dysplasia; traditional serrated adenoma; sessile serrated lesion containing any grade of dysplasia; serrated polyp of at least 10 mm in size; and 3 to 5 (or more) sessile serrated lesions. More studies are needed to fully comprehend the patients who are most likely to benefit from surveillance colonoscopy and the ideal surveillance interval to prevent metachronous CRC.
7.Magnesium intake and dietary sources among Koreans: findings from the Korea National Health and Nutrition Examination Survey 2016–2019
Jee-Seon SHIM ; Ki Nam KIM ; Jung-Sug LEE ; Mi Ock YOON ; Hyun Sook LEE
Nutrition Research and Practice 2023;17(1):48-61
BACKGROUND/OBJECTIVES:
Magnesium is an essential nutrient for human health.However, inadequate intake is commonly reported worldwide. Along with reduced consumption of vegetables and fruits and increased consumption of refined or processed foods, inadequate magnesium intake is increasingly reported as a serious problem.This study aimed to assess magnesium intake, its dietary sources, and the adequacy of magnesium intake in Korean populations.
SUBJECTS/METHODS:
Data was obtained from the Korea National Health and Nutrition Examination Survey 2016–2019 and included individuals aged ≥1 yr who had participated in a nutrition survey (n=28,418). Dietary intake was assessed by 24-h recall, and dietary magnesium intake was estimated using a newly established magnesium database. Diet adequacy was evaluated by comparing dietary intake with the estimated average requirement (EAR) suggested in the Korean Dietary Reference Intakes 2020.
RESULTS:
The mean dietary magnesium intake of Koreans aged ≥1 yr was 300.4 mg/d, which was equivalent to 119.8% of the EAR. The prevalence of individuals whose magnesium intake met the EAR was 56.8%. Inadequate intake was observed more in females, adolescents and young adults aged 12–29 yrs, elders aged ≥65 yrs, and individuals with low income. About four-fifths of the daily magnesium came from plant-based foods, and the major food groups contributing to magnesium intake were grains (28.3%), vegetables (17.6%), and meats (8.4%). The top 5 individual foods that contributed to magnesium intake were rice, Baechu (Korean cabbage) kimchi, tofu, pork, and milk. However, the contribution of plant foods and individual contributing food items differed slightly by sex and age groups.
CONCLUSIONS
This study found that the mean dietary magnesium intake among Koreans was above the recommended intake, whereas nearly one in 2 Koreans had inadequate magnesium intake. To better understand the status of magnesium intake, further research is required, which includes the intake of dietary supplements.
8.Dietary zinc intake and sources among Koreans: findings from the Korea National Health and Nutrition Examination Survey 2016–2019
Jee-Seon SHIM ; Ki Nam KIM ; Jung-Sug LEE ; Mi Ock YOON ; Hyun Sook LEE
Nutrition Research and Practice 2023;17(2):257-268
BACKGROUND/OBJECTIVES:
Zinc is an essential trace mineral which is important for the growth and development of the human body and immunological and neurological functions.Inadequate zinc intake may cause zinc deficiency with its adverse consequences. In this study, we aimed to estimate the dietary zinc intake levels and sources among Koreans.
SUBJECTS/METHODS:
For this secondary analysis, we obtained data from the Korea National Health and Nutrition Examination Survey (KNHANES) 2016–2019. Individuals aged ≥ 1 yr who had completed a 24-h recall were included. The dietary zinc intake of each individual was calculated by applying data from a newly developed zinc content database to the KNHANES raw data. We also compared the extracted data with the sex-, age-specific reference values suggested in the Korean Dietary Reference Intakes 2020. The prevalence of adequate zinc intake was then evaluated by the proportion of the individuals who met the estimated average requirement (EAR).
RESULTS:
The mean zinc intake of Koreans aged ≥ 1 yr and adults aged ≥ 19 yrs were 10.2 and 10.4 mg/day, equivalent to 147.4% and 140.8% of the EAR, respectively. Approximately 2 in 3 Koreans met the EAR for zinc, but the zinc intake differed slightly among the different age and sex groups. In children aged 1–2 yrs, 2 out of 5 exceeded the upper level of intake, and nearly half of the younger adults (19–29 yrs) and the elders (≥ 75 yrs) did not meet the EAR. The major contributing food groups were grains (38.9%), meats (20.4%), and vegetables (11.1%). The top 5 food contributors to zinc intake were rice, beef, pork, egg, and baechu kimchi, which accounted for half of the dietary intake.
CONCLUSION
The mean zinc intake among Koreans was above the recommended level, but 1 in 3 Koreans had inadequate zinc intake and some children were at risk of excessive zinc intake. Our study included zinc intake from diet only, thus to better understand zinc status, further research to include intake from dietary supplements is needed.
9.Estimated dietary vitamin D intake and major vitamin D food sources of Koreans: based on the Korea National Health and Nutrition Examination Survey 2016–2019
Ki Nam KIM ; Jung-Sug LEE ; Jee-Seon SHIM ; Mi Ock YOON ; Hyun Sook LEE
Nutrition Research and Practice 2023;17(3):451-463
BACKGROUND/OBJECTIVES:
The purpose of this study was to establish a database (DB) of foods containing vitamin D that were investigated in the Korea National Health and Nutrition Examination Survey (KNHANES), to estimate the dietary vitamin D intake, to evaluate the dietary adequacy of this intake, and to identify the major food sources of Koreans that contain vitamin D.
SUBJECTS/METHODS:
This study used data from the KNHANES 2016–2019. Individuals aged ≥ 1 year who participated in the nutrition survey (n = 28,418) were included. The dietary intake was assessed by the 24-h dietary recall method and individual dietary vitamin D intake was estimated using a newly established vitamin D DB. Dietary adequacy was evaluated by comparing the dietary intake of the participants with adequate intake (AI) as defined by Dietary Reference Intakes for Koreans (KDRIs) 2020.
RESULTS:
The average dietary vitamin D intake for all the subjects was 3.13 μg/d, which was 33.1% of AI. Dietary vitamin D intake was lower in rural residents, the elderly, and those with low income. The major food groups that contributed to the total dietary vitamin D intake were fish and shellfish (61.59%), eggs (17.75%), meat (8.03%), milk (4.25%), legumes (3.93%), and grains (3.84%). The top 10 individual food items that contributed to the total vitamin D intake were eggs (17.44%), squid (8.5%), eels (7.44%), salmon (5.35%), mackerel (5.27%), anchovies (4.65%), yellow croakers (4.58%), pork meat (4.47%), soymilk (4.46%), and skipjack tuna (3.80%).
CONCLUSION
These results show that the mean dietary vitamin D intake of Koreans is lower than the reference AI level. Nutritional policies need to be put in place to increase the vitamin D intake of Koreans in the future. In addition, comprehensive research on all the sources of vitamin D, including intake of supplements and biosynthesis in the skin, is required.
10.Dietary intake and major source foods of vitamin E among Koreans: findings of the Korea National Health and Nutrition Examination Survey 2016–2019
Jee-Seon SHIM ; Ki Nam KIM ; Jung-sug LEE ; Mi Ock YOON ; Hyun Sook LEE
Nutrition Research and Practice 2022;16(5):616-627
BACKGROUND/OBJECTIVES:
Vitamin E is essential for health, and although vitamin E deficiency seems rare in humans, studies on estimates of dietary intake are lacking. This study aimed to estimate dietary vitamin E intake, evaluate dietary adequacy of vitamin E, and detail major food sources of vitamin E in the Korean population.
SUBJECTS/METHODS:
This study used data from the Korea National Health and Nutrition Examination Survey (KNHANES) 2016–2019. Individuals aged ≥ 1 year that participated in a nutrition survey (n = 28,418) were included. Dietary intake was assessed by 24-h recall and individual dietary vitamin E intake was estimated using a newly established vitamin E database. Dietary adequacy was evaluated by comparing dietary intake with adequate intake (AI) as defined by Korean Dietary Reference Intakes 2020.
RESULTS:
For all study subjects, mean daily total vitamin E intake was 7.00 mg α-tocopherol equivalents, which was 61.6% of AI. The proportion of individuals that consumed vitamin E at above the AI was 12.9%. Inadequate intake was observed more in females, older individuals, rural residents, and those with a low income. Mean daily intakes of tocopherol (α-, β-, γ-, and δ-forms) and tocotrienol were 6.02, 0.30, 6.19, 1.63, and 1.61 mg, respectively.The major food groups that contributed to total dietary vitamin E intake were grains (22.3%), seasonings (17.0%), vegetables (15.3%), and fish, and shellfish (7.4%). The top 5 individual food items that contributed to total vitamin E intake were baechu kimchi, red pepper powder, eggs, soybean oil, and rice.
CONCLUSIONS
This study shows that mean dietary vitamin E intake by Koreans did not meet the reference adequate intake value. To better understand the status of vitamin E intake, further research is needed that considers intake from dietary supplements.

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