억제제 내성 TEM β-lactamase

곽이경,우준희 대한감염학회 2003 감염과 화학요법 Vol.35 No.6

단독과 연조직염의 임상적 특성과 원인균에 관한 연구

곽이경,김남중,최상호,최성호,정진원,추은주,김계형,윤나라,이신원,권기태,조재현 대한감염학회 2012 Infection and Chemotherapy Vol.44 No.2

Background: Although erysipelas and cellulitis are common soft tissue infectious diseases, there have been a few studies which investigate clinical characteristics and causative organisms in Korea. Materials and Methods: We retrospectively reviewed the medical records of patients who had been diagnosed with erysipelas or cellulitis from ten general hospitals between January 2009 and February 2011. Results: During the study period, a total of 144 patients with erysipelas and 735 with cellulitis were recruited. The mean age of erysipelas patients was 53.6 years, and that of cellulitis patients was 47.5 years. Diabetes mellitus was the most common underlying disease in both groups. The most common site of erysipelas was the face (80.6%) and that of cellulitis was the lower extremity (64.9%). Culture studies have been done in 31.9% (46/144) of patients with erysipelas, and 41.1% (302/735)with cellulites. Causative organisms were identified in 3 patients (2.1%) with erysipelas and 57 (7.8%) with cellulitis. Streptococcus pyogenes was isolated from two patients with erysipelas, and group G streptococcus from one. Staphylococcus aureus (44.0%) was the most common isolate in patients with cellulitis, followed by streptococci (27.1%), Enteobateriaceae (11.9%), and Vibrio species (6.8%). Firstgeneration cephalosporin was the most commonly used antimicrobial agent in both groups. Conclusions: β -hemolytic streptococcus and S. aureus were the most common causative organisms of patients with erysipelas and cellulitis.

흉부둔상 후 관상동맥 박리에 의해 유발된 급성심근경색증 1예

곽이경,이주희,박보형,서정기,김대혁,이기훈,권준,박금수,이우형 한국심초음파학회 2001 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.9 No.1

Coronary artery dissection after blunt chest trauma is very rare conditon, and this can result in a serious acute myocardial infarction. We report a case of a 54-year old male who was presented with an anterior myocardial infarction after traffic accident, with steering wheel injury. His coronary angiography revealed a discrete eccentric 85% stenosis of proximal left anterior descending coronary artery with dissection and intravascular ultrasound showed a dissecting flap from the distal left main coronary artery to proximal left anterior descending coronary artery. He was successfully treated by percutaneous transluminal coronary angioplasty with stent. 저자들은 교통사고후 심근경색으로 진단된 환자에서 관상동맥 조영술과 혈관내 초음파 영상을 통해 확인된 관상동맥 박리 환자를 스텐트 삽입술로 치료한 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

담도협착을 동반한 간내담석 환자에서 담도확장술 시행 후의 재발에 관한 장기 추적 연구

곽이경,정석,이진우,이돈행,김범수,김형길,조용범,권계숙,조현근,신용운,김영수 대한소화기내시경학회 2002 Clinical Endoscopy Vol.25 No.1

목적: 간내담석증의 치료에 있어 간내담도협착은 간내담석 환자에서 수술이나 담도경을 이용한 치료 실패와 담석 재발의 가장 흔한 원인으로, 최근 경피적 담도확장술이 수술을 대신하여 널리 이용되고 있다. 국내에서 담도경을 이용한 담석제거술에 대해 많은 연구보고가 있으나, 담도협착이 동반된 경우 담도 확장 후 장기적인 치료 효과에 대한 연구가 부족한 상황이다. 본 연구는 담도협착이 동반된 간내담석 환자에서 담도내시경을 이용한 경피적 풍선확장술을 시행한 후 담석의 완전 제거와 재발여부에 대해 장기간에 걸쳐 관찰하여 담도확장술이 담석 재발에 미치는 영향에 대해 알아보고자 하였다. 대상 및 방법: 1996년 10월부터 1999년 12월까지 본원에서 간내담석 및 담도협착 진단하에 경피경간담도경검사나 수술 후 담도경검사를 이용한 담석 제거술을 시행하고 담도협착에 대해 풍선확장술을 시행 받은 28명의 환자들을 대상으로 하였으며, 거대 담석인 경우 전기수압쇄석술을 이용하여 분쇄 후 제거하였다. 담도확장술 시행 후 정기적으로 임상적 및 방사선학적 검사를 시행하여 재발 유무를 확인하였다. 결과: 대상 환자 28명 중 23명(82.1%)에서 결석의 완전제거에 성공하였고, 성공적으로 담석이 제거된 환자에서 평균 41개월의 추적 기간 중 재발률은 17.4%였다. 결론: 간내담석 환자에서 담도협착이 동반된 경우 담도확장술을 시행하는 것이 담석의 완전 제거와 재발률 감소에 도움이 될 수 있다고 생각한다. Background/Aims: Intrahepatic biliary stricture is one of the most common cause of treatment failure in hepatolithiasis, and it is also the main cause of stone recurrence. Ductal dilatation with percutaneous cholangioscopy is a promising therapy for biliary stricture, however the long- term outcome of this treatment modality has limited documentation. We performed the long-term follow up examination of these cases to investigate stone clearance and recurrence after percutaneous balloon dilatation, with or without stenting, and of stricture associated with intrahepatic cholelithiasis. Methods: From October 1996 to December 1999, 28 patients with hepatolithiasis and intrahepatic biliary stricture were treated with percutaneous transhepatic cholangioscopic or postoperative cholangioscopic lithotripsy, and balloon dilatation. Choledochoscopic electrohydraulic lithotripsy was applied when impacted or large stones were encountered. We studied clinical and radiological examination regularly to evaluate the complete clearance and recurrence of stone after ductal dilatation. Results: Complete clearance of stones was achieved in 23 patients (82.1%). The rate of stone recurrence in complete stone clearance group after mean follow up period of 41 months was 17.4%. Conclusions: Balloon dilatation is an efficient method of complete stone removal and prevention of the stone recurrence in biliary stricture-associated hepatolithiasis. (Korean J Gastrointest Endosc 2002;25:19-24)

전국의료관련감염감시체계 중환자실 부문 결과 보고: 2015년 7월부터 2016년 6월

곽이경,최영화,최준용,유현미,이상오,김홍빈,한수하,이미숙,김효열,김성란,김태형,박선희,유소연,최평균,은병욱,신명진,최지연,구현숙,어영,유진홍 대한의료관련감염관리학회 2017 의료관련감염관리 Vol.22 No.1

Background: In this report, we present the annual data of the intensive care unit (ICU) module of the Korean National Healthcare-associated Infections Surveillance System (KONIS) from July 2015 through June 2016.Methods: We performed a prospective surveillance of healthcare-associated urinary tract infection (UTI), bloodstream infection (BSI), and pneumonia (PNEU) at 178 ICUs in 103 hospitals using KONIS surveillance system. Healthcare- associated infections (HAI) rates were calculated as the numbers of infections per 1,000 patient-days or device-days. Results: A total of 2,608 HAIs were found during the study period: 718 UTIs (702 cases were urinary catheter- associated), 1,236 BSIs (1,058 were central line-associated), and 654 PNEUs (389 were ventilator-associated). The rate of catheter-associated UTIs (CAUTI) was 0.88 cases per 1,000 device-days (95% confidence interval [CI, 0.82-0.95]) and urinary catheter utilization ratio was 0.84 (95% CI, 0.839-0.841). The rate of central line-associated BSIs (CLABSI) was 2.20 (95% CI, 2.07-2.33) per 1,000 device-days and the utilization ratio was 0.51 (95% CI, 0.509-0.511). The rate of ventilator-associated PNEUs (VAPs) was 1.00 (95% CI, 0.91-1.11) per 1,000 device-days and the utilization ratio was 0.41 (95% CI, 0.409-0.411). The ventilator utilization ratio was lower; however, VAPs were more common in the ICUs of hospitals with 700-899 beds (1.23 [95% CI, 1.07-1.42]) than in those of hospitals with more than 900 beds (0.87 [95% CI, 0.71-1.06]).Conclusion: Compared with the previous year, the device utilization ratio was similar but the rate of VAP was significantly decreased.

Clinical Guidelines for the Antibiotic Treatment for Community-Acquired Skin and Soft Tissue Infection

곽이경,최성호,김탁,박성연,서수홍,김민범,최상호 대한감염학회 2017 Infection and Chemotherapy Vol.49 No.4

Skin and soft tissue infection (SSTI) is common and important infectious disease. This work represents an update to 2012 Korean guideline for SSTI. The present guideline was developed by the adaptation method. This clinical guideline provides recommendations for the diagnosis and management of SSTI, including impetigo/ecthyma, purulent skin and soft tissue infection, erysipelas and cellulitis, necrotizing fasciitis, pyomyositis, clostridial myonecrosis, and human/animal bite. This guideline targets community- acquired skin and soft tissue infection occurring among adult patients aged 16 years and older. Diabetic foot infection, surgery-related infection, and infections in immunocompromised patients were not included in this guideline.

노동하는 유령들 : “우리는 어디에나 있습니다.” - 정상과 비정상 사이에서, 성소수자 노동자로 산다는 것

곽이경 심미안 2012 문학들 Vol.- No.30

전국병원감염감시체계 중환자실 부문 결과 보고: 2009년 7월부터 2010년 6월

곽이경,조용균,김진용,이미숙,김효열,김영근,박은숙,진혜영,김홍빈,김의석,정선영,엄중식,김성란,이지영,홍혜경,성주헌,어영,이영선,오희복,김의종,전국병원감시체계 대한의료관련감염관리학회 2011 의료관련감염관리 Vol.16 No.1

배경: 전국병원감염감시체계(Korean Nosocomial Infections Surveillance System, KONIS) 중환자실 부문에서 2009년 7월부터 2010년 6월까지 감시를 수행한 세 번째 연간 자료를 정리하여 보고하고자 한다. 방법: 전국의 63개 병원에서 116개 중환자실이 KONIS에 참여하여 중환자실에서 발생하는 요로감염, 혈류감염, 폐렴에 대해 전향적으로 감시를 수행하였다. 병원감염률은 1,000 재원일수 또는 기구일수 당 감염 건수로 구하였다. 결과: 총 3,965건의 병원감염이 발생하였는데, 요로감염이 2,156건, 혈류감염이 1,110건, 폐렴이 699건이었다. 요로카테터 관련 요로감염은 2,119건으로 기구일수감염률은 4.75 (95% 신뢰구간, 4.55-4.95)이었고, 기구사용률은 0.86 (0.859-0.861)이었다. 중심정맥관 관련 혈류감염은 948건으로 기구일수 감염률은 3.28 (3.07-3.49)이었고, 기구사용률은 0.56 (0.559-0.561)이었다. 인공호흡기 관련 폐렴은 410건으로 기구일수 감염률은 1.95 (1.77-2.15)이었고, 기구사용률은 0.41 (0.409-0.411)이었다. CAUTI와 VAP 기구일수 감염률은 400-699병상의 병원 중환자실에서 그 이상 규모의 병원 중환자실에 비해 기구사용률이 낮았음에도 감염률은 의미 있게 더 높았다. 주요 세균의 항생제 내성률을 분석하였을 때 A. baumannii의 imipenem에 대한 내성률이 82.5%로 지속적으로 증가 추세였다. 결론: 병상 규모가 작은 병원의 중환자실에서 큰 병원의 중환자실에 비해 CAUTI, VAP 기구일수 감염률이 높았고, A. baumannii의 imipenem 내성률이 증가 추세여서 향후 이에 대한 보다 집중적인 감시와 적극적인 감염관리 활동이 필요할 것으로 생각된다.

전국의료관련감염감시체계 중환자실 부문 결과 보고: 2014년 7월부터 2015년 6월

곽이경,최준용,유현미,이상오,김홍빈,한수하,최희정,김효열,김성란,김태형,이혁민,천희경,김재석,은병욱,구현숙,조은희,어영,이경원 대한의료관련감염관리학회 2016 의료관련감염관리 Vol.21 No.2

Background: In this report, we present annual data of the intensive care unit (ICU) module of the Korean National Healthcare-associated Infections Surveillance System (KONIS) from July 2014 through June 2015. Methods: We performed prospective surveillance of nosocomial urinary tract infection (UTI), bloodstream infection (BSI), and pneumonia (PNEU) cases at 169 ICUs in 96 hospitals using the KONIS surveillance system. Nosocomial infection (NI) rates were calculated as the numbers of infections per 1,000 patient-days or device-days. Results: A total of 2,524 NIs were found during the study period: 699 UTIs (675 cases were urinary catheter-associated), 1,090 BSIs (932 were central line-associated), and 735 PNEUs (443 were ventilator-associated). The rate of urinary catheter-associated UTIs (CAUTI) was 0.91 cases per 1,000 device-days (95% confidence interval, 0.84-0.98), and the urinary catheter utilization ratio was 0.84 (0.839-0.841). The rate of central line-associated BSIs (CLABSI) was 2.04 (1.91-2.17), and the utilization ratio was 0.52 (0.519-0.521). The rate of ventilator-associated PNEUs was 1.23 (1.12-1.35), and the utilization ratio was 0.41 (0.409-0.411). The urinary catheter utilization ratio was lower; however, CAUTIs were more common in the ICUs of hospitals with 300-699 beds than in the ICUs of hospitals with more than 900 beds. Conclusion: BSIs were the most commonly reported NIs. The rates of CAUTI and CLABSI were lower in this study period than during the previous period (July 2013 through June 2014).

Use of the Monoclonal Antibody Regdanvimab to Treat Patients Hospitalized with COVID-19: Real-World Data during the Delta Variant Predominance

곽이경,Song Je Eun,Kang Jieun,Kang Jiyeon,강형구,Koo Hyeon-Kyoung,Park Hye Kyeong,Choi Sang Bong,Lee Hyuk Pyo,Lee Myung Jin,Kim Baek-Nam 대한감염학회 2022 Infection and Chemotherapy Vol.54 No.4

Regdanvimab is the only monoclonal antibody available in Korea that targets severe acute respiratory syndrome coronavirus 2. We retrospectively evaluated the clinical characteristics of 374 adults hospitalized with coronavirus disease 2019 (COVID-19) who were treated with regdanvimab from September through December 2021. In total, 322 (86.1%) patients exhibited risk factors for disease progression. Most patients (91.4%) improved without additional treatment. No patient died or was transferred to intensive care. This study shows that regdanvimab prevented disease progression in high-risk patients with mild to moderate COVID-19 infections during Delta variant predominance.