Antimicrobial Resistance in Bacterial Isolates Recovered from Nursing Hospitals between 2014 and 2017 / 대한임상미생물학회지

BACKGROUND: Antimicrobial resistance (AMR) is an issue not only with regard to public health, but also in terms of economic impact. AMR surveillance has mainly been carried out in general hospitals, and not in nursing hospitals. This study was conducted to investigate the AMR rate for bacterial strains isolated from nursing hospital samples.METHODS: Antimicrobial susceptibility testing (AST) results from a total of 23,518 bacterial isolates recovered from clinical specimens taken in 61 nursing hosals were analyzed. AST was conducted using Vitek 2 with AST cards specific for the bacterial strains.RESULTS: A total of 19,357 Gram-negative and 4,161 Gram-positive bacterial strains were isolated. Pseudomonas aeruginosa (n=6,384) and Escherichia coli (n=5,468) were the most prevalent bacterial species and, among Gram-positive bacteria, Staphylococcus aureus (n=1,565) was common. The AMR rate was high for the following strains: cefotaxime-resistant Klebsiella pneumoniae, 77.4%; cefotaxime-resistant E. coli, 70.6%; imipenem-resistant Acinetobacter baumannii, 90.3%; imipenem-resistant P. aeruginosa, 49.3%; oxacillin-resistant S. aureus, 81.1%, penicillin-resistant Enterococcus faecalis, 44.8%, and vancomycin-resistant Enterococcus faecium, 53.5%. AMR rate change varied by bacterial species and antimicrobial drug.CONCLUSION: AMR rates of major pathogens from nursing hospitals were higher than those from general hospitals with the exception of imipenem-resistant A. baumannii. Continuous monitoring and infection control strategies are needed.

<b>2. Agenda for the Sound and Effective Implementation of Risk Management Plan System </b> / 薬剤疫学

One year and a half has passed since the implementation of the guideline on drug risk management plan (RMP). Japanese RMP system practically began to work. While a post-marketing surveillance study, which has played the central role in pharmacovigilance activities in Japan, is positioned as a measure to collect information to be used in the application document for re-examination, the environment surrounding pharmacovigilance has dramatically changed, e.g. increased number of spontaneous reports, improved medical information database and expansion of its availability, compared to the situation when the reexamination scheme was incorporated into law 35 years ago. Now we need to examine diversified approaches to improve the traditional method and mindset taking advantage of the advances in information technology. In order that RMP system be implemented effectively as well as soundly, it is important to implement the PDCA (plan-do-check-act) cycle in a timely manner. Also we need to assess the overall balance between the resources for post-marketing risk management activities and the performance obtained by them from the viewpoint of ensuring patients' safety.

Sports Injury Surveillance during Summer Asian Games 2010 in Guangzhou / 대한스포츠의학회지

The purpose of this study was to do the surveillance study of sports injuries which were suffered to National players of South Korea Team during the summer Asian Games 2010 in Guangzhou. All medical staffs of Korea Delegation were asked to report all sports injuries newly incurred during the Games on injury report form, and the physicians made clinical diagnoses of the injuries. Total 725 injuries (430 athletes) were reported, and 288 injuries (209 athletes) were newly incurred: 68 injuries (58 athletes) were recurrent with previous history, resulting in total incidence rate: 45.5 injuries/1000 athlete exposures (AE) (95% confidence interval [CI]: 40.1-50.6 injuries/1000 AE) and incidence proportion: 26% (95% CI: 23-29). The new injury was highest in athletics (n=37, 12.8%), hockey (n=26, 9.0%), and basketball (n=23, 8.0%). While 162 injuries (56.2%) were incurred during practice, 126 injuries (43.8%) were incurred in competition. The most frequent diagnoses were lateral ankle ligament sprain (n=28, 9.7%, 95% CI: 6.3-13.1), calf muscle cramp (n=23, 95% CI: 4.9-11.1), and hamstring strain (n=22, 95% CI: 4.6-10.7). The relapsed injury was highest in athletics (n=16, 23.5%), basketball (n=6, 8.8%), and wrestling (n=5, 7.4%). While 50 injuries (73.5%) were recurred during practice, 18 injuries (26.5%) were recurred in competition. The most frequent diagnoses of relapsed injury were calf muscle cramp (n=11, 16.2%, 95% CI: 7.4-25.0), low back strain (n=6, 8.8%, 95% CI: 2.1-15.6), and hamstring strain (n=6, 8.8%, 95% CI: 2.1-15.6). Our data indicated incidence rates, incidence proportions, characteristics and frequent diagnoses of acute and recurrent sports injuries during the games, therefore these results could provide relevant information for the sports injury prevention at elite level.