BACKGROUND: In this report, we present the annual data of the intensive care unit (ICU) module of the Korean Nosocomial Infections Surveillance System (KONIS) from July 2008 through June 2009. METHODS: We performed a prospective surveillance of nosocomial urinary tract infections (UTI), bloodstream infections (BSI), and pneumonia (PNEU) at 101 ICUs in 57 hospitals using KONIS. Nosocomial infection (NI) rates were calculated as the numbers of infections per 1,000 patient-days or device-days. RESULTS: We identified 3,287 NIs during the study period: 1,787 UTIs (1,772 cases were urinary catheter-associated), 917 BSIs (797 were central line-associated), and 583 PNEUs (335 were ventilator-associated). The rate of urinary catheter-associated UTIs was 4.80 cases per 1,000 device-days (95% confidence interval, 4.58-5.03) and urinary catheter utilization ratio was 0.85 (0.849-0.851). Although the urinary catheter utilization ratios were lower in the hospitals with 400-699 beds than in the hospitals with 700-899 beds and more than 900 beds, the rates of urinary catheter-associated UTIs were higher in hospitals with 400-699 beds than in the larger ones. The rate of central line-associated BSIs was 3.27 (3.05-3.51) and the utilization ratio was 0.56 (0.559-0.561). The rate of ventilator-associated PNEUs was 1.86 (1.67-2.07) and the utilization ratio was 0.41 (0.409-0.411). The rate of ventilator-associated PNEUs was lower in July 2008-June 2009 than in July 2007-June 2008 and July 2006-December 2006. CONCLUSION: It appears that the KONIS influences the reduction in the rate of device-associated infections, especially ventilator-associated PNEU; therefore, ongoing targeted surveillance and infection control strategies are needed to control device-associated infections.
Cross Infection ; Gossypol ; Infection Control ; Critical Care ; Intensive Care Units ; Pneumonia ; Urinary Catheters ; Urinary Tract Infections

BACKGROUND: Ventilator-associated pneumonia (VAP) is the most severe form of nosocomial infection. However the actual incidence of pneumonia associated with ventilator is not known. The purpose of this study is to examine the incidence of VAP, find out related risk factors, and establish effective preventive measures. METHODS: The medical records of 172 consecutive patients, who have been admitted to the intensive care unit (ICU) from January 2005 to October 2005 and were subjected to mechanical ventilation for more than 48 hours, have been reviewed retrospectively. VAP was defined according to the definition of CDC (1992). The statistical software SPSS (version 12.0) was used to conduct descriptive and comparative analysis including Chi-square, student's t-test, and logistic regression. RESULTS: The incidence was 163 per 1,000 persons and 19.0 per 1,000 ventilator use patient-days. The significant risk factors for VAP were type of ICU (surgical ICU, OR=5.942, 95% CI=1.894-8.644) and duration of ventilator use (OR=3.603, 95% CI=1.810-7.173). VAP developed 3.04 (+/-0.88) days after initiating mechanical ventilation. Causative agents of VAP were Acinetobacter baumanii (35.2%), MRSA (18.8%), Enterobacter aerogenes (12.4%), Klebsiella pneumonia (9.4%), Staphylococcus aureus (6.3%), Burkholderia (6.3%), Serratia marcesceus (6.3%), Stenotrophomonas (3.1%), and Pseudomonas (3.1%) spp. CONCLUSION: Type of ICU (surgical ICU, OR=5.942, 95% CI=1.894-18.644) and duration of ventilator use (OR=3.603, 95% CI=1.810-7.173) were considered to increase the incidence of VAP. Further study with larger number of cases and preventive measures would be necessary to identify risk factors related to the ventilator-associated pneumonia.
Acinetobacter ; Burkholderia ; Centers for Disease Control and Prevention (U.S.) ; Cross Infection ; Enterobacter aerogenes ; Humans ; Incidence ; Critical Care ; Intensive Care Units ; Klebsiella ; Medical Records ; Methicillin-Resistant Staphylococcus aureus ; Pneumonia ; Pneumonia, Ventilator-Associated ; Pseudomonas ; Respiration, Artificial ; Retrospective Studies ; Risk Factors ; Serratia ; Staphylococcus aureus ; Stenotrophomonas ; Tertiary Care Centers ; Ventilators, Mechanical

BACKGROUND: This is the first annual data on the surveillance of intensive care unit (ICU) module by the Korean Nosocomial Infections Surveillance System (KONIS) from July 2007 through June 2008. METHODS: The KONIS performed a prospective surveillance for nosocomial urinary tract infections (UTI), bloodstream infections (BSI), and pneumonia (PNEU) at 96 ICUs in 56 hospitals. Nosocomial infection (NI) rates were calculated as the numbers of infections per 1,000 patient-days or device-days. RESULTS: A total of 2,637 NIs were found during the study period; 1,391 UTIs (1,365 cases were urinary catheter-associated), 667 BSIs (563 were central line-associated), and 579 PNEUs (357 were ventilator-associated). The rate of urinary catheter-associated UTIs was 4.43 cases per 1,000 device-days (95% confidence interval, 4.20-4.67) and urinary catheter utilization ratio was 0.84 (0.839-0.841). The rate of central line-associated BSIs was 2.83 (2.61-3.07) and the utilization ratio was 0.54 (0.538-0.542). The rate of ventilator-associated PNEUs was 2.49 (2.25-2.76) and the utilization ratio was 0.39 (0.388-0.392). Although the ventilator utilization ratios were lower in the hospitals with less than 900 beds than in the hospitals with more than 900 beds, the rates of ventilator-associated PNEUs were higher in the smaller hospitals than in the larger ones. CONCLUSION: This result suggests that ongoing targeted surveillance and implementation of proven infection control strategies are needed.
Cross Infection ; Infection Control ; Critical Care ; Intensive Care Units ; Pneumonia ; Prospective Studies ; Urinary Catheters ; Urinary Tract Infections ; Ventilators, Mechanical

OBJECTIVES: This study was performed to provide the basic data for establishing countermeasures for preventing injury by analyzing the incidence rates, the risk factors, the characteristics of the injury and the utilization of medical care for mild injury that lasted for two weeks. METHODS: We examined the injury survey data among the National Health and Nutrition Survey data. The definition of mild injury that lasted for two weeks was that the injury that caused pain at least once a day for two weeks or the injury for which the usual daily activity of the injured person was severely affected. We used statistical analysis methods such as chi-square test and multiple logistic regression analysis. RESULTS: The incidence rate of injury that lasted for two weeks was 4.7 per 1,000 persons. On the multiple logistic regression, the children and adolescents (OR=3.80, 95%CI=1.63-8.84) had higher rates of injuries than the adults, and the middle and high school (OR=0.51, 95%CI=0.31-0.85) and college(OR=0.34, 95%CI=0.17-0.68) students had lower rates of injuries than the elementary school students. The unemployed (OR=0.39, 95%CI=0.20-0.73) and others (OR=0.38, 95%CI=0.21-0.70) had lower rates of injuries than the blue collar workers. The major causes of injuries were found to be falling and slipping, and the most prevalent place of occurrence was near or at home. CONCLUSIONS: A prevention program needs to be developed and continuous education must be offered to the children, adolescents and blue collar workers.
Adolescent ; Adult ; Child ; Female ; Humans ; Incidence ; Korea/epidemiology ; Male ; Middle Aged ; *Nutrition Surveys ; Risk Factors ; Trauma Severity Indices ; Wounds and Injuries/classification/*epidemiology

PURPOSE: To investigate the prevalence rates of overweight and obesty, and their associations in children and adolescents(12-18years) who were defined as normal weight, overweight , and obese. METHODS: Korean National Health and Nutrition Examination Survey 2005 raw data was utilized. The data on the 669 subjects aged 12-18 consisted of variables from the health interview survey, health examination and nutrition survey, and health consciousness behavior survey. Overweight and obesity was evaluated by established body mass index criteria. Chi-squire and Fisher exact test were performed to analyze differences among normal, overweight and obese groups according to basic characteristics and health consciousness behavior. Logistic regression was used to analyze risk factors for the overweight and obese groups. RESULTS: Overweight and obesity prevalence rates were 11.7% and 8.1%, respectively. Of the subjects from urban regions, 20% were overweight and 12.2% were obese. Of those from semi-urban regions, 10.2% were overweight and 3.8% were obese. Of those from rural regions, 9.0% were overweight and 10.1% were obese. The obesity rate in semi-urban regions were 0.38% times lower than the rural rate. CONCLUSIONS: Geographical location constitutes a risk factor for overweight and obesity, which may influence preventative and education programs aimed at schools and the general community.
Aged ; Body Mass Index ; Child ; Consciousness ; Health Surveys ; Humans ; Logistic Models ; Nutrition Surveys ; Obesity ; Overweight ; Prevalence ; Risk Factors

BACKGROUND: Despite prophylactic preoperative managements, surgical site infection (SSI) still has a significant influence on the mortality and morbidity of surgical patients because of an increased number of immunocompromised patients, prolonged anesthesia or an increased use of various operative equipments. In the end, it leads to an increase in hospital days and medical expenses. Therefore, we tried to find out significant risk factors for SSI in a general hospital. METHODS: The study was carried out on the 1,239 patients who underwent a surgical operation in a general hospital, and the incidence rate and risk factors of SSI were analyzed. RESULTS: Among the 1,239 patients, 33 (2.7%) had SSI and the incidence rate was 26.6 per 1,000 person. Of these, 27 (81.8%) and 6 (18.2%) developed an infection before and after discharge, respectively. The influencing factors of SSI were the dirty wound, the frequency of re-operation, the duration of preoperative hospitalization, and the duration of the operation. The most common pathogen isolated from the surgical site was Staphylococcus aureus (27.2%). CONCLUSION: To prevent SSI, a professional group must be established to manage surgical sites and wounds, and the patients should be covered by strict standardized knowledge and guidance.
Anesthesia ; Cross Infection ; Hospitalization ; Hospitals, General* ; Humans ; Immunocompromised Host ; Incidence ; Mortality ; Risk Factors* ; Staphylococcus aureus ; Wounds and Injuries

BACKGROUND: This is a theory verification study in which the theory of planned behavior (TPB) of Ajzen is applied to predict operating room (OR) infection control behavior. The study was carried out to know the path of attitude, subjective norm, perceived behavioral control, and intention towards OR infection control behavior. METHODS: A total of 178 OR nurses working at 13 hospitals in Seoul were the subjects of this study. A questionnaire survey was performed; the data were collected from April 6 to April 19, 2005 and analyzed with t-test, ANOVA, multiple regression, and person's correlation using SPSS program. Using AMOS, the factors of TPB were analyzed with path analysis. RESULTS: The total mean of infection control behavior of OR nurses was 4.37 points out of possible 5.0, and asepsis/operating instrument sterilization had 4.69, which was the highest among all areas of infection control behavior. In case of the relation between attitude, subjective norm, perceived behavior control, and intention, there was the strongest relation of cause and effect (path coefficient 0.38, 39%). In case of intention, perceived behavior control, and behavior, the relation of cause and effect between intention and behavior was path coefficient 0.17 and behavior was path coefficient 0.19. The degree of explanation was 10%. CONCLUSION: We should try to improve environment management in behavior area, and through this study, the importance of education was verified.
Behavior Control ; Cross Infection ; Education ; Infection Control* ; Intention ; Operating Rooms* ; Seoul* ; Sterilization ; Surveys and Questionnaires

BACKGROUND: This is a theory verification study in which the theory of planned behavior (TPB) of Ajzen is applied to predict operating room (OR) infection control behavior. The study was carried out to know the path of attitude, subjective norm, perceived behavioral control, and intention towards OR infection control behavior. METHODS: A total of 178 OR nurses working at 13 hospitals in Seoul were the subjects of this study. A questionnaire survey was performed; the data were collected from April 6 to April 19, 2005 and analyzed with t-test, ANOVA, multiple regression, and person's correlation using SPSS program. Using AMOS, the factors of TPB were analyzed with path analysis. RESULTS: The total mean of infection control behavior of OR nurses was 4.37 points out of possible 5.0, and asepsis/operating instrument sterilization had 4.69, which was the highest among all areas of infection control behavior. In case of the relation between attitude, subjective norm, perceived behavior control, and intention, there was the strongest relation of cause and effect (path coefficient 0.38, 39%). In case of intention, perceived behavior control, and behavior, the relation of cause and effect between intention and behavior was path coefficient 0.17 and behavior was path coefficient 0.19. The degree of explanation was 10%. CONCLUSION: We should try to improve environment management in behavior area, and through this study, the importance of education was verified.
Behavior Control ; Cross Infection ; Education ; Infection Control* ; Intention ; Operating Rooms* ; Seoul* ; Sterilization ; Surveys and Questionnaires

PURPOSE: This study was performed to provide the basic data in the establishment of preventive countermeasures for injury by analyzing the characteristics of injury, and risk factors of injury. METHODS: From 2,059 injury patients among 19,947 patients admitted between January and December, 2004 at a university hospital located in Gyeonggi-do, 500 injury patients were sampled randomly by systematic sampling. A total of 500 questionnaires was collected and used for this study. The statistical SPSS was used to analyze data that included chi-square, fisher's exact test. RESULTS: Injury patients among total admission patients was 10.3%. In both general characteristics of injury and non-injury patients, gender, age, length of stay was significant. As the cause of injury were compared with those of injury external causes, type, place, site, and time of injury were significant. As the cause of injury were compared with the characteristics of related-injury, surgery, multiple injuries, mental history, consciousness at the time emergency room visit, length stays were significant. CONCLUSION: With regard to general characteristics, injury external causes, injury-related causes, and factors such as sex, age, occupation, and educational background were related to each other. Injury does not occur by accident or unexpectedly. Therefore, if preventive attention is focused on individuals with high risk factors of injury, the incidence rate will be diminished.
Consciousness ; Emergency Service, Hospital ; Gyeonggi-do ; Humans ; Incidence ; Length of Stay ; Multiple Trauma ; Occupations ; Risk Factors ; Wounds and Injuries ; Surveys and Questionnaires

PURPOSE: The study analyzed and categorized the colorectal cancers related medical journals published in Korea by the name of the journal, research materials, study method, statistical method and by content of study for the quality improvement of colorectal cancers related studies. METHODS: The authors reviewed a total of 567 colorectal cancer-related studies published in the Korean medical journals during the period 1967 and 2004 and kept in the National Assembly Library. The distribution of research materials, study method, statistical method and content of these studies were analyzed by the 5 year publication interval. RESULTS: By study period, the number of published studies steeply increase during the period between 2000 and 2004. As the research materials, hospital patients(64.6%) and In-vitro(16.6%) were the most prevalently used research materials, but health adults were the lowest research materials by only taking up 0.4%. In study methods, patient follow up studies(28.7%) and human in vitro experimental(27.9%) were prevalent, and human in vitro experimental were relatively the most popular performed studies during the years of 1990-1994. As the statistical method, life table and survival analysis(27.0%) were the mostly performed methods, and the use of statistical method was applied in nearly all studies. The contents of the studies mainly focused on the patient prognostic estimations(27.6%) of therapeutic safety & efficacy(25.6%), but only the 4.1% of risk factors studies. Among the 109 studies which analyzed the survival term 78.9% of the studies mainly used the 5 year term in the analysis of survival rates. CONCLUSION: The results of the study could be utilized as the basic data for the quality improvement of further colorectal cancers related studies.
Adult ; Colorectal Neoplasms* ; Follow-Up Studies ; Humans ; Korea ; Life Tables ; Publications ; Quality Improvement ; Research Design ; Risk Factors ; Survival Rate