Journal of Yeungnam Medical Science

Original articles

Infection prevention measures and outcomes for surgical patients during a COVID-19 outbreak in a tertiary hospital in Daegu, South Korea: a retrospective observational study: Kyung-Hwa Kwak, Jay Kyoung Kim, Ki Tae Kwon, Jinseok Yeo; J Yeungnam Med Sci. 2022;39(3):223-229. Published online November 5, 2021; DOI: https://doi.org/10.12701/yujm.2021.01431

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Abstract PDF: Background
The first large coronavirus disease 2019 (COVID-19) outbreak outside China occurred in Daegu. In response, we developed infection prevention measures for surgical patients during the outbreak at our hospital and retrospectively reviewed the outcomes of COVID-19–related surgical patients.
Methods
We reviewed the medical records of 118 COVID-19–related surgical patients and monitored their clinical outcomes until March 31, 2021. We also interviewed healthcare workers who participated in their perioperative care at Kyungpook National University Chilgok Hospital. The perioperative management guidelines for COVID-19–related patients were prepared through multidisciplinary discussions, including the infection control department, surgical departments, and anesthesiology department before and during the COVID-19 outbreak.
Results
One standard operating room was temporarily converted to a negative-pressure room by increasing the exhaust air volume, creating a relative pressure of −11.3 Pa. The healthcare workers were equipped with personal protective equipment according to the patient's classification of the risk of COVID-19 transmission. The 118 COVID-19–related patients underwent emergent surgery in the negative-pressure room, including three COVID-19–confirmed patients and five COVID-19–exposed patients.
Conclusion
All surgeries of the COVID-19–related patients were performed without specific adverse events or perioperative COVID-19 transmission. Our experience setting up a negative-pressure operating room and conservative perioperative protocol to prevent COVID-19 transmission will help plan and execute infection control measures in the future.

Does oral doxycycline treatment affect eradication of urine vancomycin-resistant Enterococcus? A tertiary hospital study: Yoonjung Kim, Sohyun Bae, Soyoon Hwang, Ki Tae Kwon, Hyun-Ha Chang, Su-Jeong Kim, Han-Ki Park, Jong-Myung Lee, Shin-Woo Kim; Yeungnam Univ J Med. 2020;37(2):112-121. Published online February 18, 2020; DOI: https://doi.org/10.12701/yujm.2019.00430

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Background
Vancomycin-resistant Enterococcus (VRE) has become more common in nosocomial infections, especially in urine samples. However, until now, no treatment regimen has been proven to effectively eradicate urine VRE colonization. Therefore, to evaluate the efficacy of doxycycline in eradicating urine VRE and shortening VRE isolation period, we compared VRE colony detection period between doxycycline-treated and untreated patients.
Methods
A retrospective cohort study of 83 patients with VRE colonization in urine cultures was conducted at a tertiary academic hospital from January 2011 to February 2018. Kaplan-Meier survival analysis was used to evaluate eradication rates in the treatment and non-treatment groups. Factors affecting urine VRE colonization persistence were analyzed by multiple logistic regression analysis.
Results
The overall rate of VRE eradication during the entire hospital stay was higher in the doxycycline treatment group (90.5%) than in the non-treatment group (58.1%, p=0.014). Survival analysis showed that the 5-, 10-, and 20-day cumulative eradication rates were 78.3%, 100%, and 100% in the doxycycline treatment group, and 18.5%, 45.7%, and 67.8% in the non-treatment group, respectively, thereby indicating that eradication rates were higher in the doxycycline treatment group than in the non-treatment group (p<0.001). Only doxycycline treatment was shown to affect urine VRE colonization persistence in multivariate logistic regression analysis
Conclusion
Doxycycline treatment enhanced the eradication rate of urine VRE colonization and appeared to be useful in shortening VRE isolation period.

Citations

Citations to this article as recorded by

Therapeutics for Vancomycin-Resistant Enterococcal Bloodstream Infections
Kelly A. Cairns, Andrew A. Udy, Trisha N. Peel, Iain J. Abbott, Michael J. Dooley, Anton Y. Peleg
Clinical Microbiology Reviews.2023;[Epub] CrossRef
Aminopenicillins for treatment of ampicillin-resistant enterococcal urinary tract infections
Kristen Bunnell, Amy Duong, Thomas Ringsred, Asia Mian, Sanaya Bhathena
American Journal of Health-System Pharmacy.2022; 79(13): 1056. CrossRef
Doxycycline for ESBL-E Cystitis
Tomasz Jodlowski, Charles R Ashby, Sarath G Nath
Clinical Infectious Diseases.2021; 73(1): e274. CrossRef

Original Article

Tigecycline Treatment for Infections Caused by Multidrug-Resistant Pathogens.: Mi Jung Lee, A Young Seo, Sang Soo Bae, Dong Hyong Jeong, Kyung Hwa Yoon, Byung Sik Hwang, Sung Hoon Kang, Dae Myung Oh, Ki Tae Kwon, Shin Won Lee, Do Young Song; Yeungnam Univ J Med. 2011;28(2):133-144. Published online December 31, 2011; DOI: https://doi.org/10.12701/yujm.2011.28.2.133

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Abstract PDF

BACKGROUND
Tigecycline (TIG), a new broad-spectrum glycylcycline with anti-multidrug-resistant-(MDR)-pathogen activity, was launched in March 2009 in South Korea, but there are insufficient clinical studies on its use in the country. As such, this study was performed to analyze cases of severe MDR-pathogen-caused infections treated with TIG. METHODS: Patients treated with TIG within the period from May 2009 to June 2010 were enrolled in this study. Their clinical and microbiologic data were reviewed retrospectively. RESULTS: Twenty-one patients were treated with TIG for complicated skin and soft-tissue infections (cSSTIs) (42.9%), complicated intra-abdominal infections (cIAIs) (38.1%), or pneumonia (19.1%) caused by MDR pathogens like carbapenem-resistant Acinetobacter baumannii (76.2%), methicillin-resistant Staphylococcus aureus (61.9%), extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae (38.1%), and penicillin-resistant Enterococcus species (33.3%). Thirteen patients (61.9%) had successful clinical outcomes while five (23.8%) died within 30 days. The rate of clinical success was highest in cSSTI (77.8%), followed by cIAI (50%) and pneumonia (50%), and the mortality rate was highest in pneumonia (50%), followed by cIAI (25%) and cSSTI (11.1%). CONCLUSION: Tigecycline therapy can be an option for the treatment of severe MDR-pathogen-caused infections in South Korea. Due to its high risk of failure and mortality, however, prudence is required in its clinical use for the treatment of severe infections like nosocomial pneumonia.

Citations

Citations to this article as recorded by

Evaluation of Clinical outcomes after Tigecycline and Colistin Treatment against Multidrug-resistant Acinetobacter baumannii
Sunhee Park, 최인, 김혜미, 최은주
Journal of Korean Society of Health-System Pharmacists.2016; 33(3): 228. CrossRef

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