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대유행 인플루엔자(H1N1 2009)에서 신속항원검사 양성률
김영근,김효열,어영,전진경 대한감염학회 2010 감염과 화학요법 Vol.42 No.2
There are few datas on the diagnostic accuracy of rapid antigen test for pandemic influenza A (H1N1). We evaluated the performance of rapid antigen test for the diagnosis of pandemic influenza A (H1N1). During the period from 21 August 2009 to 20 September 2009, 451 patients with influenza-like symptom underwent the rapid antigen test (SD Influenza Antigen, Standard Diagnostics, Yongin, Korea) and real-time reverse transcriptase-polymerase chain reaction (rRT-PCR) at the same time. Rapid antigen test results were positive for 65 of 90 patients with the positive results for pandemic influenza A (H1N1) on rRT-PCR assay. The sensitivity of the rapid antigen test was 72.2% (95% CI, 61.8-81.1) and the specificity was 100% (95% CI, 99.0-100). The positive predictive value was 100% (95% CI, 94.5-100) and negative predictive value was 93.5% (95% CI, 90.6-95.8).
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냉장 닭고기의 저장 및 시판동안 미생물학적 품질에 관한 연구
김창렬,고대희,강어진 서강전문대학 2000 산업과학연구 Vol.2 No.-
Microbiological evaluations of refrigerated chicken during a commercial chicken processing, storage, and handling at between March and July, 1998 were assessed. Aerobic plate counts (APC) of chicken wings obtained from retail store during storage of 7 days (2±2℃) were 5.80 log unit, which was the highest levels compared to chicken legs, chicken breasts, and whole chicken. APC and gram-negative bacterial counts (GNC) of whole chicken during refrigerated (4℃) storage under temperature abuse for lhr at 35℃ were 6.711og unit and 6.22 log unit, respectively. However, APC and GNC of whole chicken during refrigerated (10℃) storage under temperature abuse for lhr at 35℃ were not microbiological acceptable after storage of 4 days. Whole chicken obtained from a commercial chicken processing after evisceration significantly (P< 0.05) increased APC and GNC compared to those of after defeathering, before air chilling, and after final processing.
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( Uh Jin KIM ),( Seunghun LEE ),( Myung Ho JEONG ),( Ju Han KIM ),( HyukJin PARK ),( Ji Eun KIM ),( Youngkeun AHN ),( Jong Hyun KIM ),( Shung Chull CHAE ),( Young Jo KIM ),( Seung Ho HUR ),( In Whan S 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: The correlation between obesity and metabolic syndrome (MetS) remains unclear. This study aims to investigate impact of obesity phenotype on clinical outcomes with ST-segment elevation myocardial infarction (STEMI). Methods: We analyzed in-hospital mortality and major adverse cardiac events (MACE) of 2,606 obese patients who underwent primary percutaneous coronary intervention (PCI) in the Korea Acute Myocardial Infarction Registry from November 2005 to October 2010. Patients were divided into two groups: unhealthy (any of the Mets components) obesity (BMI =25 kg/m2) and healthy (none of the Mets components) obesity. Results: The unhealthy obesity group was composed of 703 patients (27%) and healthy obesity group 1,903 patients (73%). Unhealthy obesity was more frequent in female (25.9% vs. 10.1%, P<0.001) and multi-vessel disease (53.1% vs. 47.6%, P=0.012). There were no signifi cant differences in other baseline characteristics, angiographic and procedural fi ndings, and prescribed medications between two groups. The overall incidence of complications after PCI (13.1% vs. 10.7%, P=0.097) and in-hospital mortality (1.9% vs. 1.6%, P=0.521) were similar in unhealthy obesity group compared with healthy obesity group. By the multivariate Cox regression analyses, the presence of Mets in obese patients was not an independent factor for predicting the adjusted MACE rate at one-month (HR 1.19, 95% CI 0.56-2.54, P=0.645), six-month (HR 1.48, 95% CI 0.94-2.32, P=0.088), and twelve-month (HR 1.10, 95% CI 0.75-1.61, P=0.622). Conclusions: Obesity phenotype is not an independent prognostic factor for patients with STEMI who undergoing primary PCI. The risk stratifi cation by presence or absence of Mets is not useful in these patients.
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Kim Jieun,Myung Rangmi,Kim Bongyoung,Kim Jinyeong,Kim Tark,Lee Mi Suk,Kim Uh Jin,Park Dae Won,Kim Yeon-Sook,Lee Chang-Seop,Kim Eu Suk,Lee Sun Hee,Chang Hyun-Ha,Lee Seung Soon,Park Se Yoon,Choi Hee Jun 대한의학회 2024 Journal of Korean medical science Vol.39 No.12
Background: Since the emergence of hypervirulent strains of Clostridioides difficile, the incidence of C. difficile infections (CDI) has increased significantly. Methods: To assess the incidence of CDI in Korea, we conducted a prospective multicentre observational study from October 2020 to October 2021. Additionally, we calculated the incidence of CDI from mass data obtained from the Health Insurance Review and Assessment Service (HIRA) from 2008 to 2020. Results: In the prospective study with active surveillance, 30,212 patients had diarrhoea and 907 patients were diagnosed with CDI over 1,288,571 patient-days and 193,264 admissions in 18 participating hospitals during 3 months of study period; the CDI per 10,000 patientdays was 7.04 and the CDI per 1,000 admission was 4.69. The incidence of CDI was higher in general hospitals than in tertiary hospitals: 6.38 per 10,000 patient-days (range: 3.25–12.05) and 4.18 per 1,000 admissions (range: 1.92–8.59) in 11 tertiary hospitals, vs. 9.45 per 10,000 patient-days (range: 5.68–13.90) and 6.73 per 1,000 admissions (range: 3.18–15.85) in seven general hospitals. With regard to HIRA data, the incidence of CDI in all hospitals has been increasing over the 13-year-period: from 0.3 to 1.8 per 10,000 patient-days, 0.3 to 1.6 per 1,000 admissions, and 6.9 to 56.9 per 100,000 population, respectively. Conclusion: The incidence of CDI in Korea has been gradually increasing, and its recent value is as high as that in the United State and Europe. CDI is underestimated, particularly in general hospitals in Korea.
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Shi Hye Jin,Yang Jinyoung,Eom Joong Sik,Ko Jae-Hoon,Peck Kyong Ran,Kim Uh Jin,Jung Sook In,Kim Seulki,Seok Hyeri,Hyun Miri,Kim Hyun Ah,Kim Bomi,Joo Eun-Jeong,Cheong Hae Suk,Jun Cheon Hoo,Wi Yu Mi,Kim 대한의학회 2023 Journal of Korean medical science Vol.38 No.28
Background: The coronavirus disease 2019 (COVID-19) pandemic has caused the death of thousands of patients worldwide. Although age is known to be a risk factor for morbidity and mortality in COVID-19 patients, critical illness or death is occurring even in the younger age group as the epidemic spreads. In early 2022, omicron became the dominant variant of the COVID-19 virus in South Korea, and the epidemic proceeded on a large scale. Accordingly, this study aimed to determine whether young adults (aged ≤ 50 years) with critical COVID-19 infection during the omicron period had different characteristics from older patients and to determine the risk factors for mortality in this specific age group. Methods: We evaluated 213 critical adult patients (high flow nasal cannula or higher respiratory support) hospitalized for polymerase chain reaction-confirmed COVID-19 in nine hospitals in South Korea between February 1, 2022 and April 30, 2022. Demographic characteristics, including body mass index (BMI) and vaccination status; underlying diseases; clinical features and laboratory findings; clinical course; treatment received; and outcomes were collected from electronic medical records (EMRs) and analyzed according to age and mortality. Results: Overall, 71 critically ill patients aged ≤ 50 years were enrolled, and 142 critically ill patients aged over 50 years were selected through 1:2 matching based on the date of diagnosis. The most frequent underlying diseases among those aged ≤ 50 years were diabetes and hypertension, and all 14 patients who died had either a BMI ≥ 25 kg/m2 or an underlying disease. The total case fatality rate among severe patients (S-CFR) was 31.0%, and the S-CFR differed according to age and was higher than that during the delta period. The S-CFR was 19.7% for those aged ≤ 50 years, 36.6% for those aged > 50 years, and 38.1% for those aged ≥ 65 years. In multivariate analysis, age (odds ratio [OR], 1.084; 95% confidence interval [CI], 1.043–1.127), initial low-density lipoprotein > 600 IU/L (OR, 4.782; 95% CI, 1.584–14.434), initial C-reactive protein > 8 mg/dL (OR, 2.940; 95% CI, 1.042–8.293), highest aspartate aminotransferase > 200 IU/L (OR, 12.931; 95% CI, 1.691–98.908), and mechanical ventilation implementation (OR, 3.671; 95% CI, 1.294–10.420) were significant independent predictors of mortality in critical COVID-19 patients during the omicron wave. A similar pattern was shown when analyzing the data by age group, but most had no statistical significance owing to the small number of deaths in the young critical group. Although the vaccination completion rate of all the patients (31.0%) was higher than that in the delta wave period (13.6%), it was still lower than that of the general population. Further, only 15 (21.1%) critically ill patients aged ≤ 50 years were fully vaccinated. Overall, the severity of hospitalized critical patients was significantly higher than that in the delta period, indicating that it was difficult to find common risk factors in the two periods only with a simple comparison. Conclusion: Overall, the S-CFR of critically ill COVID-19 patients in the omicron period was higher than that in the delta period, especially in those aged ≤ 50 years. All of the patients who died had an underlying disease or obesity. In the same population, the vaccination rate was very low compared to that in the delta wave, indicating that non-vaccination significantly affected the progression to critical illness. Notably, there was a lack of prescription for Paxlovid for these patients although they satisfied the prescription criteria. Early diagnosis and active initial treatment was necessary, along with the proven methods of vaccination and personal hygiene. Further studies are needed to determine how each variant affects critically ill patients.
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The Survival Rate of Korean Patients with COPD with or without Acute Exacerbations
Uh, Soo-Taek,Lee, Ji-Yeon,Koo, So-Mi,Kim, Yang-Ki,Kim, Ki-Up,Park, Jong-Sook,Park, Sung-Woo,Jang, An-Soo,Kim, Do-Jin,Choi, Jae-Sung,Na, Joo-Ok,Suh, Ki-Hyun,Kim, Yong-Hoon,Park, Choon-Sik The Korean Academy of Tuberculosis and Respiratory 2011 Tuberculosis and Respiratory Diseases Vol.70 No.6
Background: Chronic obstructive pulmonary disease (COPD) is characterized by air low limitation, which is one of the leading causes of mortality worldwide. There have been many studies on survival rates in the world literature, but there have been few reports regarding the survival rate in Korean patients with COPD. Acute exacerbation is regarded as a risk factor for mortality in patients with COPD. The purpose of this study was to investigate the survival rate and the effect of acute exacerbations on the survival rate of Korean patients with COPD. Methods: A total of 502 COPD patients who were diagnosed on the basis of history and lung function tests were enrolled in this study. The frequency of acute exacerbations, body mass index (BMI), C-reactive protein (CRP) and pulmonary hypertension were analyzed. Results: The 3- and 5-year survival rates were 98% and 83%, respectively. The median survival time was 78 months. The median survival time was 55 months in 322 patients with one or more acute exacerbations. The 3- and 5-year survival rates were significantly lower in the 322 patients with one or more acute exacerbations than in those without any. The mortality rate was significantly higher in patients with CRP>3 mg/L than in those with CRP ${\leq}3$ mg/L (p<0.005); it was significantly higher in patients with pulmonary hypertension than in those without it (p<0.01). Conclusion: Because the 5-year survival rate is 83% in Korean patients with COPD, the management of stable patients with COPD should focus on the prevention of acute exacerbations.
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Kim Hyung-Sook,Park Kyung-Hwa,Choi Heun,Park Ji Young,Lee Mi Suk,Eun Byung Wook,Lee Hyukmin,Choi Jun Yong,Kim Hong Bin,Jeong Su Jin,Uh Young,Kim Bongyoung 대한감염학회 2022 Infection and Chemotherapy Vol.54 No.3
Background It is necessary to develop a roadmap for antimicrobial usage monitoring in order to perform monitoring of antimicrobial use at the national level properly. Therefore, this study aimed to develop a roadmap for establishing surveillance and monitoring of antimicrobial use in medical institutions at the national level. Materials and Methods A modified Delphi study was conducted, including 3 rounds of an online survey and a virtual meeting with 16 expert panels. The survey items were developed based on a literature review of the surveillance systems for antimicrobial use in 12 countries and interviews with experts. The questionnaire was designed to include both the surveillance and benchmarking systems. Results Regarding the scope of target institutions to be included in the surveillance system, medical institutions for sentinel surveillance had the highest proportion of agreement among the panels (75.0%, 9/12). For the benchmarking system, “tertiary- and secondary-care hospitals” were accepted as the scope of target institutions at the current moment. Furthermore, the National Health Insurance claims and prescription data of individual hospitals were considered appropriate data sources for the surveillance system. As for the measures to promote the participation of hospitals in the benchmarking system, “compensation through the establishment of antimicrobial management fees” and “set the participation in the program as a quality evaluation or accreditation index for hospital evaluation” were accepted. Conclusion This study provides a roadmap for establishing an antimicrobial use monitoring and benchmarking system for medical institutions at a national level in Korea. Background It is necessary to develop a roadmap for antimicrobial usage monitoring in order to perform monitoring of antimicrobial use at the national level properly. Therefore, this study aimed to develop a roadmap for establishing surveillance and monitoring of antimicrobial use in medical institutions at the national level. Materials and Methods A modified Delphi study was conducted, including 3 rounds of an online survey and a virtual meeting with 16 expert panels. The survey items were developed based on a literature review of the surveillance systems for antimicrobial use in 12 countries and interviews with experts. The questionnaire was designed to include both the surveillance and benchmarking systems. Results Regarding the scope of target institutions to be included in the surveillance system, medical institutions for sentinel surveillance had the highest proportion of agreement among the panels (75.0%, 9/12). For the benchmarking system, “tertiary- and secondary-care hospitals” were accepted as the scope of target institutions at the current moment. Furthermore, the National Health Insurance claims and prescription data of individual hospitals were considered appropriate data sources for the surveillance system. As for the measures to promote the participation of hospitals in the benchmarking system, “compensation through the establishment of antimicrobial management fees” and “set the participation in the program as a quality evaluation or accreditation index for hospital evaluation” were accepted. Conclusion This study provides a roadmap for establishing an antimicrobial use monitoring and benchmarking system for medical institutions at a national level in Korea.
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Kim, Soo Hyun,Shin, Jong Hee,Kim, Eui-Chong,Lee, Kyungwon,Kim, Mi-Na,Lee, Won Gil,Uh, Young,Lee, Hye Soo,Lee, Mi-Kyung,Jeong, Seok Hoon,Jung, Sook In,Park, Kyung Hwa,Lee, Jin-Sol,Shin, Myung Geun,Suh, Oxford University Press 2009 Medical mycology Vol.47 No.3
<P>There have been very few multicenter studies of the relationship between the use of antifungals and resistance to them. We investigated the antifungal susceptibility of 1,301 clinical isolates of Candida collected from nine Korean hospitals during a 3-month period in 2006 to explore the existence of this type of relationship. Antifungal usage in the preceding year, defined as the daily dose per 1,000 patient days (DDD/1,000 PD), was calculated for each hospital. Resistance to fluconazole, itraconazole, and amphotericin B was detected in 2, 9, and 0.2% of the isolates, respectively. The MIC(50)/MIC(90) values were 0.03/0.125 mg/L for voriconazole, 0.06/0.25 mg/l for caspofungin, and 0.03/0.125 mg/l for micafungin. The total usage of systemic antifungals varied considerably among the nine hospitals, ranging from 6.1 to 96.2 DDD/1,000 PD. No relationship was found between the use of fluconazole (MIC> or =64 mg/l) or itraconazole (MIC> or =1 mg/l) and resistance in the Candida species (P>0.05). However, significant correlations were found between the percentage of Candida isolates that were non-susceptible to fluconazole (MIC> or =16 mg/l) and fluconazole usage (r=0.733, P=0.025) or total antifungal usage (r=0.767, P=0.016).</P>
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Rothia aeria Infective Endocarditis: a First Case in Korea and Literature Review
Uh-Jin Kim,원은정,Ji-Eun Kim,Mi-Ok Jang,강승지,장희창,박경화,정숙인,신종희 대한진단검사의학회 2014 Annals of Laboratory Medicine Vol.34 No.4
Rothia species are pleomorphic gram-positive bacteria that belong to the Micrococcaceae family [1]. The Rothia genus presently comprises 6 named species, 2 of which are deemed clinically relevant: Rothia dentocariosa and Rothia mucilaginosa [2-6]. Another member of the genus, Rothia aeria, a taxon group provisionally named R. dentocariosa genomovar II, is a rare cause of human infections [2, 7] To date, only 6 cases of human infection caused by R. aeria have been reported, including bacteremia [8], neck abscesses [9], respiratory tract infection [10, 11], septic arthritis [12], and infective endocarditis [13]. Although Rothia species have rarely been reported as a causative pathogen of infective endocarditis, no case has been reported in Korea. Moreover, the risk factors for invasive infection by R. aeria are not well defined because of its rarity and the difficulty of correct species identification. Here, we report a case of infective endocarditis caused by R. aeria in a patient taking tumor necrosis factor (TNF)-α blocker.
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