Epidemiological characteristics of carbapenemaseproducing Enterobacteriaceae outbreaks in the Republic of Korea between 2017 and 2022

Objectives@#We aimed to describe the epidemiological characteristics of carbapenemaseproducing Enterobacteriaceae (CPE) outbreaks in healthcare settings in the Republic of Korea between 2017 and 2022. @*Methods@#Under the national notifiable disease surveillance system, we obtained annual descriptive statistics regarding the isolated species, carbapenemase genotype, healthcare facility type, outbreak location and duration, and number of patients affected and recommended interventions. We used epidemiological investigation reports on CPE outbreaks reported to Korea Disease Control and Prevention Agency from June 2017 to September 2022. @*Results@#Among the 168 reports analyzed, Klebsiella pneumoniae (85.1%) was the most frequently reported species, while K. pneumoniae carbapenemase (KPC, 82.7%) was the most common carbapenemase genotype. Both categories increased from 2017 to 2022 (p < 0.01). General hospitals had the highest proportion (54.8%), while tertiary general hospitals demonstrated a decreasing trend (p < 0.01). The largest proportion of outbreaks occurred exclusively in intensive care units (ICUs, 44.0%), and the frequency of concurrent outbreaks in ICUs and general wards increased over time (p < 0.01). The median outbreak duration rose from 43.5 days before the coronavirus disease 2019 (COVID-19) pandemic (2017–2019) to 79.5 days during the pandemic (2020–2022) (p = 0.01), and the median number of patients associated with each outbreak increased from 5.0 to 6.0 (p = 0.03). Frequently recommended interventions included employee education (38.1%), and 3 or more measures were proposed for 45.2% of outbreaks. @*Conclusion@#In the Republic of Korea, CPE outbreaks have been consistently dominated by K. pneumoniae and KPC. The size of these outbreaks increased during the COVID-19 pandemic. Our findings highlight the need for continuing efforts to control CPE outbreaks using a multimodal approach, while considering their epidemiology.

The relationship between metabolic syndrome and the incidence of colorectal cancer

OBJECTIVES@#This study evaluated the incidence of colorectal cancer (CRC) according to the number of metabolic syndrome (MetS) components.@*METHODS@#Using health checkup and insurance claims data of 6,365,409 subjects, the occurrence of CRC according to stage of MetS by sex was determined from the date of the health checkup in 2009 until December 31, 2018.@*RESULTS@#Cumulative incidence rates (CIR) of CRC in men and women was 3.9 and 2.8 per 1000 (p < 0.001), respectively. CIR of CRC for the normal, pre-MetS, and MetS groups in men was 2.6, 3.9, and 5.5 per 1000 (p < 0.001) and CIR in women was 2.1, 2.9, and 4.5 per 1000 (p < 0.001), respectively. Compared with the normal group, the hazard ratio (HR) of CRC for the pre-MetS group was 1.25 (95% CI 1.17-1.33) in men and 1.09 (95% CI 1.02-1.17) in women, and the HR of CRC for the MetS group was 1.54 (95% CI 1.43-1.65) in men and 1.39 (95% CI 1.26-1.53) in women after adjustment.@*CONCLUSIONS@#We found that MetS is a risk factor for CRC in this study. Therefore, the prevention and active management of MetS would contribute to the prevention of CRC.

Contributions and Limitations of National Cervical Cancer Screening Program in Korea: A Retrospective Observational Study

PURPOSE: The purpose of this study was to evaluate the contributions and limitations of the cervical cancer screening test with accuracy in Korea. METHODS: This was a retrospective observational study. The study population consisted of all participants who underwent cervical cancer screening test from 2009 to 2014. The data were obtained from National Health Information Database (NHID) which represents medical use records of most Koreans. As the indices for contributions and limitations of the screening test, crude detection rate, incidence rate of interval cancer, sensitivity, specificity, and positive predictive value were used. RESULTS: The crude detection rate of screening test per 100,000 participants increased from 100.7 in 2009 to 102.1 in 2014. The incidence rate of interval cancer per 100,000 negatives decreased from 13.0 in 2009 to 10.2 in 2014. The sensitivities of screening test were 88.7% in 2009 and 91.2% in 2014, and the specificities were 98.5% in 2009 and 97.7% in 2014. The positive predictive value of screening decreased from 6.2% in 2009 to 4.3% in 2014. CONCLUSIONS: The Korean national cervical cancer screening program has improved in accuracy and has contributed to detection of early stage of cervical cancer over the years. Along with efforts to promote participation in cancer screening programs, quality control over the screening program should be enhanced.

Factors Affecting the Validity of Self-Reported Data on Health Services from the Community Health Survey in Korea

PURPOSE: As a follow-up for the validity study of Community Health Surveys (CHSs), the purpose of this study was to evaluate the factors affecting the accuracy of CHSs by investigating subjects' characteristics. MATERIALS AND METHODS: We used data from 11,217 participants (aged 19 years or older) who had participated in the CHS, conducted by a local government in 2008 and analyzed the variables affecting the sensitivity and specificity of hospitalization and outpatient visit. RESULTS: Multivariate logistic regression analysis showed that, factors related with the sensitivity of hospitalization and outpatient visit questions were gender, age, marital status, chronic diseases, medical checkup, the subjective health status and necessary medical services. Factors related with the specificity were gender, marital status, educational background, chronic diseases, medical checkup, alcohol consumption, necessary medical services and sadness. CONCLUSION: This study revealed the subject-related factors associated with the validity of the CHS. Efforts to improve the sensitivity and the specificity from self-report questionnaires should consider how the characteristics of subjects may affect their responses.