Min Hyok Jeon

Early Acute Kidney Injury Is a Risk Factor That Predicts Mortality in Patients Treated with Colistin

The nephrotoxicity of colistin has been reported in the literature. A previous report has shown that acute kidney injury (AKI) occurred after an average of 13.5 days, but we have experienced that AKI developed with colistin administration earlier. We investigated clinical features of patients who developed AKI according to the time of AKI development after colistin use. We retrospectively collected the data of the patients who were admitted to 4 hospitals between January 2007 and May 2009. This study included 119 patients who had received intravenous colistin for over 72 h. We compared the early AKI group (AKI developed within 7 days) with the late AKI group. The patients’ age was 64.1 ± 14.0 years. AKI occurred in 65 of the 119 patients (54.6%). The duration of colistin use was 7.7 ± 6.4 days. AKI occurred in 46 patients within 7 days after colistin treatment and in 19 patients after 7 days. The patients with early AKI had a higher mortality rate than those with late AKI (OR: 4.37, 95% CI: 1.34, 14.18). In conclusion, clinicians might be cautioned that the mortality rate is higher for the patients with early occurrence of AKI than that for the patients with late occurrence of AKI.

The burden of nosocomial staphylococcus aureus bloodstream infection in South Korea: a prospective hospital-based nationwide study

BackgroundWe estimated the nationwide burden of nosocomial S. aureus bloodstream infection (SA-BSI), a major cause of nosocomial infection, in South Korea.MethodsTo evaluate the nationwide incidence of nosocomial SA-BSI, cases of SA-BSI were prospectively collected from 22 hospitals with over 500 beds over 4?months. Data on patient-days were obtained from a national health insurance database containing the claims data for all healthcare facilities in South Korea. The additional cost of SA-BSI was estimated through a matched case?control study. The economic burden was calculated from the sum of the medical costs, the costs of caregiving and loss of productivity.ResultsThree hundred and thirty nine cases of nosocomial SA-BSI were included in the study: 254 cases of methicillin-resistant SA-BSI (MRSA-BSI) and 85 cases of methicillin-susceptible SA-BSI (MSSA-BSI). Death related to BSI occurred in 81 cases (31.9%) of MRSA-BSI and 12 cases (14.1%) of MSSA-BSI. The estimated incidence of nosocomial MRSA-BSI was 0.12/1,000 patient-days and that of nosocomial MSSA-BSI, 0.04/1,000 patient-days. The estimated annual cases of nosocomial BSI were 2,946 for MRSA and 986 for MSSA in South Korea. The additional economic burden per case of nosocomial SA-BSI was US

Clinical and Economic Consequences of Failure of Initial Antibiotic Therapy for Patients with Community-Onset Complicated Intra-Abdominal Infections

20,494 for MRSA-BSI and

Korean Nosocomial Infections Surveillance System, Intensive Care Unit Module Report: Data Summary from July 2012 through June 2013

6,914 for MSSA-BSI. Total additional annual cost of nosocomial SA-BSI was

Necrotizing fasciitis in three university hospitals in Korea: a change in causative microorganisms and risk factors of mortality during the last decade.

67,192,559.ConclusionIn view of the burden of nosocomial SA-BSI, a national strategy for reducing nosocomial SA-BSI is urgently needed in South Korea.

Korean Nosocomial Infections Surveillance System, Intensive Care Unit Module Report: Summary of Data from July 2011 through June 2012

Objectives Complicated intra-abdominal infection (cIAI) is infection that extends beyond the hollow viscus of origin into the peritoneal space, and is associated with either abscess formation or peritonitis. There are few studies that have assessed the actual costs and outcomes associated with failure of initial antibiotic therapy for cIAI. The aims of this study were to evaluate risk factors and impact on costs and outcomes of failure of initial antibiotic therapy for community-onset cIAI. Methods A retrospective study was performed at eleven tertiary-care hospitals. Hospitalized adults with community-onset cIAI who underwent an appropriate source control procedure between August 2008 and September 2011 were included. Failure of initial antibiotic therapy was defined as a change of antibiotics due to a lack of improvement of the clinical symptoms and signs associated with cIAI in the first week. Results A total of 514 patients hospitalized for community-onset cIAI were included in the analysis. The mean age of the patients was 53.3 ± 17.6 years, 72 patients (14%) had health care-associated infection, and 48 (9%) experienced failure of initial antibiotic therapy. Failure of initial antibiotic therapy was associated with increased costs and morbidity. After adjustment for covariates, patients with unsuccessful initial therapy received an additional 2.9 days of parenteral antibiotic therapy, were hospitalized for an additional 5.3 days, and incurred

Four Cases of Dengue Fever-Dengue Hemorrhagic Fever and Domestic Literature Review

3,287 in additional inpatient charges. Independent risk factors for failure of initial antibiotic therapy were health care-associated infection, solid cancer, and APACHE II ≥13. Conclusions To improve outcomes and costs in patients with community-onset cIAI, rapid assessment of health care-associated risk factors and severity of disease, selection of an appropriate antibiotic regimen accordingly, and early infection source control should be performed.