여성의 재발성 요로감염 예방

김백남 대한감염학회 2012 Infection and Chemotherapy Vol.44 No.5

Urinary tract infection (UTI) is one of the most common bacterial infections affecting women. One in four of these women will develop a recurrence. Recurrent UTIs are common among otherwise healthy women with anatomically and physiologically normal urinary tracts. These conditions have a significant effect on their quality of life and have a considerable economic impact due to health care costs. This article will review risk factors predisposing pre- and postmenopausal women to recurrent UTIs, and discuss antimicrobial prophylaxis and other non-antimicrobial preventive measures, including modification of behavioral factors, estrogen, and cranberry products.

임상강좌 : 요로감염증의 진단과 치료에서 경험할 수 있는 문제들

김백남 대한내과학회 2002 대한내과학회 추계학술대회 Vol.63 No.-

국내 Epstein-Barr 바이러스 일차감염의 임상적 특성

김백남,곽이경,문치숙,김의석,박상원,이창섭 대한감염학회 2007 Infection and Chemotherapy Vol.39 No.6

In this study, the clinical features of 264 patients of primary Epstein-Barr virus (EBV) infection between the years of 2002-2006 were evaluated retrospectively. The median age of the patients was 6 years old (0-69), and the hospitalization rate was 78.0%. Fever (83.3%) and sore throat (50.4%) were the most common symptoms. Cervical lymphadenopathy (71.2%), tonsillitis (51.1%), splenomegaly (26.1 %), hepatomegaly (25.8%), rash (10.2%) and jaundice (1.5%) were observed. Cervical lymphadenopathy was less frequent in older age groups. The annual number of primary EBV infections according to the age group during the study period did not change significantly in this study.

쯔쯔가무시병에서 가피의 위치와 복장과의 관계

김백남,곽이경,문치숙,김의석,박상원,이창섭 대한감염학회 2006 감염과 화학요법 Vol.38 No.6

목적 : 쯔쯔가무시병의 예방을 위하여 위험지역에서 긴소매 윗옷을 입고 바지 끝을 양말 속에 넣는 것이 권장되고 있다. 이러한 예방조치의 효용성을 알아보기 위하여 우리는 쯔쯔가무시병에서 가피의 위치와 신발과 복장과의 관계를 살펴보았다. 재료 및 방법 : 2005년 10-12월 사이 6개 병원에서 전형적인 임상양상, 가피의 존재, 혈청검사 결과로 쯔쯔가무시병이 의심되거나 확진된 159명의 성인을 대상으로 가피의 위치, 추정 감염일, 야외활동, 당시 착용한 신발과 복장 등 을 조사하였다. 결과 : 혈청검사는 5명에서 시행되지 않았고 99명이 양성이었으며, 가피는 142명에서 발견되었다. 몸의 두 군데에서 발견된 6명을 제외한 136명 중 82명(60.3%)에서 가피는 하반신(아랫배, 엉덩이, 서혜부, 생식기, 넓적다리, 종아리)에 있었다. 감염일이 추정가능하고 가피가 1개만 있는 44명을 대상으로 하였을 때, 가피가 하반신에서 발견된 17명에서 슬리퍼를 신거나 맨발인 경우는 5명이었으나 상반신에 있는 27명 중에는 아무도 없었다(P=0.006). 바지아랫단을 양말 속에 집어 넣은 4명 중 1명은 하반신에서 3명은 상반신에서 가피가 발견되었다. 42명이 긴 소매 윗옷을 입었는데, 이중 16명은 하반신에서 26명은 상반신에서 가피가 발견되었다(P=1.00). 결론 : 쯔쯔가무시병 환자에서 신발을 신지 않거나 발이 잘 보호되지 않았을 때 가피는 하반신에 더 잘 생겼다. 바지 아랫단의 처리방법이나 긴 소매 윗옷의 착용은 가피의 위치와 통계적으로 유의한 연관관계는 발견되지는 않았다. 그러나 표본수가 적고 유충의 침범경로에 영향을 줄수 있는 다른 요인이 있기 때문에 가피의 위치와 연관관계가 없다고 이 연구에서 단정할 수는 없다. 따라서 쯔쯔가무시병의 예방을 위한 실용적인 권고를 위해서는 더 많은 연구가 필요하다. Background:Wearing a long-sleeved shirt and tucking the pants legs into the socks is recommended to prevent scrub typhus. This study investigated associations between the location of eschar and the type of clothes and shoes to evaluate the efficacy of these protective measures. Materials and Methods:One-hundred and fifty nine patients in whom scrub typhus was confirmed or suspected based on the typical clinical manifestations, presence of eschar, or positive results of serologic tests at 6 Korean hospitals from October to December 2005 were included in this study. We collected the information on the location of eschar, presumed exposure date to chiggers, and the clothes and shoes which they had worn. Results:Serologic tests were positive in 99 patients. Eschars were observed in 142 patients and 6 of them exhibited more than 2 eschars. Eighty-two (60.3%) of 136 patients with a single eschar had an eschar on the lower half of the body. Of the 44 patients whose exposure date could be estimated, and who had only a single eschar, 5 of the 17 patients with eschars in the lower half of their bodies, and none of the 27 patients with eschars in the upper half of their bodies went barefoot or wore open footware (P=0.006). Only 4 patients tucked the pants into their socks, and an eschar was found in the lower half in one patient, and in the upper half of the body in the other 3 patients. Of 42 patients who wore long-sleeved shirts, eschars were found in their lower bodies in 16, and on their upper bodies in 26 (P=1.00). Conclusion:When the feet were not protected properly with shoes, eschars were found more frequently on the lower half of the body than on the upper half. Wearing a long-sleeved shirt or tucking the pants legs into the socks was not found to be significantly correlated to the location of eschars. Further studies involving larger samples are necessary for the development of practical guidelines of protective measures to prevent scrub typhus.

Factitious Fever로 밝혀진 불명열 1예

김백남,강재명,배인규,김양수,우준희,류지소 대한감염학회 2000 감염 Vol.32 No.5

Antibiotic Control Policies in South Korea, 2000-2013

김백남,김홍빈,오명돈 대한감염학회 2016 Infection and Chemotherapy Vol.48 No.3

Antibiotic stewardship is a key strategy for limiting antibiotic resistance. Over the last decade the South Korean government has implemented a series of healthcare policies directed to this end, consisting of legislative separation of drug prescribing and dispensing, antibiotic utilization reviews, healthcare quality assessment, and public reporting. As a result, the proportion of antibiotic prescriptions for acute upper respiratory tract infections in primary healthcare facilities decreased from 72.9% in 2002 to 42.7% in 2013. However, no significant decrease in antibiotic resistance occurred over the same period in clinically important bacteria such as Streptococcus pneumoniae. These government-driven policies played a pivotal role in improving antibiotic use for outpatients and surgical patients in South Korea. However, to achieve long-lasting successful outcomes, coordinated efforts and communications among the stakeholders, including physicians and medical societies, are needed.

미생물학과 감염 분야 논문 검색에 국내 문헌데이터베이스의 유용성 비교

김백남 대한감염학회 2009 Infection and Chemotherapy Vol.41 No.1

Backgrounds : Korean bibliographic databases are used to search and retrieve domestic literature for research purposes. However, doubts about their accuracy, completeness, and coverage have been raised since their development and implementation. There have been controversies as to which database is best for searching domestic medical literature. This study was conducted to investigate the usefulness of Korean bibliographic databases in identifying domestic literature related to microbiology and infectious diseases. Materials and Methods : Four bibliographic databases, including KoreaMed (www.koreamed.org), KISS (kiss.kstudy.com), KMbase (kmbase.medric.or.kr), and RISS (www.riss4u.net), were used for this study. One public bibliographic database, which discontinued its update, and other commercial database services were not evaluated. After performing searches utilizing representative terms related to microbiology and infectious diseases, numbers of retrieved results were compared. The results of bibliographic records gathered by using KoreaMed were compared with those of three other databases; only the journals published from 2001 to 2007 were taken into account. Results : The number of search results retrieved by using each of the four databases ranged from 3 to 5,444 records depending on the search terms. In general, more search results were identified with KMbase and RISS than with KoreaMed and KISS. The concordance rate of the search results, utilizing the same search terms, between KoreaMed and three other databases ranged from 0% to 93.3%. Bibliographic errors including wrong order of authors, misspelled authors’names, use of the old journal title, and duplicate records were found in all databases. Conclusions : Total number of results obtained from each of the four Korean bibliographic databases using the same search terms was different and discordant. Researchers are recommended to take into account their characteristics and limitations when using Korean bibliographic databases for medical researches. Backgrounds : Korean bibliographic databases are used to search and retrieve domestic literature for research purposes. However, doubts about their accuracy, completeness, and coverage have been raised since their development and implementation. There have been controversies as to which database is best for searching domestic medical literature. This study was conducted to investigate the usefulness of Korean bibliographic databases in identifying domestic literature related to microbiology and infectious diseases. Materials and Methods : Four bibliographic databases, including KoreaMed (www.koreamed.org), KISS (kiss.kstudy.com), KMbase (kmbase.medric.or.kr), and RISS (www.riss4u.net), were used for this study. One public bibliographic database, which discontinued its update, and other commercial database services were not evaluated. After performing searches utilizing representative terms related to microbiology and infectious diseases, numbers of retrieved results were compared. The results of bibliographic records gathered by using KoreaMed were compared with those of three other databases; only the journals published from 2001 to 2007 were taken into account. Results : The number of search results retrieved by using each of the four databases ranged from 3 to 5,444 records depending on the search terms. In general, more search results were identified with KMbase and RISS than with KoreaMed and KISS. The concordance rate of the search results, utilizing the same search terms, between KoreaMed and three other databases ranged from 0% to 93.3%. Bibliographic errors including wrong order of authors, misspelled authors’names, use of the old journal title, and duplicate records were found in all databases. Conclusions : Total number of results obtained from each of the four Korean bibliographic databases using the same search terms was different and discordant. Researchers are recommended to take into account their characteristics and limitations when using Korean bibliographic databases for medical researches.

혈액배양검사의 원리와 실제

김백남 대한감염학회 2007 Infection and Chemotherapy Vol.39 No.3

Blood cultures are the gold standard for diagnosing bloodstream infections and identifying causative organisms. Every effort should be made to improve diagnostic yield, and obtained results should be interpreted cautiously in the context of clinical findings. In this review, several issues of clinical relevance with regard to blood culturing are addressed; these issues include indications, skin antisepsis, timing and number of blood cultures, volume of obtained, and interpretation of positive blood culture results.

미생물학과 감염 분야의 연구논문 경향 : KoreaMed와 PubMed로 검색되는 한국 문헌의 서지분석

김백남 대한감염학회 2009 Infection and Chemotherapy Vol.41 No.1

This study was conducted to determine the trend of domestic and overseas literature in microbiology and infectious diseases published by Korean researchers over the past five decades. Using 23 search terms related to microbiology and infectious diseases, domestic and overseas publications were retrieved with bibliographic databases, KoreaMed and PubMed, respectively. For all search terms, the number of Korean publications from both databases increased up to 50 times in the 2000s compared with that of the 1980s. For the majority of the search terms, the numbers of domestic literature retrieved with KoreaMed were higher than those of overseas literature retrieved with PubMed. However, for several search terms, the results obtained with PubMed outnumbered those of KoreaMed in the last decade. In summary, the number of publications related to microbiology and infectious diseases by Korean researchers have recently increased both in domestic and overseas medical journals.

IgE매개 세팔로스포린 과민반응

김백남,조유숙 대한감염학회 2010 감염과 화학요법 Vol.42 No.3

Cephalosporins are commonly prescribed either orally or parenterally for the treatment of bacterial infections because of wide safety margin compared with penicillins. Skin testing with a parent cephalosporin antibiotic has routinely been performed in Korea in the fear of developing anaphylaxis after the administration of a cephalosporin although penicillins are antibiotics that most commonly induce severe or life-threatening IgE-mediated reactions (anaphylaxis). In this review, we will discuss IgE-mediated hypersensitivity reactions to cephalosporins. Immunopathogenesis of IgE-mediated hypersensitivity reaction to cephalosporins, limitations of skin testing with parent cephalosporin antibiotics, and prescription strategy of cephalosporins for patients with a history of cephalosporin or penicillin hypersensitivity was described.