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1.
Journal of Korean Academic Society of Nursing Education ; : 86-97, 2023.
Artículo en Coreano | WPRIM | ID: wpr-967255

RESUMEN

Purpose@#This study aimed to assess exposure to traumatic events, knowledge and attitudes concerning post-traumatic stress disorder (PTSD) and the level of resilience among nurses and paramedics working in emergency departments. @*Methods@#Data were collected from May 22 to June 12, 2022, using a self-administered survey questionnaire. The participants comprised 135 nurses and 80 paramedics working in emergency departments. The collected data were analyzed with descriptive statistics, a t-test, and an analysis of variance with Scheffé’s test. @*Results@#Compared with emergency room nurses, paramedics were more positive about the government’s spending on job opportunities for people with PTSD. There were no significant differences in attitude regarding government strategies and people with PTSD between nurses and paramedics. Paramedics had higher scores on the effective treatment for PTSD, while emergency room nurses showed higher scores on effective psychotherapy. General knowledge of PTSD differed according to sex (t=-2.33, p=.021) and education level (F=3.21, p=.042). Resilience scores differed significantly according to sex (t=2.02, p=.045), education level (F=4.10, p=.018), self-reported economic state (F=10.34, p<.001), and self-reported health (F=11.57, p<.001). @*Conclusion@#The findings support that emergency department nurses and paramedics are in need of self-care programs to support their mental health and indicate that intervention programs should be developed to enhance resilience in emergency department professionals.

2.
Epidemiology and Health ; : e2022003-2022.
Artículo en Coreano | WPRIM | ID: wpr-937579

RESUMEN

OBJECTIVES@#In July 2019, there were multiple reports on patients with hepatitis A among the visitors of a restaurant in Busan. The current study presents the results of an epidemiological investigation and outlines the supplementary measures that would help with hepatitis A control. @*METHODS@#A cohort study was conducted for all 2,865 customers who visited restaurant A from June to July. Using a standardized questionnaire, participants reported the presence of hepatitis A symptoms and whether they had consumed any of 19 food items. As for participants who had visited public health centers, their specimens were collected. @*RESULTS@#From the study cohort, 155 participants (5.4%) had confirmed hepatitis A. The epidemic curve was unimodal, and the median number of days from the restaurant visit to symptom onset was 31 days. A genotype analysis indicated that 89 of 90 tested patients had hepatitis A virus (HAV) genotype 1A. The results of a multivariate logistic regression analysis indicated that the ingestion of salted clams increased the risk of hepatitis A by 68.12 times (95% confidence interval [CI], 9.22 to 510.87). In an unopened package of salted clams found and secured through traceback investigation, HAV genotype 1A was detected. @*CONCLUSIONS@#To prevent people from ingesting uncooked clams, there needs to be more efforts to publicize the dangers of uncooked clams; the food sampling test standards for salted clams should also be expanded. Furthermore, a laboratory surveillance system based on molecular genetics should be established to detect outbreaks earlier.

3.
Annals of Laboratory Medicine ; : 86-94, 2021.
Artículo en Inglés | WPRIM | ID: wpr-874133

RESUMEN

Background@#A lineage of Klebsiella pneumoniae that produces carbapenemase-2 (KPC-2), sequence type (ST) 307, emerged in 2017. We analyzed the complete sequences of plasmids from KPC-2-producing K. pneumoniae (KPC-Kp) ST307, investigated the antimicrobial resistance conferred by this strain, and confirmed the horizontal interspecies transmission of KPC- carbapenemase-producing Enterobacteriaceae (CPE) characteristics among Enterobacteriaceae. @*Methods@#We performed antimicrobial susceptibility testing, PCR analysis, multilocus sequence typing, curing tests, and whole-genome sequencing to characterize plasmid-derived KPC-2-producing Enterobacteriaceae clinical isolates. @*Results@#Sequence analysis of KPC-Kp strain ST307 revealed novel plasmid-located virulence factors, including a gene cluster for glycogen synthesis. Three Enterobacteriaceae strains were identified in one patient: K. pneumoniae (CPKp1825), Klebsiella aerogenes (CPEa1826), and Escherichia coli (CPEc1827). The bla KPC-2 gene from K. pneumoniae ST307 was horizontally transmitted between these strains. The plasmids could be transferred through conjugation, because all three strains of bacteria contained the type IV secretion system, pilus genes, and tra genes for conjugal transfer. The bla KPC-2 gene was located on a truncated Tn4401 transposon. Plasmids containing the bla KPC-2 gene could not be artificially removed; thus, the three strains could not be cured. @*Conclusions@#The ease of horizontal transfer of KPC-Kp ST307 carbapenem resistance has serious public health and epidemiological implications. This study provides a better understanding of the genetic characteristics that can contribute to the growth and spread of KPC-Kp ST307, and their association with antimicrobial resistance genes.

4.
Journal of Korean Clinical Nursing Research ; (3): 186-197, 2020.
Artículo | WPRIM | ID: wpr-835951

RESUMEN

Purpose@#The purpose of this study was to develop a program for reinforcing the resilience of new nurses and relation-oriented organizational culture. @*Methods@#An Intervention Research (IR) model was used to develop a program. Literature review, focus group interviews with nurses and need surveys were conducted from August to December 2018. Based on the results of the investigation, the researcher developed the content of a program. The program was revised by nurse managers for the content validation. Results: According to the results of the need surveys, 58.8% of the participants thought relation-oriented culture was the most ideal, and 61.8% of the participants wanted to participate in a program for organizational culture improvement. In the focus group interview, not only new nurses but also wards and nursing organizations should be a target subject of the program. Reinforcement of resilience and relation (3R) program was developed as a one-year course, which includes a ‘mentor-mentee’ program and a ‘thanks’ program. Conclusion: It would contribute to improving the resilience of new nurses and creating a relation-oriented organizational culture by 3R program.The 3R program could play a role as expanded program from an existing pragmatic short-term training program for improving the competencies or communication skills of new nurses.

5.
Journal of Korean Clinical Nursing Research ; (3): 1-9, 2020.
Artículo | WPRIM | ID: wpr-835945

RESUMEN

Purpose@#This study was conducted to provide fundamental data on increasing organizational commitment of clinical nurses by verifying the mediation effects of resilience in the correlation between the verbal violence experienced by nurses and their organizational commitment. @*Methods@#Participants were 167 nurses working in 2 university hospitals and 3 general hospitals located in D city Nurse managers were excluded. Data were analyzed using t-test, ANOVA, Pearson's correlation coefficient, and multiple regression analysis based on the three-step mediation effect verification procedures proposed by Baron and Kenny. SPSS 24.0 program was used. The significance of mediation effect was verified by performing the Sobel test. @*Results@#The resilience was confirmed to have a partial mediating effect in the relationship between verbal violence experience and organizational commitment (β=.25, p=.001), and verified by Sobel test (Z=-1.95, p=.026). @*Conclusion@#The results verifiying that verbal violence experience, organizational commitment, and resilience are correlated with each other, and showing that the organizational culture needs to be improved and the hospital environment needs to be changed to decrease verbal violence experiences and increase resilience in order to enhance organizational commitment.

6.
Epidemiology and Health ; : e2020035-2020.
Artículo en Inglés | WPRIM | ID: wpr-898274

RESUMEN

Objectives@#To describe and evaluate epidemiological investigation results and containment measures implemented in Busan, where 108 cases were confirmed with coronavirus disease 2019 (COVID-19) between February 21, 2020 and March 24, 2020. @*Methods@#Any individual who tested positive for COVID-19 was classified as a confirmed case. Measures were taken to identify the source of infection and trace and quarantine contacts. Serial intervals were estimated and the effective reproduction number was computed. @*Results@#Of the total 18,303 COVID-19 tests performed between January 16, 2020 and March 24, 2020 in Busan, 108 yielded positive results (positive test rate, 0.6%). All confirmed cases were placed in isolation at hospitals. Of the 108 confirmed cases, 59 (54.6%) were female. The most common age group was 20-29 years with 37 cases (34.3%). Regarding symptoms at the time of diagnosis, cough (n=38, 35.2%) and fever (n=34, 31.5%) were most common; 12 cases (11.1%) were asymptomatic. The source of infection was identified in 99 cases (91.7%). A total of 3,223 contacts were identified and quarantined. Household contacts accounted for 196, and the household secondary attack rate was 8.2% (95% confidence interval [CI], 4.7 to 12.9). The mean serial interval was estimated to be 5.54 days (95% CI, 4.08 to 7.01). After February 26, (Rt) remained below 1 in Busan. @*Conclusions@#The early containment strategy implemented in Busan shows that control is possible if outbreaks are of limited scope. In preparation for future outbreaks, public health and healthcare systems should be re-examined and put in a ready state.

7.
Epidemiology and Health ; : e2020046-2020.
Artículo en Inglés | WPRIM | ID: wpr-898263

RESUMEN

OBJECTIVES@#The objective of the study was to conduct a follow-up investigation of 10 asymptomatic patients at diagnosis among the 98 confirmed coronavirus disease 2019 (COVID-19) cases reported in Busan between February 21, 2020 and March 13, 2020 to determine whether asymptomatic infection and transmission during asymptomatic period are possible. @*METHODS@#The study analyzed 10 asymptomatic, confirmed COVID-19 cases to determine whether asymptomatic infection is possible. We conducted in-depth interviews with patients and guardians; interviews with primary physicians; review of medical records and drug utilization review (DUR) reports; and base station-based location tracking. @*RESULTS@#Among the 98, confirmed COVID-19 cases reported in Busan, the study analyzed 10 (10.2%) asymptomatic patients at diagnosis. The results confirmed that two (2.0%) patients reported to be asymptomatic during the initial epidemiological investigation, but turned symptomatic before diagnosis as per the in-depth interview results. Four cases (4.0%) of early detection led to confirmed diagnosis during the incubation period and presentation of symptoms after diagnosis. In addition, the remaining four patients (4.0%), having no subjective symptoms nor specific findings on chest radiography and computed tomography, remained asymptomatic until the isolation order was lifted. With regard to whether transmission during the asymptomatic period is possible, it was found that one out of 23 household contacts of the confirmed patients was identified as an additional confirmed case after coming in close contact with an index patient during the presymptomatic period. @*CONCLUSIONS@#Among the 98 confirmed cases, asymptomatic infection was confirmed in four cases (4.0%). In addition, there was one additional confirmed case in which the patient was a family member who came in close contact with an index patient during the incubation period, thereby confirming that transmission during the asymptomatic period is possible. The possibility of transmission during the asymptomatic period has been confirmed; therefore, it is necessary to review the measures for expanding contact tracing that is currently being applied starting one day prior to the onset of symptoms.

8.
Epidemiology and Health ; : e2020035-2020.
Artículo en Inglés | WPRIM | ID: wpr-890570

RESUMEN

Objectives@#To describe and evaluate epidemiological investigation results and containment measures implemented in Busan, where 108 cases were confirmed with coronavirus disease 2019 (COVID-19) between February 21, 2020 and March 24, 2020. @*Methods@#Any individual who tested positive for COVID-19 was classified as a confirmed case. Measures were taken to identify the source of infection and trace and quarantine contacts. Serial intervals were estimated and the effective reproduction number was computed. @*Results@#Of the total 18,303 COVID-19 tests performed between January 16, 2020 and March 24, 2020 in Busan, 108 yielded positive results (positive test rate, 0.6%). All confirmed cases were placed in isolation at hospitals. Of the 108 confirmed cases, 59 (54.6%) were female. The most common age group was 20-29 years with 37 cases (34.3%). Regarding symptoms at the time of diagnosis, cough (n=38, 35.2%) and fever (n=34, 31.5%) were most common; 12 cases (11.1%) were asymptomatic. The source of infection was identified in 99 cases (91.7%). A total of 3,223 contacts were identified and quarantined. Household contacts accounted for 196, and the household secondary attack rate was 8.2% (95% confidence interval [CI], 4.7 to 12.9). The mean serial interval was estimated to be 5.54 days (95% CI, 4.08 to 7.01). After February 26, (Rt) remained below 1 in Busan. @*Conclusions@#The early containment strategy implemented in Busan shows that control is possible if outbreaks are of limited scope. In preparation for future outbreaks, public health and healthcare systems should be re-examined and put in a ready state.

9.
Epidemiology and Health ; : e2020046-2020.
Artículo en Inglés | WPRIM | ID: wpr-890559

RESUMEN

OBJECTIVES@#The objective of the study was to conduct a follow-up investigation of 10 asymptomatic patients at diagnosis among the 98 confirmed coronavirus disease 2019 (COVID-19) cases reported in Busan between February 21, 2020 and March 13, 2020 to determine whether asymptomatic infection and transmission during asymptomatic period are possible. @*METHODS@#The study analyzed 10 asymptomatic, confirmed COVID-19 cases to determine whether asymptomatic infection is possible. We conducted in-depth interviews with patients and guardians; interviews with primary physicians; review of medical records and drug utilization review (DUR) reports; and base station-based location tracking. @*RESULTS@#Among the 98, confirmed COVID-19 cases reported in Busan, the study analyzed 10 (10.2%) asymptomatic patients at diagnosis. The results confirmed that two (2.0%) patients reported to be asymptomatic during the initial epidemiological investigation, but turned symptomatic before diagnosis as per the in-depth interview results. Four cases (4.0%) of early detection led to confirmed diagnosis during the incubation period and presentation of symptoms after diagnosis. In addition, the remaining four patients (4.0%), having no subjective symptoms nor specific findings on chest radiography and computed tomography, remained asymptomatic until the isolation order was lifted. With regard to whether transmission during the asymptomatic period is possible, it was found that one out of 23 household contacts of the confirmed patients was identified as an additional confirmed case after coming in close contact with an index patient during the presymptomatic period. @*CONCLUSIONS@#Among the 98 confirmed cases, asymptomatic infection was confirmed in four cases (4.0%). In addition, there was one additional confirmed case in which the patient was a family member who came in close contact with an index patient during the incubation period, thereby confirming that transmission during the asymptomatic period is possible. The possibility of transmission during the asymptomatic period has been confirmed; therefore, it is necessary to review the measures for expanding contact tracing that is currently being applied starting one day prior to the onset of symptoms.

10.
Journal of Korean Physical Therapy ; (6): 76-81, 2019.
Artículo en Coreano | WPRIM | ID: wpr-765426

RESUMEN

PURPOSE: This study examined the effects of squatting with different foot positions on the muscle activation of the vastus medialis oblique (VMO) and vastus lateralis (VL) muscles in subjects with genu varum. METHODS: Thirty four subjects participated in this study. Surface electromyography was used to measure the muscle activation of the VMO and VL muscles at the knee angles (15°, 60°) at three foot positions (internal rotation, neutral position, external rotation) during squatting. RESULTS: Muscle activation differences at different knee angles and foot positions differed significantly between the VMO and VL muscles in both the varus and normal groups. In addition, there was a significant difference according to the knee angles with the foot in external rotation in the VMO and VL ratio. In the varus group, however, the VMO and VL ratio were significantly different only with the feet in internal rotation. In the muscle activation changes of the knee angle differences in the foot position, there was no significant difference in the varus group, but both the VMO and VL muscles were significant different in the normal group. CONCLUSION: In both groups, regardless of the foot position, muscle activation of the VMO and VL muscles increased with increasing knee flexion angle. In the normal group, when squatting with the feet in external rotation, the VMO and VL muscles activations increased with increasing knee angle. In the varus group, however, the foot position did not affect the VMO or VL muscle activation. This study shows that subjects with genu varum and normal subjects have different VMO and VL muscle activation patterns during squat exercises.


Asunto(s)
Electromiografía , Ejercicio Físico , Pie , Genu Varum , Rodilla , Músculos , Músculo Cuádriceps
11.
Safety and Health at Work ; : 216-223, 2018.
Artículo en Inglés | WPRIM | ID: wpr-715504

RESUMEN

BACKGROUND: Many studies have reported negative psychological or physical effects of emotional labor. Relationship between work-related musculoskeletal disorder and psychosocial factors has been reported. To manage organizational and psychosocial factors of musculoskeletal disorder with work place intervention among emotional laborers, the factors contributing to musculoskeletal pain must be identified and clarified. METHODS: Data from the fourth Korean Working Conditions Survey was analyzed. Based on the questionnaire, we selected emotional laborers and included 3,979 participants, excluding participants whose variables were of interest to the researcher. Weight variable was applied. The association with musculoskeletal pain and psychosocial factors, such as workload, monotonous work, job control, social support, and job satisfaction, was investigated. RESULTS: Univariate analysis demonstrated that there was a statistically significant relationship between social support, job satisfaction, and musculoskeletal pain. In multivariate analysis, job satisfaction showed a strong correlation with musculoskeletal pain at all sites. Social support was significantly associated with backache. Monotonous work seemed to reduce the pain in the neck and/or upper limbs. Job control and work intensity were not significantly associated with musculoskeletal pain. CONCLUSION: In this study, job satisfaction was significantly associated with musculoskeletal pain, and social support among the social psychological stressors could reduce musculoskeletal pain. However, unlike previously known, the presence of monotonous work resulted in reduced musculoskeletal pain. The results of this study will help to establish the direction of improvement of atmosphere in the workplace to prevent the musculoskeletal pain of emotional laborers.


Asunto(s)
Atmósfera , Dolor de Espalda , Satisfacción en el Trabajo , Análisis Multivariante , Dolor Musculoesquelético , Cuello , Psicología , Carencia Psicosocial , Control Social Formal , Estrés Psicológico , Extremidad Superior , Lugar de Trabajo
12.
Annals of Occupational and Environmental Medicine ; : 37-2018.
Artículo en Inglés | WPRIM | ID: wpr-762511

RESUMEN

BACKGROUND: Using analysis of air samples from the workplace, we report on one case of pneumoconiosis in an individual who has been working in a polytetrafluoroethylene (PTFE) spraying process for 28 years. CASE PRESENTATION: The patient was diagnosed with granulomatous lung disease caused by PTFE using computed tomography (CT), lung biopsy and electron microscopy. To assess the qualitative and quantitative exposure to PTFE in workplace, Fourier transform infrared spectroscopy (FT-IR), energy-dispersive X-ray spectroscopy (EDX) and thermogravimetric analysis (TGA) were performed on air samples from the workplace. The presence of PTFE particles was confirmed, and the airborne concentration of PTFE was estimated to be 0.75 mg/m3. CONCLUSIONS: This case demonstrates that long-term exposure to PTFE spraying can cause granulomatous lung lesions such as pneumoconiosis; such lesions appear to be caused not by the degradation products of PTFE from high temperatures but by spraying the particles of PTFE. Along with air-sampling analysis, we suggest monitoring the concentration of airborne PTFE particles related to chronic lung disease.


Asunto(s)
Humanos , Biopsia , Higiene , Pulmón , Enfermedades Pulmonares , Microscopía Electrónica , Enfermedades Profesionales , Neumoconiosis , Politetrafluoroetileno , Espectroscopía Infrarroja por Transformada de Fourier , Análisis Espectral
13.
Journal of Korean Clinical Nursing Research ; (3): 137-146, 2018.
Artículo en Coreano | WPRIM | ID: wpr-750254

RESUMEN

PURPOSE: The purpose of this study was to identify the influence of nursing organization culture on resilience of new nurses. METHODS: Participants were 1,033 new nurses with careers of less than 12 months and who were from 43 general hospitals located in Seoul, Incheon, other metropolitan cities and provinces in Korea. The data were analyzed using t-test, ANOVA, Pearson correlation coefficient and multiple regression with SPSS/WIN 24.0 program. RESULTS: Relation-oriented culture was scored highest for perception of organizational culture by new nurses (3.35), followed by hierarchy-oriented culture (3.19), innovation-oriented culture (3.12), and task-oriented culture (2.73). The score for resilience of the new nurses was 3.49, and the first subcategories were interpersonal relationship ability 3.66, self-positivity 3.45, and self-control ability 3.36. Relation-oriented culture (β=.30, p < .001) was the most significant factor influencing resilience of new nurses, followed by innovation-oriented culture (β=.14, p=.001), hierarchy-oriented culture (β=.12, p < .001), task-oriented culture (β=−.10, p=.003) in that order (R2(adj. R2)=.16, F=47.04, p < .001). CONCLUSION: Findings show that for improved resilience in new nurses it is necessary to develop relation-oriented culture to provide a cooperative work environment( friendly interpersonal relation and dialogue) for new nurses and to encourage involvement of these members in the hospital culture.


Asunto(s)
Hospitales Generales , Relaciones Interpersonales , Corea (Geográfico) , Enfermería , Cultura Organizacional , Autocontrol , Seúl
14.
Healthcare Informatics Research ; : 206-216, 2016.
Artículo en Inglés | WPRIM | ID: wpr-177094

RESUMEN

OBJECTIVES: Despite the importance of the protection of patients' health information in clinical settings, little is known about the awareness of this concept in nursing students due to the lack of a suitable measurement tool. Hence, this study attempted to redevelop the Patients' Health Information Protection Awareness Scale, and evaluate its construct validity and reliability for nursing students. METHODS: A cross-sectional descriptive study was conducted. Nursing students who were in their 3rd and 4th year were recruited from 10 universities in Korea to assess the construct validity, and 30 experts (27 nurses and 3 faculty members) participated in the content validation process. RESULTS: The content validity assessment indicated that 23 items were ideal. The assessment of construct validity using exploratory factor analysis revealed three factors: communication, management, and referrals. They together accounted for 54.1% of the variance in scale scores. The three-factor scale had good fit in the confirmatory factor analysis. Scale reliability was confirmed, with a Cronbach's alpha of 0.94 for all items. CONCLUSIONS: This study was the first attempt to redevelop the Patients' Health Information Protection Awareness Scale for student nurses. The 23-item scale was shown to be a reliable and valid tool. It facilitates the assessment of nursing students' awareness of patient information protection. Academic nursing programs and health organizations can use its scores to implement adequate education plans to safeguard information in nursing students.


Asunto(s)
Humanos , Seguridad Computacional , Educación , Gestión de la Información en Salud , Corea (Geográfico) , Enfermería , Derivación y Consulta , Reproducibilidad de los Resultados , Estudiantes de Enfermería
15.
Journal of Veterinary Science ; : 149-155, 2014.
Artículo en Inglés | WPRIM | ID: wpr-56422

RESUMEN

This study was conducted to evaluate the usefulness of coronary arterial profiles from normal dogs (11 animals) and canines (six dogs) with experimental myocardial infarction (MI) induced by ligation of the left coronary artery (LCA). Blood velocity of the LCA and right coronary artery (RCA) were evaluated following transthoracic pulsed-wave Doppler echocardiography. The LCA was observed as an infundibular shape, located adjacent to the sinus of Valsalva. The RCA appeared as a tubular structure located 12 o'clock relative to the aorta. In normal dogs, the LCA and RCA mean peak diastolic velocities were 20.84 +/- 3.24 and 19.47 +/- 2.67 cm/sec, respectively. The LCA and RCA mean diastolic deceleration times were 0.91 +/- 0.14 sec and 1.13 +/- 0.20 sec, respectively. In dogs with MI, the LCA had significantly (p < 0.01) lower peak velocities (14.82 +/- 1.61 cm/sec) than the RCA (31.61 +/- 2.34 cm/sec). The RCA had a significantly (p < 0.01) rapid diastolic deceleration time (0.71 +/- 0.06 sec) than that found in the LCA (1.02 +/- 0.22 sec) of MI dogs. In conclusion, these profiles may serve as a differential factor for evaluating cardiomyopathy in dogs.


Asunto(s)
Animales , Femenino , Masculino , Velocidad del Flujo Sanguíneo/veterinaria , Vasos Coronarios/cirugía , Enfermedades de los Perros/diagnóstico , Perros/fisiología , Ecocardiografía Doppler de Pulso/normas , Infarto del Miocardio/diagnóstico
16.
Annals of Laboratory Medicine ; : 133-138, 2012.
Artículo en Inglés | WPRIM | ID: wpr-89101

RESUMEN

BACKGROUND: Differentiation of atypical pathogens is important for community-acquired pneumonia (CAP). In this study, we compared sputum and nasopharyngeal swabs (NPS) for use in detection of Mycoplasma pneumoniae (MP), Chlamydophila pneumoniae (CP), and Legionella pneumophila (LP), using Seeplex PneumoBacter ACE Detection Assay (PneumoBacter; Seegene). METHODS: Sputum and NPS specimens were collected from patients in 15 hospitals. DNA was extracted from sputum using QIAamp DNA Stool Mini Kit (Qiagen) and from NPS using easyMAG (bioMerieux). Both types of specimens were evaluated by multiplex PCR using PneumoBacter. To determine the diagnostic performance of this assay, sputum samples were also tested using BD ProbeTec ET Atypical Pneumonia Assay (APA; Becton Dickinson). RESULTS: Among 217 sputum and NPS, 20 (9.2%), 2 (0.9%), and 0 sputum were positive for MP, LP, and CP, respectively, whereas 8 (3.7%) NPS were positive for MP. The sputum APA test yielded 186, 206, and 204 interpretable results for MP, LP, and CP, respectively. Of these, 21 (11.3%) were positive for MP, 2 (1.0%) were positive for LP, and 0 samples were positive for CP. Compared to APA, the sensitivity and specificity of the sputum assay for MP were 95.2% and 100.0%, respectively, whereas for the NPS assay, these were 38.1% and 93.9%. Sputum testing was more sensitive than NPS testing (P=0.002). For LP and CP diagnosis, PneumoBacter and APA tests agreed 100%. CONCLUSIONS: Specimen type is crucial and sputum is preferred over NPS for simultaneous detection of MP, LP, and CP using multiplex PCR in CAP.


Asunto(s)
Humanos , Infecciones por Chlamydophila/diagnóstico , Chlamydophila pneumoniae/genética , Infecciones Comunitarias Adquiridas/diagnóstico , ADN Bacteriano/análisis , Legionella pneumophila/genética , Enfermedad de los Legionarios/diagnóstico , Reacción en Cadena de la Polimerasa Multiplex , Mycoplasma pneumoniae/genética , Nasofaringe/microbiología , Neumonía por Mycoplasma/diagnóstico , Juego de Reactivos para Diagnóstico , Esputo/microbiología
17.
The Korean Journal of Laboratory Medicine ; : 637-646, 2010.
Artículo en Coreano | WPRIM | ID: wpr-73305

RESUMEN

BACKGROUND: Susceptibility testing of Staphylococcus aureus often requires cumbersome supplementary tests. MicroScan Pos Breakpoint Combo Panel Type 28 (PBC28) (Siemens, USA) includes cefoxitin screening to detect methicillin-resistant Staphylococcus aureus (MRSA), inducible clindamycin resistance detection (ICD), and determination of low-range minimum inhibitory concentration of vancomycin (0.5-16 microgram/mL). The purpose of this study was to evaluate the performance of PBC28 in comparison with that of Pos Combo Type 1A (PC1A) (Siemens). METHODS: From December 2009 to March 2010, 500 non-duplicate clinical isolates of S. aureus were tested with PC1A and PBC28. Categorical agreements (CA) between the interpretations of the 2 panels were estimated. The presence of the mecA gene was determined by PCR, and double-disk diffusion test (D-test) was performed on the isolates resistant to erythromycin but susceptible or intermediately resistant to clindamycin. Ninety-six isolates representing various vancomycin minimum inhibitory concentrations (MICs) were tested in parallel with repeat PBC28, broth macrodilution, and epsilometer test (E test). RESULTS: The CA was 99.3% with a very major error (VME) of 0.2%, major error (ME) of 0.1%, and minor error (mE) of 0.4% in total. PBC28 showed 100% CA for 1 isolate with vancomycin MIC of 4 microgram/mL and 35 isolates (7.0%) with MIC of 2 microgram/mL. However, only 15, 27, and 35 isolates with vancomycin MIC of 2 microgram/mL showed 100% CA in repeat PBC28, broth macrodilution, and E test, respectively. PC1A and PBC28 detected all 314 mecA-positive isolates. Among the 63 isolates tested with the D-test, 58 (92.1%) were positive, and the results were 100% concordant with those of ICD. CONCLUSIONS: PBC28 can be appropriate susceptibility testing of S. aureus, including MRSA detection and ICD. However, the lower-range vancomycin MIC test was not reproducible enough to reliably differentiate MIC of 2 microgram/mL from MIC< or =1 microgram/mL.


Asunto(s)
Antibacterianos/farmacología , Proteínas Bacterianas/genética , Cefoxitina/farmacología , Clindamicina/farmacología , Farmacorresistencia Bacteriana , Staphylococcus aureus Resistente a Meticilina/genética , Pruebas de Sensibilidad Microbiana , Juego de Reactivos para Diagnóstico , Sensibilidad y Especificidad , Staphylococcus aureus/efectos de los fármacos , Vancomicina/farmacología
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