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Korean Journal of Epidemiology 1986;8(1): 127-146.
문헌고찰을 통한 우리나라 병원감염의 역학적특성에 관한 연구
김남이
A literature review study on nosocomial infection
Nam yi Kim
Abstract
It is generally recognized that nosomial infection has been one of the major obstacles for improving health conditions in spite of the considerable decline of infectious disease due to progress in medical technology and medicine. The purpose of this study is to examine epidemiologic characteristics of nosocomical infection and to find out effectives measures for preventing them. The main sources of references are the medical journals published from 1960 to 1985 from which the basic information on nosocomial infection, such as incidence of nosocomial infection, major pathohens, and antibiotics resistancy rate of pathogens were collected. For this analysis more than 180 articles related to nosocomial infection were reviewed. The major findings of the analysis can be summarized as follows. 1) The incidence rate of nosocomial infection is about 5~6%, and it has a tendency to be declined over time. 2) The nosocomial infection is more frequently found in the area of lower respiratory, urinary tract, surgical wound, and infection for these areas constitute more than 50% of the total incidence of infection. 3) The incidence rate of nosocomial infection is higher for surgery than other clinics. 4) The nosocomial infection is caused by E. coli, Klebsiella, Pseudomonas, Staphylococci, and Proteus. The use of antibiotics produced antibiotics resistant organism which may change the frequency of pathogen for nosocomial infection. 5) Staphylococci is more likely to infect for surgical wound and new born infants, but which shows a high resistancy rate for antibiotics. 6) Gram negative pathogens is the most important pathogens for nosocomial infection. The blood stream infection is frequently caused by it particularly for the aged, infant and those who have underlying disease. 7) Legionnaires' disease and pontiac fever are caused by Legionella pneumophyla which is related to air conditioning water. 8) Lower respiratory infection is attributable to continuous use of respiratory aid. Pneumonia caused by Gram negative pathogens is typical of them. 9) Urinary tract infection is one of the most popular nosocomial infection which is mainly occasioned by use of urinary catheter. The typical pathogen of it is E. coli which has high resistancy rate for antibiotics. 10) The incidence rate of sungical wound infection is dependent upon duration of surgery, physical condition of a patient, and degree of contamination of surgical wound. The pathogens have been changed from Gram(十) organisms to Gram (一) organisms which has high resistancy rate for antibiotics. 11) The infection after blood transfusion is caused by the transfer of pathogens through contaminated blood of donors. 12) The infection related to injection is due to contamination of needles and syringes and injection area as well as hands of personnel. 13) The main causes of nosocomia inflection are hospital environments, patients and pathogens. 14) The following measures can be suggested to prevent nosocomial infection: isolation, hand washing, aseptic operation, vaccination of hospital personnel and education of nosocomial infection for patients and hospital personnel. But the most important and effective one seems to be an establishment of nosocomial infection control committee and monitoring nosocomial infection by full time nurse epidemiologist.


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