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- 저자 : ( My Young Jeon ) (검색결과 2 건)
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Characteristics of Device-Associated Cerebrospinal Fluid Infection in Adults
So My Koo,Eun Jung Lee,Se Yoon Park,Shi Nae Yu,Min Young Lee,Tae Hyong Kim,Eun Ju Choo,Min Huok Jeon 순천향대학교 순천향의학연구소 2013 Journal of Soonchunhyang Medical Science Vol.19 No.2
Objective: Device-associated infections in the central nervous system are serious complications of procedures involving indwelling devices among neurosurgical patients. In this study, the clinical characteristics and outcome of microbiologically confirmed deviceassociated cerebrospinal fluid (CSF) infection were evaluated. Methods: We performed a retrospective analysis of adult patients found to have a positive CSF culture result during a hospital admission between 1 January 2005 through 2 October 2010 in Soonchunhyang University Hospital. Results: During the study period, all episodes (n=161 CSF specimens, 87 patients) involving a culture-positive CSF were enrolled. Thirty-two episodes of device-associated CSF infection were included in the analysis among the study group. Most device-associated infections were ventriculo-peritoneal shunt infections (14/32, 44%). Fever (>38°C) was present in 17 episodes (53%). Overall, the most common microorganism was coagulase-negative staphylococcus (7/32 [22%]). Gram-negative rods (Pseudomonas aeruginosa 6/32 [19%], Acinetobacter baumannii/haemolyticus 5/32 [16%]) were identified in culture in 16/32 (50%). Device was removed for the control of device-associated infection in 30/32 (94%). Cure rate was 69% (22/32). All patients with treatment failure (10/32, 34%) expired. Conclusion: It is difficult to diagnosis device-associated CSF infections early since those are frequently presented with nonspecific clinical signs and symptoms. In our study, gram-negative infections accounted for 50% of cases and the empiric antibiotics initially chosen were found to not be effective against the final identified pathogen in many cases. Device-associated CSF infections should be strongly considered a serious risk factor associated with CSF infections, and prompt initiation of broad coverage antibiotics should be started after appropriate assessment.
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( Hye Soo Kim ),( Seung Up Kim ),( Beom Kyung Kim ),( Jun Yong Park ),( Do Young Kim ),( Sang Hoon Ahn ),( Ki Jun Song ),( Ja Yoon Heo ),( My Young Jeon ),( Ji Hye Park ),( Kwang-hyub Han ) 대한간학회 2016 춘·추계 학술대회 (KASL) Vol.2016 No.1
Aims: It is not well known whether the risk of hepatocellular carcinoma (HCC) development in patients with chronic hepatitis B (CHB) treated with oral antiviral agents is similar to that of patients in inactive stage CHB. We compared the risk of HCC development between patients with CHB receiving oral antiviral therapy and those in inactive stage CHB, after adjusting for fibrotic burden. Methods: A total of 1708 patients with CHB who achieved virological response (VR, defined as HBV-DNA <2000 IU/mL) through oral antiviral therapy (NUC-VR group) and 840 inactive carriers who had negative hepatitis B e antigen (HBeAg), normal alanine aminotransferase (ALT) level, and HBV-DNA<2000 IU/mL (IC group) were enrolled. Cumulative rate of HCC development was assessed by Kaplan-meier method with a comparison by log-rank test. Cox regression analysis was performed for multivariate analysis. Rescue therapy was performed, if appropriate. Results: NUC-VR group had a higher portion of male (65.3% vs. 57.5%), higher total billirubin level (median 0.8 mg/dL vs. 0.7 mg/dL), lower serum albumin levels (median 4.4 g/dL vs. 4.6 g/dL), lower platelet count (median 161x103/mm3 vs. 200x103/mm3), higher proportion of ultrasonographic cirrhosis (43.8% vs. 6.3%), and higher LS value (median 7.7 kPa vs. 5.0 kPa) (all p<0.001). On multivariate analysis, NUC-VR group was at a higher risk of HCC development compared with IC group (p<0.001). Conclusions: Even patients who achieved NUC-VR through oral antiviral therapy was at a higher risk of HCC development compared with IC group.
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