손위생 문화 정착 프로그램을 통한 수행률 증진 효과:한 대학병원의 3개년 활동 중심

권오미,박은숙,이동숙,하은진,용동은,최준용,김기환,이철,이경원,이주현 대한의료관련감염관리학회 2012 의료관련감염관리 Vol.17 No.2

배경: 손위생은 의료관련감염 예방을 위해 가장 기본적이고 중요한 방법이다. 인간행위로서손위생은 개인의 동기와 신념뿐만 아니라 사회적인 측면으로 개인이 속한 조직문화가 많은 영향을 미친다. 본 연구는 조직문화의 변화를 중점전략으로 손위생 수행률을 증진시키기 위하여진행되었다. 방법: 2009년부터 2011년까지 2000병상 규모의 3차 의료기관의 6,000여명의 직원을 대상으로하였다. 손위생 증진을 위한 접근은 팀별 활동으로 진행되었으며 다양한 리더쉽 지원과 손위생운영위원회가 상호보완적으로 운영되었다. 매년병원 차원의 손위생 목표가 설정되고 이에 대한계획과 중재, 평가가 이루어졌다. 결과: 2008년 43.8%였던 손위생 수행률은 2009년 75.3%, 2010년 80.7%, 2011년 83.2%로 매년 통계적으로 유의하게 증가하였다. Vancomycin-resistant Enterococcus (VRE) 검출률과 의료기관관련 S. aureus 균혈증은 증진활동 후 감소 추세를 보였다. 결론: 조직문화 변화를 위한 체계적인 중재활동 이후 손위생 수행률은 괄목할 만한 개선효과를 보였다. 또한 손위생 수행률이 증가함에 따라VRE 검출이나 S. aureus 균혈증 발생이 감소 추세를 보여 손위생이 의료관련감염의 중요한 예방법 중 하나임을 확인할 수 있었다.

Growth Profile and Toxigenicity of Bacillus cereus in Ready-to-eat Food Products of Animal Origin

오미화,함준상,설국환,장애라,이승규,이종문,박범영,강은실,권기성,황인균 한국축산식품학회 2011 한국축산식품학회지 Vol.31 No.1

The growth profile of Bacillus cereus in ready-to-eat (RTE) food products of animal origin was examined under different temperature and incubation conditions. In sandwiches and Kimbab, B. cereus did not grow or exhibited only minimal growth at 4 and 10℃, but it grew rapidly at ambient temperature. In sandwiches, B. cereus did not grow efficiently at 25℃,however, in ham, the main ingredient of sandwiches, B. cereus growth was observed at the same temperature, with bacterial levels reaching 7.94 Log CFU/g after incubation for 24 h at 25℃. Toxigenicity of B. cereus was observed only at temperatures above 25℃. In Kimbab, B. cereus produced toxin after 9 h at 30℃ and after 12 h at 25℃. Ingredients of sandwiches and Kimbab were collected from 3 different Korean food-processing companies to investigate the source of contamination by B. cereus. Among the 13 tested food items, 6 items including ham were found to be contaminated with B. cereus. Of these ingredients, B. cereus isolates from 3 items produced enterotoxins. None of these isolates harbored the emetic toxin-producing gene. The findings of the present study can be used for risk assessments of food products, including ham and cheese,contaminated with B. cereus.

영ㆍ유아 식품의 미생물학적 위해평가 및 감소방향

권기성(Kisung Kwon),오미화(Mihwa Oh),강윤숙(Yunsook Kang) 한국식품과학회 2006 식품과학과 산업 Vol.39 No.2

대유행 인플루엔자(H1N1 2009) 원내 노출자 관리결과

이경원,권오미,이동숙,박은숙,김창오,한상훈,김기환,이주현,하은진,이경원 대한의료관련감염관리학회 2010 의료관련감염관리 Vol.15 No.2

Background: This study is aimed at describing the outcomes of the management of the patients, caregivers, and healthcare workers (HCWs) who are exposed to the pandemic influenza (H1N1 2009) virus and at evaluating the adequacy in exposure management and infection control. Methods: From July 2009 to January 2010, for 7 a month period, we managed patients and healthcare workers without any respiratory protective devices, who came within 1 m distance of H1N1-positive individuals for more than 1h and performed a 1-week follow-up. Results: The total of 157 cases with exposure to pandemic influenza (H1N1 2009) virus and exposed individuals of 907 were reported. Of the exposed individuals who were under management, 15 were confirmed to be infected with the infection rate being 1.7%. The confirmed individuals did not have a secondary infection after the exposure. Rates of infection of the exposed patients and healthcare workers were 1.8% and 1.6%, respectively, and these figures were not statistically significant. Conclusion: The exposure management results at the hospital revealed that the infection had spread by contact with individuals who were positive for the infection. The high incidence of early exposure to the virus warrants the need to ensure the use of protective equipment and the adoption of assertive teaching methods that have long lasting effects.

3차 대학병원 근무 종사자에서 결핵 노출 후 접촉자 검진

김송이,이상국,권오미,이주현,하은진,정지예,박병훈,박무석,김세규,장준,강영애 대한결핵 및 호흡기학회 2011 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.112 No.-

전국의료관련감염감시체계 중환자실 부문 결과 보고: 2019년 7월부터 2020년 6월

김은진,곽이경,곽선희,고수희,권오미,김의석,김진화,김태형,김택수,문희원,박선희,안진영,유소연,유현미,이상오,조난형,최평균,홍기호,이유미,이미숙 대한의료관련감염관리학회 2021 의료관련감염관리 Vol.26 No.2

Background: This report presents the annual data of the intensive care unit (ICU) module of the Korean National Healthcare-associated Infections Surveillance System (KONIS) between July 2019 and June 2020. Methods: We performed prospective surveillance of healthcare-associated infections (HAI), including urinary tract infections (UTIs), bloodstream infections (BSIs), and pneumonia (PNEU), at 340 ICUs in 256 hospitals using the KONIS database. HAI and device-associated infection (DAI) rates were calculated as the number of infections per 1,000 patient-days (PD) and device-days (DD), respectively. Device utilization was calculated as the ratio (DUR) of device to patient days. Results: A total of 4,489 HAIs were found during the study period: 1,646 UTIs (1,597 cases were urinary catheter-associated); 1,964 BSIs (1,695 were central line-associated); and 879 PNEUs (470 were ventilator-associated). The rate of urinary catheter-associated UTIs (CAUTI) was 1.26/1,000 DD (95% confidence interval [CI] 1.20-1.32), whereas the urinary catheter utilization ratio was 0.80 (95% CI, 0.799-0.801). The rate of central line-associated BSIs was 2.16/1,000 DD (95% CI 2.06-2.26), whereas the central line utilization ratio was 0.50 (95% CI 0.499-0.501). The rate of ventilator-associated PNEUs was 0.93/1,000 DD (95% CI 0.85-1.02), whereas the ventilator utilization ratio was 0.32 (95% CI 0.319-0.321). Conclusion: The overall DAI rate was similar to that in the previous year. In particular, the device utilization ratios were reduced. Continuous surveillance prevented an increase in the infection rate and led to a decrease in device use. A continuous infection surveillance system can reduce the infection rate.

전국의료관련감염감시체계 중환자실 부문 결과 보고: 2020년 7월부터 2021년 6월

김은진,곽이경,곽선희,고수희,권오미,김의석,김진화,김태형,김택수,문희원,박선희,안진영,유소연,유현미,이상오,이유미,조난형,최영화,최평균,홍기호,이미숙,전국의료관련감염 중환자실감시체계 대한의료관련감염관리학회 2023 의료관련감염관리 Vol.28 No.1

Background: The Korean National Healthcare-associated Infections Surveillance System (KONIS) is a nationwide surveillance network established by the Korean Society for Healthcare-Associated Infection and Prevention in July 2006 to perform healthcare-associated infection surveillance using standardized methods. This report presents the annual data of the intensive care unit (ICU) module of the KONIS system between July 2020 and June 2021. Methods: We performed prospective surveillance of healthcare-associated infections (HAIs), including urinary tract infections (UTIs), bloodstream infections (BSIs), and pneumonia (PNEU), at 339 ICUs in 257 hospitals using the KONIS database. HAI rates and device-associated infection (DAI) rates were calculated as the numbers of infections per 1,000 patient days (PD) and device days (DD), respectively. Device utilization was calculated as the ratio (DUR) of device days to patient days. Results: A total of 4,435 HAIs were found during the study period: 1,645 UTIs (1,589 cases were urinary catheter-associated), 1,994 BSIs (1,753 were central line-associated), and 796 PNEUs (383 were ventilator-associated). The rate of urinary catheter-associated UTIs (CAUTI) was 1.30 cases per 1,000 DD (95% confidence interval [CI], 1.24-1.36) and DUR was 0.74 (95% CI, 0.739-0.741). The rate of central line-associated BSIs was 2.21/1,000 DD (95% CI, 2.11-2.31) and DUR was 0.48 (95% CI, 0.479-0.481). The rate of ventilator-associated PNEUs was 0.79/1,000 DD (95% CD, 071-0.87) and DUR was 0.29 (95% CI, 0.289-0.291). Conclusion: The overall DAI rate was similar to that of the previous year’s data; however, the rate of VAP showed a trend of decline. Furthermore, all DURs were reduced. Therefore, continuous infection surveillance may reduce infection rates and device use.

중소병원의 의료관련감염 감시

박은숙,진혜영,정선영,권오미,유소연,박신영,김성란,홍혜경,김옥선,김경미,윤성원,정재심,용동은,김명수,박대원,조용균,오향순,염준섭,김의종 대한의료관련감염관리학회 2011 의료관련감염관리 Vol.16 No.2

배경: 본 연구의 목적은 400병상 미만 규모의 중소병원에서의 의료관련감염 현황을 파악하기 위함이다. 방법: 2010년 8월부터 10월까지 27개 병원에서 웹기반 감시를 진행하였다. 의료관련감염 감시는 각 병원에서 1-2개의 중환자실과 일반병동에서 미국 CDC 정의에 의하여 진행하였으며, 다제내성균주는 모든 혈액배양결과를 조사하였다. 결과: 총 269,436 환자일수 동안 319건의 의료관련감염이 발생하여 환자일수 1,000일당 1.18건(CI 1.05-1.32)의 감염률을 보였다. 부위별감염의 분포는 요로감염이 52.4%로 가장 많았으며 폐렴 18.9%, 혈류감염 14.2%, 수술부위감염 7.9%, 기타 6.6%의 순이었다. 요로감염의 76.5%, 혈류감염의 46.7%, 폐렴의 18.3%는 삽입기구와 연관성이 있었다. 전체 감염률은 중환자실에서 일반병동보다 유의하게 발생률이 높았으나(4.6 vs 0.9), 유치도뇨관 관련 요로감염은 중환자실이 유의하게 낮았다(2.6 vs 4.4). 중심정맥관(1.5 vs 1.8)이나 인공호흡기관련 폐렴(3.0 vs 0.0)은 중환자실과 일반병동 간에 유의한 차이가 없었다. 원인균주의 분포는 E. coli 19.8%, S. aureus 13.1%, P. aeruginosa 12.7%의 순이었다. S. aureus의 90.9%가 methicillin 내성이었고 P. aeruginosa의 38.2%와 A.baumannii의 44.4%가 imipenem내성이었다. 혈액에서 분리된 다제내성균주는 총 66건이었으며, MRSA 84.6% (56주), carbepenem-resistant Acinetobacterspp. 10.6% (7주), VRE 4.6% (3주)였다. 결론: 본 연구로 파악한 중소병원에서의 의료관련감염의 특성은 정부의 감염관리 관련 정책결정시 필요한 기초자료가 되고 참여병원들 간에 상호비교할 수 있는 감염률 자료를 제공할 수 있을 것이다.

신종인플루엔자 대비 모의훈련 진행 경험

이경원,이동숙,박은숙,권오미,김향숙,박정연,고신옥,좌민홍,박인철,김경애,오경환,김창오,한상훈,최준용,김준명,이주현,하은진,김동수,방동식 대한의료관련감염관리학회 2010 의료관련감염관리 Vol.15 No.2

Background: It is important that hospitals conduct disaster drills to ensure prompt response in case of a pandemic and thereby prevent a biological disaster. Methods: In a university hospital of Seoul, a drill was arranged by the members of the drill preparation team who were a part of the response team for infection control of novel influenza A (H1N1). The drill preparation team designed the scenario for the drill, made plans to resolve the potential problems that could occur during that scenario, and organized a survey team and a survey methodology. The scenario consisted of 2 modules: (1) for an intensive care unit and (2) for an emergency care center. The surveyors and field participants were evaluated after the drill exercise. Results: This drill was conducted to improve the response to outbreaks of new infectious diseases. The drill event showed that the communication among the members responsible for the infection control was effective. However, the drill revealed certain drawbacks in the process; this drawbacks involved availability of adequate quarantine space,education on using personal protective equipments, assignment of medical and nonmedical staff, management of visitors, and installment of air-conditioners, heaters, and ventilation units in the areas with H1N1 outbreak. Conclusion: This drill helped to improve the process of infection control and overcome the drawbacks in the current process, and thereby helped in achieving positive outcome during the actual pandemic situation when the number of hospital visits and admissions because of H1N1 pandemic had rapidly increased. Although disaster plans and drills are not actively performed, the drill for infection control is essential because the risk for an outbreak of a new infectious disease is increasing.

유아교사들의 양성평등교육 경험에 대한 연구

손영빈 ( Young Bin Son ),권오미 ( Oh Min Kwon ),이명희 ( Myeong Hee Lee ) 미래유아교육학회 2009 미래유아교육학회지 Vol.16 No.1