scholarly journals Changes of antibiotic prescribing pattern and its resistance to E. Coli in South Korea: a 12-year retrospective observational study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Geun Woo Lee ◽  
Sukhyun Ryu ◽  
Juhee Park ◽  
Eun Jee Lee ◽  
Kwang Jun Lee ◽  
...  
Keyword(s):  
South Korea ◽  
Significant Positive Correlation ◽  
Long Term Care ◽  
Antibiotic Prescription ◽  
Term Care ◽  
Positive Correlation ◽  
E Coli ◽  
Medical Institutions ◽  
Care Facilities

AbstractIn the present study, we investigated the pattern of changes in antibiotic prescription and antimicrobial resistance (AMR) in Escherichia coli in South Korea between 2007 and 2018. We collected data related to antibiotic prescription and AMR in E. coli from the national surveillance system. We used the Mann–Kendall test and Spearman’s correlation to identify the trends of antibiotic prescription and AMR in E. coli and to examine the relationship between them, respectively. Although we noted a significant decreasing trend of ampicillin and gentamicin prescriptions in all medical institutions, we identified a higher level of AMR in long-term care facilities than in other medical institutions. We did not identify a significant positive correlation between ampicillin and gentamicin prescriptions and their resistance in E. coli. However, we found a significant positive correlation between cefotaxime prescription and its resistance in E. coli in hospitals, long-term care facilities, and clinics. Our results strongly suggest that long-term care facilities in South Korea have the potential to sustain AMR epidemics and that more efforts are needed to curb AMR in E. coli. Further epidemiological studies using enhanced AMR surveillance are warranted.

Gaining access to the field in medical ethnography: Reflections on ethical, methodological, and structural challenges in the study of long-term care facilities

2021 ◽  
pp. 136345932098887
Author(s):  
Neta Roitenberg
Keyword(s):  
Long Term Care ◽  
Ethnographic Research ◽  
Term Care ◽  
Medical Institutions ◽  
Care Workers ◽  
Care Facilities ◽  
Key Issues ◽  
Access To The Field ◽  
Medical Ethnography

The article extends the discussion on the challenges in gaining access to the field in medical ethnographic research, focusing on long-term care (LTC) facilities. Medical institutions have been documented to be difficult sites to access. The reference, however, is to the recruitment of patients as informants. The challenges of recruiting practitioners as informants have not been investigated at all. The article presents the key issues that emerged in the process of gaining social access at the sites of two LTC facilities as part of a study on care workers’ identities. The main obstacles encountered during the fieldwork were organizational constraints and negotiating control over the process of recruiting the lower occupational tier of care workers with gatekeepers. The article presents the coping strategies implemented to overcome the ethical and methodological obstacles: continually reassessing the consent and cooperation of participants and developing a rapport with nurse’s aides during interviews.

scholarly journals Spread of ceftriaxone non-susceptible pneumococci in South Korea: Long-term care facilities as a potential reservoir

PLoS ONE ◽  
2019 ◽  
Vol 14 (1) ◽  
pp. e0210520 ◽  
Author(s):  
Min Joo Choi ◽  
Ji Yun Noh ◽  
Hee Jin Cheong ◽  
Woo Joo Kim ◽  
Min Ja Kim ◽  
...  
Keyword(s):  
South Korea ◽  
Long Term Care ◽  
Term Care ◽  
Care Facilities ◽  
Potential Reservoir

scholarly journals Feasibility of a Mobile Meal Assistance Program for Direct Care Workers in Long-Term Care Facilities in South Korea

2020 ◽  
Vol Volume 15 ◽  
pp. 2019-2029
Author(s):  
Dukyoo Jung ◽  
Jennie C De Gagne ◽  
Minkyung Lee ◽  
Hyesoon Lee ◽  
Kyuri Lee ◽  
...  
Keyword(s):  
South Korea ◽  
Long Term Care ◽  
Direct Care ◽  
Direct Care Workers ◽  
Assistance Program ◽  
Term Care ◽  
Care Workers ◽  
Care Facilities

scholarly journals 1238. A National Comparison of Antibiograms Between Veterans Affairs Long-Term Care Facilities and Affiliated Hospitals

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S376-S377 ◽  
Author(s):  
Maria-Stephanie Tolg ◽  
Aisling Caffrey ◽  
Haley Appaneal ◽  
Robin Jump ◽  
Vrishali Lopes ◽  
...  
Keyword(s):  
Long Term Care ◽  
Veterans Affairs ◽  
Self Report ◽  
Chi Square ◽  
Term Care ◽  
E Coli ◽  
Care Facilities ◽  
National Comparison ◽  
Research Grant

Abstract Background Long-term care facilities (LTCFs) face several barriers to creating antibiograms. Here, we evaluate if LTCFs can use antibiograms from affiliated hospitals as their own antibiogram. Methods Facility-specific antibiograms were created for all Veterans Affairs (VA) LTCFs and VA Medical Centers (VAMCs) for 2017. LTCFs and affiliated VAMCs were paired and classified as being on the same campus or geographically distinct campuses based on self-report. For each pair, Escherichia coli susceptibility rates (%S) to cefazolin, ceftriaxone, cefepime, ciprofloxacin, nitrofurantoin, sulfamethoxazole/trimethoprim, ampicillin/sulbactam, piperacillin/tazobactam, and imipenem were compared. As guidelines discourage empiric use of antibiotics if susceptibility rates are <80%, we assessed clinical discordance between each LTCF and affiliated VAMC antibiogram at a threshold of 80% susceptible. The proportions of concordant susceptibilities between LTCFs and VAMCs on the same campus vs. geographically distinct campuses were compared using Chi-square tests. Results A total of 119 LTCFs and their affiliated VAMCs were included in this analysis, with 70.6% (n = 84) of facilities located on the same campus and 29.4% (n = 35) on geographically distinct campuses. The table below shows the overall clinical concordance (agreement) of LTCFs with their affiliated VAMC in regards to E. coli %S to the compared antibiotics. No significant differences were found when comparing LTCFs on the same campus vs. geographically distinct campuses. Conclusion Antibiograms between LTCFs and affiliated VAMCs had a high concordance, except for sulfamethoxazole/trimethoprim, cefazolin and ceftriaxone in regards to susceptibility rates of E. coli. Facilities on the same campus were found to have similar concordance rates to geographically distinct facilities. Future studies are needed to investigate how the various approaches to creating LTCF-specific antibiograms are associated with clinical outcomes. Disclosures M. S. Tolg, Veterans Affairs: Investigator, Research grant. A. Caffrey, Veterans Affairs: Investigator, Research grant. H. Appaneal, Veterans Affairs: Grant Investigator, Research grant. R. Jump, Veterans Affairs: Investigator, Research grant. V. Lopes, Veterans Affairs: Investigator, Research grant. D. Dosa, Veterans Affairs: Grant Investigator, Research grant. K. LaPlante, Veterans Affairs: Investigator, Research grant.

Nurses' Views on Infection Control in Long-Term Care Facilities in South Korea: A Focus Group Study

2018 ◽  
Vol 30 (6) ◽  
pp. 634 ◽  
Author(s):  
Chi-Young Lee ◽  
Min-Hye Lee ◽  
Seong-Hyeon Lee ◽  
Yeon-Hwan Park
Keyword(s):  
Focus Group ◽  
Infection Control ◽  
South Korea ◽  
Long Term Care ◽  
Focus Group Study ◽  
Term Care ◽  
Care Facilities

scholarly journals Long-Term Care Facilities Are Reservoirs for Antimicrobial-Resistant Sequence Type 131 Escherichia coli

2015 ◽  
Vol 2 (1) ◽  
Author(s):  
Mary J. Burgess ◽  
James R. Johnson ◽  
Stephen B. Porter ◽  
Brian Johnston ◽  
Connie Clabots ◽  
...  
Keyword(s):  
Risk Factors ◽  
Escherichia Coli ◽  
Gel Electrophoresis ◽  
Long Term Care ◽  
Pulsed Field Gel Electrophoresis ◽  
Sequence Type ◽  
Term Care ◽  
E Coli ◽  
Care Facilities

Abstract Background.  Emerging data implicate long-term care facilities (LTCFs) as reservoirs of fluoroquinolone-resistant (FQ-R) Escherichia coli of sequence type 131 (ST131). We screened for ST131 among LTCF residents, characterized isolates molecularly, and identified risk factors for colonization. Methods.  We conducted a cross-sectional study using a single perianal swab or stool sample per resident in 2 LTCFs in Olmsted County, Minnesota, from April to July 2013. Confirmed FQ-R E. coli isolates underwent polymerase chain reaction-based phylotyping, detection of ST131 and its H30 and H30-Rx subclones, extended virulence genotyping, and pulsed-field gel electrophoresis (PFGE) analysis. Epidemiological data were collected from medical records. Results.  Of 133 fecal samples, 33 (25%) yielded FQ-R E. coli, 32 (97%) of which were ST131. The overall proportion with ST131 intestinal colonization was 32 of 133 (24%), which differed by facility: 17 of 41 (42%) in facility 1 vs 15 of 92 (16%) in facility 2 (P = .002). All ST131 isolates represented the H30 subclone, with virulence gene and PFGE profiles resembling those of previously described ST131 clinical isolates. By PFGE, certain isolates clustered both within and across LTCFs. Multivariable predictors of ST131 colonization included inability to sign consent (odds ratio [OR], 4.16 [P = .005]), decubitus ulcer (OR, 4.87 [ P = .04]), and fecal incontinence (OR, 2.59 [P = .06]). Conclusions.  Approximately one fourth of LTCF residents carried FQ-R ST131 E. coli resembling ST131 clinical isolates. Pulsed-field gel electrophoresis suggested intra- and interfacility transmission. The identified risk factors suggest that LTCF residents who require increased nursing care are at greatest risk for ST131 colonization, possibly due to healthcare-associated transmission.

scholarly journals Factors Influencing Retention Intention of Nurses at Long-term Care Hospitals in Korea

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 883-883
Author(s):  
So Young Shin ◽  
Joo Hee Kim
Keyword(s):  
Work Environment ◽  
Role Conflict ◽  
Significant Positive Correlation ◽  
Long Term Care ◽  
Explanatory Power ◽  
Term Care ◽  
Positive Correlation ◽  
Nursing Work Environment ◽  
Factors Influencing

Abstract Purpose This study aimed to investigate the levels and correlations of role conflict, nursing professionalism, nursing work environment and retention intention, and the factors influencing retention intention of nurses at long-term care hospitals. Methods The subjects included 183 nurses at nine long-term care hospitals in one metropolitan city in Korea. A set of self-reported questionnaires was administered to assess general characteristics, role conflict, nursing professionalism, nursing work environment, and retention intention of the subjects. Collected data was analyzed using descriptive statistics, t-tests, one-way ANOVA, Pearson correlation coefficients, and multiple linear regression. Results 183 subjects with a mean (±SD) age of 41.66 (±12.29) years were included in the final analyses. Retention intention had a significant positive correlation with nursing professionalism (r=.39, p<.001) and nursing work environment (r=.51, p<.001). Nursing work environment had a significant negative correlation with role conflict (r=-.30, p<.001) and a significant positive correlation with nursing professionalism (r=.48, p<.001). In the final multiple regression analysis, the factors influencing retention intention of subjects were number of beds (β=-.15 p<.026), nursing professionalism (β=.19, p=.007) and nursing work environment (β=.36, p<.001). The explanatory power of number of beds, nursing professionalism and nursing work environment on retention intention was 34.0% (F=16.66, p<.001). Conclusion Improving nursing professionalism and nursing work environment of nurses at long-term care hospitals will ultimately enhance their retention intention and positively impact on the quality of gerontological nursing service.

scholarly journals Nationwide Results of COVID-19 Contact Tracing in South Korea: Individual Participant Data From an Epidemiological Survey (Preprint)

2020 ◽  
Author(s):  
Seung Won Lee ◽  
Woon Tak Yuh ◽  
Jee Myung Yang ◽  
Yoon-Sik Cho ◽  
In Kyung Yoo ◽  
...  
Keyword(s):  
Mortality Rate ◽  
South Korea ◽  
Long Term Care ◽  
Contact Tracing ◽  
Term Care ◽  
Social Distancing ◽  
Percentage Difference ◽  
Care Facilities ◽  
Epidemiological Characteristics

BACKGROUND Evidence regarding the effectiveness of contact tracing of COVID-19 and the related social distancing is limited and inconclusive. OBJECTIVE This study aims to investigate the epidemiological characteristics of SARS-CoV-2 transmission in South Korea and evaluate whether a social distancing campaign is effective in mitigating the spread of COVID-19. METHODS We used contract tracing data to investigate the epidemic characteristics of SARS-CoV-2 transmission in South Korea and evaluate whether a social distancing campaign was effective in mitigating the spread of COVID-19. We calculated the mortality rate for COVID-19 by infection type (cluster vs noncluster) and tested whether new confirmed COVID-19 trends changed after a social distancing campaign. RESULTS There were 2537 patients with confirmed COVID-19 who completed the epidemiologic survey: 1305 (51.4%) cluster cases and 1232 (48.6%) noncluster cases. The mortality rate was significantly higher in cluster cases linked to medical facilities (11/143, 7.70% vs 5/1232, 0.41%; adjusted percentage difference 7.99%; 95% CI 5.83 to 10.14) and long-term care facilities (19/221, 8.60% vs 5/1232, 0.41%; adjusted percentage difference 7.56%; 95% CI 5.66 to 9.47) than in noncluster cases. The change in trends of newly confirmed COVID-19 cases before and after the social distancing campaign was significantly negative in the entire cohort (adjusted trend difference –2.28; 95% CI –3.88 to –0.68) and the cluster infection group (adjusted trend difference –0.96; 95% CI –1.83 to –0.09). CONCLUSIONS In a nationwide contact tracing study in South Korea, COVID-19 linked to medical and long-term care facilities significantly increased the risk of mortality compared to noncluster COVID-19. A social distancing campaign decreased the spread of COVID-19 in South Korea and differentially affected cluster infections of SARS-CoV-2.

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