Public Trust in Community Pharmacists in South Korea: A Survey Study

Background@#Trust is a key component for the good relationship between patients and healthcare professionals but trust for community pharmacists has not been studied much. @*Objectives@#This study aimed to measure public trust in community pharmacists and to investigate variables that affect trust level in South Korea. @*Methods@#A total of 25 questions, including 13-items for three dimensions of trust (pharmacists’ behavior/attitude, technical competence, communication skills) and 1-item for overall trust were developed. The survey was conducted online and the data from 416 respondents were analyzed with a t-test, an ANOVA and a multiple linear regression analysis. @*Results@#The average scores (mean ± standard deviation) for the three dimensions of trust in community pharmacists were 3.47±1.05 (out of 5 points) for pharmacists’ behavior/attitude, 3.67 ± 0.99 for technical competence, and 3.66±0.99 for communication skills. The average of the 13 items incorporating all parameters was 3.56±1.02 and the overall trust level was 7.16±1.62 (out of 10 points). The total sum of the 13 items differed significantly by age group (p=0.02) and frequency of pharmacy visits (p=0.04). Each dimension had an independent impact on the trust level, and pharmacists’ behavior/attitude had the greatest impact on trust levels. @*Conclusions@#This study showed that pharmacists’ behavior/attitude had the most significant impact on the trust level. However, the level of trust in pharmacists’ behavior/attitude is not yet sufficiently satisfactory, and further improvements are required to increase trust in community pharmacists.

A Case of Vascular Leiomyoma in Nasal Cavity: Case Report and Literature Review / 대한이비인후과학회지

Vascular leiomyoma may arise from the muscular layer of blood vessel wall, which is extremely rare in the nasal cavity or paranasal sinuses. According to the online search on pubmed and koreamed, only 62 cases with vascular leiomyoma arising from nasal cavity or paranasal sinuses, including 13 cases of the nasal septum, have been reported since the first case was reported in 1966. The authors experienced a case of vascular leiomyoma arising in the left side of nasal septum in a patient. It was successfully removed by trans-nasal approach. In addition, we conducted a literature review of clinical features of the 62 cases of vascular leiomyoma in the nasal cavity.

Effect of Foot Orthoses on Children With Lower Extremity Growing Pains

OBJECTIVE: To evaluate the effect of custom molded foot orthoses on children with growing pains of the lower extremities. METHODS: Children with growing pains were recruited during a clinic visit. None had any bony deformities, inflammatory joint disease or depression. Resting calcaneal stance position (RCSP) and calcaneal pitch angle were measured, and individual custom molded rigid foot orthoses were prescribed using the inverted orthotic technique to control for foot overpronation using the RCSP angle. Pain sites, degree and frequency of pain, and balance ability were evaluated using Balance Master computerized posturography prior to foot orthosis fitting, and 1 and 3 months later. RESULTS: Twenty children completed the study. Seventeen (75%) had overpronated feet. Significant improvements were noted after 1 and 3 months in pain degree and frequency, and after 3 months in balancing ability. CONCLUSION: The use of custom molded foot orthoses is a good method for treating children with multiple musculoskeletal pains in the leg.

Effect of Custom-Molded Foot Orthoses on Foot Pain and Balance in Children With Symptomatic Flexible Flat Feet

OBJECTIVE: To evaluate the effect of custom-molded foot orthoses on foot pain and balance in children with symptomatic flexible flat foot 1 month and 3 months after fitting foot orthosis. METHOD: A total of 24 children over 6 years old with flexible flat feet and foot pain for at least 6 months were recruited for this study. Their resting calcaneal stance position and calcaneal pitch angle were measured. Individual custom-molded rigid foot orthoses were prescribed using inverted orthotic technique to control foot overpronation. Pain questionnaire was used to obtain pain sites, degree, and frequency. Balancing ability was determined using computerized posturography. These evaluations were performed prior to custom-molded foot orthoses, 1 month, and 3 months after fitting foot orthoses. RESULT: Of 24 children with symptomatic flexible flat feet recruited for this study, 20 completed the study. Significant (p<0.001) improvements in pain degree and frequency were noted after 1 and 3 months of custom-molded foot orthoses. In addition, significant (p<0.05) improvement in balancing ability was found after 3 months of custom-molded foot orthoses. CONCLUSION: Short-term use of custom-molded foot orthoses significantly improved foot pain and balancing ability in children with symptomatic flexible flat foot.

A Case of Vidian Nerve Schwannoma: Resection by Endoscopic Sinus Surgery / 대한이비인후과학회지

Schwannoma is a benign tumor arising from the sheath of myelinated nerve fibers and may occur in any part of the body. However, a vidian nerve schwannoma is extremely rare. A 41 year-old man has experienced an occipital area headache and posterior neck stiffness for 2 weeks. Brain computed tomography (CT) angiography, magnetic resonance image revealed lobulated soft tissue density mass in left sphenoid sinus with upward displacement of sphenoid sinus floor and pressure erosion of sphenoid sinus and petrous apex. Ostiomeatal unit CT scan showed a 28x16 mm sized mass filling the left pterygoid canal. The mass was resected using endoscopic sinus surgery. The mass was confirmed as schwannoma. We report a case of vidian nerve schwan-noma that was treated by endoscopic sinus surgery.

Early Endoscopic Electrocoagulation of the Sphenopalatine Artery for Refractory Posterior Epistaxis: Preliminary Study

BACKGROUND AND OBJECTIVES: Intractable epistaxis is a challenging problem associated with clinical morbidity and high costs due to prolonged hospitalization. Early endoscopic electrocoagulation of the sphenopalatine artery can be a good alternative management. SUBJECTS AND METHODS: This study is a retrospective review of 6 patients with uncontrolled epistaxis between January 2013 and January 2014. A decision to surgically intervene was made within 24 hours of hospitalization in all cases. Endoscopic electrocoagulation of the sphenopalatine artery was conducted under general anesthesia. Clinical and hematologic information, preoperative and surgical care, postoperative complications and surgical outcome, and duration of preoperative and postoperative hospital stay were evaluated. RESULTS: Epistaxis was effectively controlled in all cases. Four patients (66.7%) complained of nasal dryness and one of them endured nasal crusting for 9 months after surgery. Recurrent posterior epistaxis occurred after 5 postoperative months in one case, which was successfully controlled without surgery. The average length of postoperative hospital stay was 2.5+/-0.5 days. The average total length of hospital stay was 4.8+/-0.8 days. CONCLUSIONS: Early endoscopic electrocoagulation of the sphenopalatine artery seems effective for controlling intractable epistaxis.

Current State of Influenza Vaccination and Factors Affecting Vaccination Rate among Pregnant Women

PURPOSE: This study was done to examine the actual state of influenza vaccination among pregnant women and factors affecting vaccination rate. METHODS: Data were collected using self-report questionnaires. Participants were pregnant women who participated in a prenatal education program at an acute care hospital in 2013. Data collected from 218 pregnant women were analyzed using the SPSS 18.0 Program. RESULTS: Only 48.6% of the pregnant women had received vaccination when the influenza was prevalent. Statistically significant factors affecting the influenza vaccination rate among pregnant women were vaccination experience in the previous year, knowledge and attitude about vaccination, and gestation period. CONCLUSION: Results indicate that the influenza vaccination rate among pregnant women is lower than that of elders, healthcare workers, and patients with chronic diseases, who have been considered to be the mandatory vaccination recipients. Therefore, it is necessary to develop programs and policies which provide information including safety of vaccines for pregnant women and to induce positive attitudes towards vaccination for these women, in order to ultimately improve the vaccination rate.

Aggravation of Relapsing Polychondritis due to the Infection and Its Manifestation on a Nasal Tip Graft

Relapsing polychondritis (RP) is an uncommon systemic disease that is characterized by episodic and progressive inflammation of the cartilaginous structures, which can be very debilitating and in some instances life-threatening. The pathogenic pathways of RP are largely unknown. However, several hypothesis have been suggested. We had an interesting case of aggravation of RP due to the infection. Graft cartilage on the nasal tip was affected by RP also. This case can give a clue of revealing the pathogenesis of RP. We introduce a case with a review of the literature.

A Case of Acute Bilateral Retrocochlear Hearing Loss as an Initial Symptom of Unilateral Thalamic Hemorrhage

A speech discrimination test is a test using a list of 25 phonetically balanced monosyllables. It is often overlooked but significant enough for pure tone audiometry. Many physicians have performed pure tone audiometry but without a speech discrimination test. A 73-year-old woman visited our clinic complaining of sudden bilateral hearing loss. Pure tone audiometry showed only bilateral high frequency loss. However, speech discrimination had decreased markedly. We decided to follow-up after 1 week of Ginexin-F(R) (ginkgo leaf extract) and Nafril(R) (nafronyl oxalate). She felt a gait disturbance within 2 days. Magnetic resonance imaging revealed a left thalamic hemorrhage. After a 1 month hospitalization, the hematoma subsided, and speech discrimination recovered 3 months later. Acute hearing loss due to thalamic hemorrhage that recovered has never been reported. We report the first case of retrocochlear hearing loss that occurred with a thalamic hemorrhage in a patient who recovered.

Pregnant Women's Knowledge and Compliance about Prevention of Respiratory Infection / 병원감염관리

BACKGROUND: Respiratory infection in pregnancy can cause various side effects and affect the fetus. Therefore, efforts to prevent infection during pregnancy are essential. This study investigated knowledge and compliance regarding the prevention of respiratory infection among pregnant women. METHODS: A survey was conducted on May 10, 2012 on 300 pregnant women who attended a maternity school education program in a tertiary care hospital. The responses of 259 women were collected and analyzed. RESULTS: Only 2 women (0.8%) had been educated about respiratory infection prevention methods, while 106 (40.9%) experienced respiratory infection during pregnancy. The mean score of respiratory infection prevention knowledge was 11.63 out of 15 points (percentage of correct answers: 77.5%). The mean score for compliance to respiratory infection prevention was 32.34 out of 52 points (percentage of practice: 62.19%). Knowledge and compliance were found to be positively correlated. CONCLUSION: Although many pregnant women experience respiratory infection during pregnancy, few have opportunities to be educated about prevention. Thus, the positive correlation between knowledge and compliance highlights the need for respiratory infection prevention education programs.

Development of Infection Control Guideline for Postpartum Care Centers / 병원감염관리

BACKGROUND: This study aimed to develop feasible and detailed infection control guidelines (ICG) and audit protocols for health care workers and auditors in postpartum care centers (PCC). METHODS: PCC ICG and audit protocols were developed in several steps: 1) review of previous ICG for PCCs; 2) establishment of frameworks for updating guidelines and audit protocols; 3) review of new ICG, regulations, etc.; 4) drafting of PCC ICG and audit protocols and revision based on feedback from the research committee; 5) Delphi survey to solicit opinions from infection control, infant care, and maternal care professionals as well as PCC health care workers; 6) re-revision after discussion with the research committee; and 7) finalization of PCC ICG and audit protocols. RESULTS: We developed ICG with 4 categories and 26 sub-categories, and internal and external audit protocols with 163 and 85 items, respectively. CONCLUSION: The ICG and audit protocols are valid and feasible; we recommend their utilization as auditing tools, baseline data for the development of national infection control policies, and as educational materials for PCC healthcare workers.

Epidemiological Characteristics and Scale for Needlestick Injury in Some University Hospital Workers / 대한산업의학회지

OBJECTIVES: Based on multicenter research among tertiary hospitals in Korea, it was our intention to effectively contribute to the prevention of needlestick injuries by understanding the current state of the incidence rate of needlestick injuries and the related epidemiology with respect to medical institution and worker's characteristics. METHODS: Ten hospitals were selected, with the research performed from July to September 2007. Data on cases of needlestick injuries were collected by hospital infection-controlling centers using a specifically developed website and a partially modified self-writing questionnaire based on the Exposure Prevention Information Network (EPINet). RESULTS: During the study period, a total of 327 needlestick injury cases were reported, with an incidence of 10.56 cases per 100 patient beds per year. The existence of source of infection could not be confirmed in one third of the needlestick injuries. There were 4.07 incidences per 100 employees per year. The job with the highest incidence was medical doctor interns (18.66 cases), followed by clinical laboratory workers (7.12 cases) and registered nurses (6.66 cases). CONCLUSIONS: There was no difference in number of incidences according to the number of beds. The highest number of cases occurred in the registered nurse-group, but the incidence rate per healthcare worker was the highest in the medical doctor intern-group. Therefore, it is important to conduct research to identify the risk of the incidence with respect to different risk-groups. As a result of this research, it is suggest that a protective policy is required relating to needlestick injuries, regardless of the number of beds and potential cause of infection.

Healthcare-Associated Infection Surveillance in Small and Medium Sized Hospitals / 병원감염관리

BACKGROUND: The purpose of this study is to know the healthcare-associated infection (HAI)s in small and medium sized hospitals, less than 400 beds. METHODS: We had web based surveillance for HAIs in 27 hospitals from August to October 2010. The surveillance performed in 1-2 ICUs and 1 general ward in each hospitals by CDC definition. And for the multi-drug resistant organisms (MDROs), we reviewed all of blood culture results. RESULTS: We identified 319 HAIs among 269,436 patients days. The HAIs rate was 1.18 (CI 1.05-1.32)/1,000 patient-days. Urinary tract infection was the most common HAI (52.4%) in this study followed by pneumonia (18.9%), blood-stream infections (14.2%), surgical site infection (7.9%), and others (6.6%). There were 76.5% of device associated infections in UTI, 46.7% in BSI, and 18.3% in pneumonia. The rate of HAIs in ICU was higher than that of in general ward (4.6 vs 0.9/1,000 patient-days). However, the indwelling catheter associated urinary tract infection rate was lower in ICU (2.6 vs 4.4/1,000 device days). There were no significant differences in central line-associated blood stream infection rate (1.5 vs 1.8) and ventilator-associated pneumonia rate (3.0 vs 0.0). The common microorganisms found in HAIs were Escherichia coli (19.8%), Staphylococcus aureus (13.1%), and Pseudomonas aeruginosa (12.7%). Moreover, 90.9% of S. aureus were resistant to methicillin, and 38.2% of P. aeruginosa and 44.4% of Acinetobacter baumannii were resistant to imipenem. Total of 66 MDROs were isolated from blood culture and the result shows that the MRSA was 84.6% (56 case), carbapenmen-resistant Acinetobacter spp. was 10.6% (7 case), and vancomycin-resistant enterococci was 4.6% (3 case). CONCLUSION: The characteristics of HAIs in small and medium sized hospitals will be contributed to the decision making of governance policy for infection control and to provide comparable data for these hospitals.

Underreporting Rate and Related Factors after Needlestick Injuries among Healthcare Workers in Small- or Medium-Sized Hospitals / 병원감염관리

BACKGROUND: This study aimed to examine the underreporting rate and related factors after needlestick injuries among healthcare workers (HCWs) in small- or medium-sized hospitals. METHODS: Convenience sampling was conducted for 1,100 HCWs in 12 small- or medium-sized hospitals with less than 500 beds. From October 1 to November 30, 2010, data were collected using self-report questionnaire that was developed by researcher. The response rate for the study was 98.3% (982 HCWs). Data were analyzed using Statistical Package for the Social Sciences (SPSS) Win 12.0. RESULTS: The reports showed that 239 HCWs (24.3%) sustained needlestick injuries within the last year. The under-reporting rate after a needlestick injury was 67.4% (161/239), and underreporting rates varied across the hospitals and ranged from 46.2% to 85.7%. The major reasons for underreporting after needlestick injuries were the assumption that no blood-borne pathogens existed in the source patient (62.8%), annoyance (17.9%), and no knowledge about the reporting procedure (6.0%). Multiple logistic regression analysis showed that the suggestion by colleagues to report the injury, the number of needlestick injuries, and the needle type were independently related to the underreporting of needlestick injuries. CONCLUSION: The underreporting rate of needlestick injuries in small- or medium-sized hospitals was similar to that in large-sized hospitals, and this finding confirmed that the suggestion by colleagues to report the injury was the most significant factor influencing the injury-report rate. Thus, creating an environment that encourages HCWs to report injuries is considered the most important method to decrease the underreporting rate of needlestick injuries in small- and medium-sized hospitals.

Epicanthoplasty Using Y-M Plasty

Lots of Koreans have relatively thick skin, small palpebral fissures and unfolded eyelids with a prominent epicanthal fold. Various methods have been developed to correct epicanthal fold. However, excessive or hypertrophic scar can be occurred, especially in the medial canthal and nasal area. And the recurrence may restrict the application of these methods. We developed a new epicanthoplasty using Y-M plasty to correct the epicanthal folds without obvious scar. From February 1999 to August 2010, all patients underwent Y-M plasty for the correction of epicanthal folds. Y-shaped incision line was designed not extending to the nasal area and the orbicularis oculi muscles were resected with skin. The dog ear deformities were corrected and sutured using nylon 7-0. The epicanthal folds were completely corrected. Prominent scar and recurrence were not observed. Most of the patients are satisfied with the results. Mean preoperative ICD(intercanthal distance) was 38.84 mm and average 2.24 mm ICD was reduced after the operation. Epicanthoplasty using Y-M plasty is relatively safe, easy and rapid method to design and apply even in the beginners with low risk of scars and recurrences. So, the authors propose this new versatile technique in the case of minimal to moderate epicanthal folds.

The Shape and the Location of Forehead Hairline of Korean Males in Their 20s & 30s

PURPOSE: It is generally believed that alopecia is caused by various factors such as scars, stress, genetical factors, androgens, etc. Androgenic alopecia is one of the most common cause of alopecia and found mainly in males. Propecia(Merck & Co., USA) and Minoxidil(McNEIL-PPC, Inc, USA) were the drugs approved from FDA for treatment of androgenic alopecia. Surgical treatments such as flap, tissue expansion, scalp reduction and hair transplantation can be considered if necessary. Hair micrograft techniques were developed for natural hair shapes and minimal adverse effect. There were attempts to measure the length of the forehead of the Korean young adults. However attempts to classify the shape and location of forehead hairline were rare. This study attempted to find out standard hairlines of young adults in their 20s & 30s and the result would be the guideline of the hairline in hair replacement surgery of male patients in their 40s & 50s. METHODS: 200 male adults in 20s and 30s were photographed and measured the length of 11 vertical index lines to determine hairline. The indexes are the distances from hairline to intercanthal midpoint(A), to medial canthus (B), to upper eyelid fissure(C), to lower eyelid fissure(D), to lateral canthus(E) and distance from lateral highest point to medial lowest point, if the hairline is M-shape(F). Additionally, we classified the hairlines into 4 groups, M, horizontal, inverted U and irregular shapes. RESULTS: The most common hairline of male adults in their 20s is inverted U-shape(53.3%), followed by horizontal-shape, M-shape, irregular-shape. In their 30s, inverted U-shape(59%) is followed by irregular-shape, M-shape, horizontal-shape. The M-shape is more frequently found in males in 30s than those in 20s. The mean values of the indexes in their 20s are as follows: A(76.14mm), B(Rt: 75.78mm, Lt:76.41mm), C(Rt: 69.43mm, Lt: 69.92mm), D(Rt: 76.92mm, Lt:77.46mm), E(Rt: 64.16mm, Lt: 64.73 mm), F(4.09mm). Those in their 30s are as follows: A(76.13mm), B(Rt: 76.114mm, Lt: 76.02mm), C(Rt: 69.87 mm, Lt: 70.37mm), D(Rt: 77.37 mm, Lt: 77.58mm), E(Rt: 69.63mm, Lt: 69.85mm), F(6.14 mm). CONCLUSION: The knowledge about human body measurement is indispensable to plastic surgeons. In this study, inverted U shape is the most common type of hairline in 30s, and similar distribution is found in 20s. The percentage of M shape in their 30s is elevated more than 10% compared to that in their 20s. The study of hairline shapes and 11 indexes of hairlines can be useful for planning of the hair transplantation and postoperative evaluation. This study being based on photogrammetry, there may be differences between actual distance of curved face and projected distance on flat photographs.

A Survey on Customers' Perceptions of Nutrition Labeling for Processed Food and Restaurant Meal

Consumer perception of processed food and restaurant food's nutrient labelling was surveyed. The subjects of this survey consisted of 1,507 parents, whose ages were 20-59 years old. The ratio of the respondents that have known nutrition labelling on processed foods was 89.8% and the ratio of whom have checked the nutrition labelling at their point of purchase was 72.3%. The nutrients which were considered important for nutrition labelling were fat (57.1%), calorie (56.3%) and sodium (49.0%). Also nutrient which were able to be recognized at a glance by the subjects were in the order of trans fat (62.1%), cholesterol (26.9%), calorie (23.9%) and sodium (21.0%). If restaurant menu's nutrient labelling be enacted, the answer rate that the menu's nutrition labelling may affect their menu choice is 90.6% of the respondents. Besides of the Fastfoods that are enforcement, restaurants of that customers want the menu to be labeled were 'pizza and chicken restaurants'. Nutrients that customers preferred to be labelled were calorie (62.0%), fat (60.3%) and sodium (50.9%).

A Case Report of Treatment of Heterotrophic Calcification in Pseudohypoparathyroidism

PURPOSE: Pseudohypoparathyroidism is a hereditary disorder characterized by symptoms and signs of hypoparathyroidism, typically in association with distinctive skeletal and developmental defects. Hypoparathyroidism is caused by a insufficient end-organ response to PTH (parathyroid hormone). Hypoparathyroidism consists of four types in which the most common form, pseudohypoparathyroidism-Ia, accompany with Albright's hereditary osteodystrophy. We experienced a case of a woman who had been suffering from calcified mass on left foot, diagnosed Albright's hereditary osteodystrophy. METHODS: We present a case of a 24-year-old Korean female who visited plastic surgery department with a painful mass on dorsum of the left foot. On the physical exam, bony hard and painful mass, fixed to dermis, was noted. Plain X-ray films demonstrate suspicious calcification on subcutaneous tissue of dorsum of the left foot. The patient was diagnosed pseudohypoparathyroidism 2 years ago at the plastic surgery department. At the visiting time, the laboratory results were within normal range even though the patient actually had a disease. The reason is because the patient has been treated with Vit.D, calcium replacement therapy and thyroid hormone therapy. Moreover, the patient has been treated with anticonvulsant agents due to epilepsy. On the brain computer tomography (CT), calcification was noted on the basal ganglia and dentate nucleus. So we decided the total excision of entire mass from the left foot. RESULTS: We excised main mass with numerous pinhead sized masses which were scattered around the main mass. The 6.0x4.0x0.5 cm sized main mass was bony hard, and its surface was flat and margin was irregular. The permanent biopsy was confirmed that the main mass and all the scattered tiny masses were heterotopic calcification. The patient did not suffer from the pain after the mass excision. The wound has been healed without any problem. CONCLUSIONS: Heterotrophic calcification is often accompanied with pseudohypoparathyroidism, but such a huge one is uncommon. We report a case of pseudohypoparathyroidism with heterotrophic calcification developed in dorsum of left foot who was diagnosed by excisional biopsy.

Survey of Under-Reporting Rate and Related Factors after Blood and Body Fluid Exposure among Hospital Employees / 성인간호학회지

PURPOSE: The purpose of this study was to examine the under-reporting rate and related factors after blood and body fluid (BBF) exposure among hospital employees. METHODS: Fifteen hundred employees were conveniently sampled from ten university and acute care hospitals. The survey questionnaire consisted of 37 items. Data were collected from September 10 to November 30, 2008. RESULTS: The survey response rate was 88.7%. The 47.9% (638/1,331) of hospital employees were exposed to BBF and the mean number of exposure was 4.7+/-5.942 within the previous year. Under-reporting rate after BBF exposure was 69.4% (443/638). By multi-variate logistic regression analysis, the exposure number, exposure type, infectious disease and hospital were independently related to the under-reporting of BBF among hospital employees. CONCLUSION: The Under-reporting Rate After Being Exposed To Blood And Body Fluids Was Relatively High. To Address This Problem, Educational Programs Are Needed To Decrease The Under-reporting Rate For Healthcare Workers. Further, It Might Be Helpful If Other Factors Related To Under-reporting Be Investigated In Future Studies.

Rate of Nasal Colonization of Methicillin-Resistant Staphylococcus aureus at Admission to a Medical Intensive Care Unit / 병원감염관리

BACKGROUND: The purpose of this study was to survey the nasal colonization of methicillin-resistant Staphylococcus aureus (MRSA) among the patients admitted in a medical intensive care unit (MICU) and analyze risk factors associated with the colonization. METHODS: The study was carried out on patients admitted into the MICU in a 1,250-bed tertiary care university hospital from January through December 2006. Nasal surveillance cultures were obtained from patients within 24 hours of admission to the unit. Data were analyzed retrospectively by the review of medical records. RESULTS: A total of 312 patients were screened with active nasal cultures; 36 patients (11.6%) were positive for MRSA. Of these, 22 (7.1%) were positive in the nasal cultures only and 14 (4.5%) were positive in the cultures of other specimens (13, sputum; 1, joint fluid) in addition to the nasal swabs. Among the risk factors for MRSA nasal colonization were sex (man), route of admission (from other ICUs or wards), a history of ICU admission during the recent 12 months, and prolonged hospital days in ICU. CONCLUSION: MRSA nasal carrier rate was found higher in this study than in those reported in the literature. Most of the patients colonized with MRSA in the nostril were not colonized with the organism elsewhere in the body. Whether or not active surveillance for MRSA should be performed would depend on the nasal colonization rate of the patients at the time of admission to the ICU.