Knowledge and Performance of Infection Control Guidelines / 병원감염관리

BACKGROUND: This study was purposed to identify the knowledge and performance level of the infection control guidelines and to improve their performance level of infection control for those nurses who care patients directly. METHODS: This study was based on the survey questionnaires about infection control guidelines with the total 626 nurses in Seoul and Kyunggi areas for the period between May 26, 2003 and July 14, 2003. RESULTS: The average knowledge level of infection control was 0.84 +/-0.07 (score range 0-1) and the average performance level of the infection control was 4.44+/-10.27 (score range 0-5). The correlation between knowledge and performance of the infection control showed positive correlation (r=.39; P<.001). The knowledge and performance level of the 'Prevention of the central catheter infection' were higher than other infection control guidelines. The performance levels of the 'Prevention of the surgical site infection' were lower than other infection control guidelines. The correlation between knowledge and performance of the 'Prevention of the nosocomial pneumonia' (r=.389; P<.001). 'Prevention of the urinary tract infection' (r=.325; P<.001), 'Prevention of the central catheter infection (r=.290; P<.001) and 'Intravascular infection control' (r=.446; P<.001) showed positive correlation. CONCLUSION: The study demonstrated that the nurses' knowledge and performance of infection control guidelines showed positive correlation. So the education on the infection control is required indispensably and it would contribute to reduce the hospital infection rate by performing the right treatment on the infection control with the basis of accurate knowledge.

Bactericidal Effect of Disinfectant Biospot(R) Against Clinical Isolates / 병원감염관리

BACKGROUND: Numerous disinfectants are available for disinfection and sterilization in the hospital environment but it is difficult to select an appropriate one. Biospot(R) is a chlorine-based disinfectant that consists of sodium dichloroisocyanurates. We evaluated the bactericidal effect of Biospot(R) against clinical isolates and compared it with that of other disinfectants. METHOD: Biospot(R), Wydex(R), HiCLO-S(R), Vipon(R), 70% ethanol, and 3% boric acid were evaluated. Clinical isolates were cultured from the patients in Kangnam St. Mary's hospital. There were two strains of Escherichia coli, methicillin-susceptible Staphylococcus aureus, methicillin-resistant Staphylococcus aureus, Klebsiella pneumoniae, vancomycin-resistant Enterococcus faecium, Pseudomonas aeruginosa, coagulase-negative staphylococcus, Streptococcus pneumoniae, and Bacillus subtilis. One strain of Candida albicans was included. Each strain was exposed to disinfectants for 0.5, 1, 2, 4, 8, and 15 minutes. RESULTS: All the non-spore forming bacteria were killed within 30 seconds in Biospot(R) (30 ppm of sodium dichloroisocyanurate). Wydex(R) (2% glutaraldehyde), HiCLO-S(R) (hypochlorous add 30ppm and electrolyzed oxidized water), Vipon(R) (50ppm of sodium hypochlorite), and 70% ethanol, but not in boric acid. Candida albicans were killed in 30 seconds with 100 ppm of BiOSpot(R) and all of disinfectants except boric acid. Bacillus subtilis, the spore forming bacteria, was killed in 4 minutes with 50 ppm, 2 minutes with 100 ppm of Btospot. Other disinfectants such as Vipon(R) killed Bacillus subtilis in 8 minutes. But Wydex(R), HiCLO-S(R), 70% ethanol, and boric acid could not kill the strain until 15 minutes. CONCLUSIONS: Biospot(R) was an effective and useful disinfectant against most common clinical isolates including fungus and spore forming bacteria.

A Case of Vacuolar Myelopathy in Patient with Acquired Immunodeficiency Syndrome / 감염

The spinal cord is a commonly affected site in human immunodeficiency virus (HIV) infection. Even though the most common disease of the spinal cord is vacuolar myelopathy, there is no case report yet in Korea. We experienced a case of suspicious vacuolar myelopathy in a 33 year-old male patient with acquired immunodeficiency syndrome. The patient presented with progressive paraparesis, gait disturbance, urinary difficulty, and the loss of sensation below thoracic spine 6~7 dermatome. Cerebrospinal fluid showed mild pleocytosis, increased protein level, and normal glucose content. The spine MRI showed extensive ill defined areas of increased signal intensity through the visualized lower cervical and thoracic spinal cord. Steroid therapy with antiretroviral drugs appeared to be ineffective to improve the symptoms of the patient.