Clinical Evaluation of BacteriokillerSystem(R) / 병원감염관리

BACKGROUND: Bacteriokiller system(BKS) produces disinfectant which is generated by the mixture of active oxygen and hypochlorous acid with tap water. Previous studies showed that BKS disinfectant is highly bacteridal against clinical isolates in in vitro testings and more effective than general soap and water for the disinfecttion of contaminated handa. This study was performed to evaluate ling-trem effects of BKS as a handwasing agent in clinical settings. METHODS: Five BKS were installed for the 9-month period from June 1995 to February 1996 in 16-bed Neurosurgery Intensive Care Unit. Handwashing was frequency was observed after 1, 6, and 8 month of BKS use. Six-month incidences of nosocomial infecrion before and after BKS installation were compared to evaluate the possible effect of handwashings on nosocomial infection rates. A self-administered questionaire was used to collect data on handwashing frequency and their opinions of the BKS disinfectant at 2 and 8 months after the installation. RESULTS: Handwashing frequency of healthcare workers(HCWs) before and after patient contacts was increased from 34.1%(137/402) to 50.3%(193/384) (p<0.00001). At the same time, the 6-month nosocomial infection rate was down to 10.5%(43/411) from the pre-BKS rate of 13.0%( 51/431) and the patient-day rate was also decreased from 18.3(56/3068) to 15.1(43/2,844). Most (80.5%) of HCWs thought that BKS promote handwashing and "convenience" was the main reason for more frequent handwashing. Ninety three percent of HCWs would recommend the replacement of tne existing sinks and handwashing disinfectants with BKS. NO adverse skin reaction were reported after 8 months. Conclusions: BKS appears to promote handwashing because it is easy to use with no skin irritation and may contribute toward the prevention of nosocomial infections.

Sensitivity of Laboratory-based Surveillance for Detecting Nosocomial Infections / 병원감염관리

BACKGROUND: Laboratory-based surveillance is an effective method' to detect nosocomial infections with limited personnel and time, and also can be used to identify clusters of organisms by unit and site. However it will fail to detect a significant number of infections because of cultures being negative or not submitted at all. This study was performed to determine the sensitivity of laboratory-based surveillance method in detecting nosocomial infections. METHODS: Four nursing units, two each of medical and surgical units, of Asan Medical Center were chosen and surveillance for nosocomial infections was performed with the total surveillance method for the 6-month period from July to December of 1995 by an infection control nurse. Proportion of the nosocomial infections that would have been detected by culture results alone was identified to determine the sensitivity of the laboratory-based surveillance method. RESULTS: A total of 164 cases of nosocomial infections were identified by the total surveillance method. Of these, 119 (72.6%) cases would have been detected by the laboratory-based surveillance method alone. Sensitivities were 100% in urinary tract infection and bacteremia, and 44.7%, 52.6% and 54.8% in lower respiratory tract, surgical site and other site infections, respectively. The 45 cases of infections that would have been undetected by microbiology data alone included 30 cases with culture negatives and 15 cases in which cultures were not submitted. CONCLUSIONS: The laboratory-based surveillance revealed different sensitivities depending on the sites of infections and patient services. The method is efficient with an acceptable level of sensitivities, but infection control teams should be aware of its shortcoming by a periodic monitoring of its sensitivity in the detection of nosocomial infections at their own hospitals.

Sensitivity of Laboratory-based Surveillance for Detecting Nosocomial Infections / 병원감염관리

BACKGROUND: Laboratory-based surveillance is an effective method' to detect nosocomial infections with limited personnel and time, and also can be used to identify clusters of organisms by unit and site. However it will fail to detect a significant number of infections because of cultures being negative or not submitted at all. This study was performed to determine the sensitivity of laboratory-based surveillance method in detecting nosocomial infections. METHODS: Four nursing units, two each of medical and surgical units, of Asan Medical Center were chosen and surveillance for nosocomial infections was performed with the total surveillance method for the 6-month period from July to December of 1995 by an infection control nurse. Proportion of the nosocomial infections that would have been detected by culture results alone was identified to determine the sensitivity of the laboratory-based surveillance method. RESULTS: A total of 164 cases of nosocomial infections were identified by the total surveillance method. Of these, 119 (72.6%) cases would have been detected by the laboratory-based surveillance method alone. Sensitivities were 100% in urinary tract infection and bacteremia, and 44.7%, 52.6% and 54.8% in lower respiratory tract, surgical site and other site infections, respectively. The 45 cases of infections that would have been undetected by microbiology data alone included 30 cases with culture negatives and 15 cases in which cultures were not submitted. CONCLUSIONS: The laboratory-based surveillance revealed different sensitivities depending on the sites of infections and patient services. The method is efficient with an acceptable level of sensitivities, but infection control teams should be aware of its shortcoming by a periodic monitoring of its sensitivity in the detection of nosocomial infections at their own hospitals.