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1.
J Korean Med Sci ; 39(21): e172, 2024 Jun 03.
Artículo en Inglés | MEDLINE | ID: mdl-38832477

RESUMEN

BACKGROUND: We aimed to analyze the effects of an antimicrobial stewardship program (ASP) on the proportion of antimicrobial-resistant pathogens in bacteremia, antimicrobial use, and mortality in pediatric patients. METHODS: A retrospective single-center study was performed on pediatric inpatients under 19 years old who received systemic antimicrobial treatment from 2001 to 2019. A pediatric infectious disease attending physician started ASP in January 2008. The study period was divided into the pre-intervention (2001-2008) and the post-intervention (2009-2019) periods. The amount of antimicrobial use was defined as days of therapy per 1,000 patient-days, and the differences were compared using delta slope (= changes in slopes) between the two study periods by an interrupted time-series analysis. The proportion of resistant pathogens and the 30-day overall mortality rate were analyzed by the χ². RESULTS: The proportion of extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae bacteremia increased from 17% (39 of 235) in the pre-intervention period to 35% (189 of 533) in the post-intervention period (P < 0.001). The total amount of antimicrobial use significantly decreased after the introduction of ASP (delta slope value = -16.5; 95% confidence interval [CI], -30.6 to -2.3; P = 0.049). The 30-day overall mortality rate in patients with bacteremia did not increase, being 10% (55 of 564) in the pre-intervention and 10% (94 of 941) in the post-intervention period (P = 0.881). CONCLUSION: The introduction of ASP for pediatric patients reduced the delta slope of the total antimicrobial use without increasing the mortality rate despite an increased incidence of ESBL-producing gram-negative bacteremia.


Asunto(s)
Antibacterianos , Programas de Optimización del Uso de los Antimicrobianos , Bacteriemia , Análisis de Series de Tiempo Interrumpido , Klebsiella pneumoniae , Humanos , Estudios Retrospectivos , Niño , Bacteriemia/tratamiento farmacológico , Bacteriemia/mortalidad , Bacteriemia/microbiología , Femenino , Masculino , Preescolar , Antibacterianos/uso terapéutico , Lactante , Klebsiella pneumoniae/efectos de los fármacos , Klebsiella pneumoniae/aislamiento & purificación , Adolescente , Escherichia coli/efectos de los fármacos , Escherichia coli/aislamiento & purificación , Hospitales Pediátricos
2.
J Korean Med Sci ; 28(9): 1276-82, 2013 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-24015030

RESUMEN

The pneumonia severity index (PSI) and CURB-65 are widely used tools for the prediction of community-acquired pneumonia (CAP). This study was conducted to evaluate validation of severity scoring system including the PSI and CURB-65 scores of Korean CAP patients. In the prospective CAP cohort (participated in by 14 hospitals in Korea from January 2009 to September 2011), 883 patients aged over 18 yr were studied. The 30-day mortalities of all patients were calculated with their PSI index classes and CURB scores. The overall mortality rate was 4.5% (40/883). The mortality rates per CURB-65 score were as follows: score 0, 2.3% (6/260); score 1, 4.0% (12/300); score 2, 6.0% (13/216); score 3, 5.7% (5/88); score 4, 23.5% (4/17); and score 5, 0% (0/2). Mortality rate with PSI risk class were as follows: I, 2.3% (4/174); II, 2.7% (5/182); III, 2.3% (5/213); IV, 4.5% (11/245); and V, 21.7% (15/69). The subgroup mortality rate of Korean CAP patients varies based on the severity scores and CURB-65 is more valid for the lower scores, and PSI, for the higher scores. Thus, these variations must be considered when using PSI and CURB-65 for CAP in Korean patients.


Asunto(s)
Infecciones Comunitarias Adquiridas/mortalidad , Neumonía/mortalidad , Índice de Severidad de la Enfermedad , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Pueblo Asiatico , Estudios de Cohortes , Femenino , Humanos , Unidades de Cuidados Intensivos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , República de Corea , Adulto Joven
3.
Adv Mater ; 24(32): 4408-13, 2012 Aug 22.
Artículo en Inglés | MEDLINE | ID: mdl-22729900

RESUMEN

A columnar-structured nanosieve is unique in the sense that it is a general thin film formed by physical vapor deposition (PVD). Instead of additional processes to make nanopores, the numerous voids naturally formed among columnar grains during PVD are used as nanopores. Since the thin film formed by PVD has vertically grown columnar grains, the fabricated nanosieve has numerous straight-opened nanopores, which is an ideal structure for a nanosieve.


Asunto(s)
Metales/química , Nanoporos/ultraestructura , Gases/química , Porosidad
4.
Opt Lett ; 32(18): 2665-7, 2007 Sep 15.
Artículo en Inglés | MEDLINE | ID: mdl-17873928

RESUMEN

A simple liquid crystal display (LCD) backlight unit (BLU) comprising only a single-sheet polydimethylsiloxane (PDMS) light-guide plate (LGP) has been developed. The PDMS LGP, having micropatterns with an inverse-trapezoidal cross section, was fabricated by backside 3-D diffuser lithography followed by PDMS-to-PDMS replication. The fabricated BLU showed an average luminance of 2878 cd/m(2) with 73.3% uniformity when mounted in a 5.08 cm backlight module with four side view 0.85cd LEDs. The developed BLU can greatly reduce the cost and thickness of LCDs, and it can be applied to flexible displays as a flexible light source due to the flexible characteristic of the PDMS itself.


Asunto(s)
Color , Presentación de Datos , Dimetilpolisiloxanos , Iluminación/instrumentación , Cristales Líquidos , Procesamiento de Señales Asistido por Computador/instrumentación , Siliconas , Diseño de Equipo , Análisis de Falla de Equipo , Luz , Miniaturización
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