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[A study on the movement for establishing a private isolation hospital under the rule of Japanese imperialism].

Koreans had an ill feeling against the only public isolation hospital, and their ill feeling was a cause the movement for establishing a private isolation hospital. The bad seating capacity and the nearness to downtown of public isolation hospital, and some violence caused in the course of taking a patient to the public isolation hospital were concrete causes of the movement for establishing a private isolation hospital. The three purposes of the movement for establishing a private isolation hospital are as follows. First, for the purpose of removing the national ill feeling, Koreans had to establish the isolation hospital by themselves. Second, for the purpose of curing the patients, doctors needed to use Oriental medicine together. Third, for the purpose of doing away with the anxiety of infection, the isolation hospital had to be located in a distant place from downtown. The movement for establishing a private isolation hospital didn't succeed. It only ended up establishing a contagious ward in Severance hospital. Because whenever an isolation hospital was planned to be constructed somehere, the residents worrying about the infection opposed to the construction, and enough money didn't be gathered. Abve all, rich pro-Japanese men didn't contribute enough money. The middle and lower classes contributed almost all of the money. The movement for estabishing a private isolation hospital was the extension of anti-Japanese national feeling that sprung from the March 1st movement. In view of strenghtening Korean ability, the movement for establishing a private isolation hospital had a common cause with the Shilryokyangsong movement in the early 1920s.

Cholera↗

A simple method for tracer containment testing of hospital isolation rooms.

A simple method for tracer containment testing of hospital isolation rooms is presented. The method does not require any equipment setup in tested rooms and can be completed in approximately one-half hour per room. Tracer samples are taken at specified time intervals in the corridor outside of an isolation room and analyzed on a portable gas chromatograph system. Results are presented from tracer testing of two isolation rooms in two different hospitals. One isolation room had a significant negative pressure differential between room and corridor, and the other isolation room was not at negative pressure. A small quantity of sulfur hexafluoride gas was injected manually from a polyethylene syringe over a bed in an isolation room. Tracer concentrations were thereafter measured in the corridor adjacent to the room at 5-minute intervals for 20 minutes after the injection, yielding a quantitative measure of leakage of the tracer from the isolation room. Finally, measuring the tracer concentration in the isolation room 30 minutes after injection yielded an indication of how effectively the ventilation system removed a contaminant released at the position of the bed. The results show that an instantaneous release of a small quantity of tracer gas in an isolation room yields tracer concentrations in the corridor outside of the room that are within the analytical range of the measuring equipment both for a properly functioning isolation room and an improperly functioning isolation room, and thus that the method is well-suited for studying containment in hospital isolation rooms. Possible practical applications of the method are discussed.

Air Microbiology↗

[The isolation hospital on Katten in Bergen].

In 1864 the Board of Health in Bergen, Norway, feared that an epidemic of smallpox might break out in the city. A house on the bastion Katten (Norwegian for "the cat") on the Fredriksberg fortress was adapted and made a provisional smallpox hospital. Later on it also served as a cholera hospital during a minor cholera epidemic in 1873, and as an isolation hospital for patients suffering from scarlet fever. The hospital housed only five to seven patients and two nurses. The doctor and hospital orderlies were isolated in an adjacent house. The Board of Health presented several plans for enlarging the hospital. Only in 1891 was the hospital on Katten replaced by a new and larger isolation hospital in another part of the city (Sandviken). At first, the Board of Health introduced rigid isolation regulations which were difficult to satisfy. When the pathogenic bacteria were discovered and the spread of infection was better understood, the view on isolation and other measures became more rational.

Disease Outbreaks↗

Burkholderia genome analysis reveals new enzymes belonging to the nitrilase superfamily. The amidase of Burkholderia cepacia (hospital isolate).

Burkholderia cepacia (formerly Pseudomonas cepacia) grows in media containing acetamide or propionamide as C and N sources. Chromosomal DNA from a hospital isolate of B. cepacia served as a template in PCRs using primers designed for the amplification of the P. aeruginosa amiE gene that encodes an aliphatic amidase. Partial sequencing of the PCR products gave a translated sequence 100% identical with the amino acid sequence of P. aeruginosa amidase. A search of Burkholderia genomes detected a putative amidase in B. cepacia J2315 with high identity to the P. aeruginosa amidase and predicted that other Burkholderia species also possessed CN_hydrolases that use the same catalytic triad (Glu-Lys-Cys) as amidase. Superimposition of theoretical three-dimensional models suggested that differences in the amino acid sequences between amidases from B. cepacia (hospital isolate) and B. cepacia J2315 do not affect their three-dimensional structure.

Amidohydrolases↗

In vitro activity of ciprofloxacin compared with other agents against recent hospital isolates.

Ciprofloxacin's in vitro activity was tested against 385 hospital isolates originating from three geographically distinct regions. Of all strains tested, only three (1 Acinetobacter sp. and 2 Pseudomonas aeruginosa) were ciprofloxacin resistant. Ciprofloxacin was more active against Escherichia coli, Enterobacter cloacae, Enterobacter aerogenes, Acinetobacter sp., Proteus sp., Shigella sp. than gentamicin, mezlocillin and cefotaxime. It was more active than azlocillin and cefsulodin against P. aeruginosa. It was more active than cloxacillin and cefamandole against staphylococci. It was as active as cefotaxime against Klebsiella pneumoniae, Citrobacter freundii and Serratia marcescens. Ciprofloxacin demonstrated similar activity in broth and solid agar. The minimal inhibitory concentrations (MIC's) of all strains were similar to the minimal bactericidal concentrations (MBC's). Ciprofloxacin's MIC was not influenced by increase of the inoculum or addition of human serum and only slightly influenced by anaerobic conditions. Decrease of the medium pH increased the MIC substantially. Ciprofloxacin exhibited a rapid bactericidal effect and had only a minimal post-antibiotic effect. These favorable in vitro characteristics of ciprofloxacin warrant further studies.

Acinetobacter↗

[Pathogenicity of Enterococcus spp. Characteristics of 169 hospital isolates].

BACKGROUND: To know the characteristics of Enterococcus spp. strains isolated in the hospital; to analyse the importance of this microorganism and its resistance to antimicrobial agents. PATIENTS AND METHODS: Retrospective analysis of the case histories of 169 patients with Enterococcus spp. isolates, selected at random at the Infanta Cristina Hospital in Badajoz. Investigation was carried out on: age, date of admission and discharge, clinical symptoms, risk factors, previous antibiotic treatment, clinical and microbiological evolution, recommended treatment and prescribed treatment. Identification of microorganisms and antibiogram with Pos Combo 41 microScam panels, read on Baxter WalkAway-40 equipment. RESULTS: The most frequently found species was Enterococcus faecalis. In 75 cases the isolations were polymicrobial. The enterococci were isolated mainly from urinary infections (27%), skin infections (20%), intrabdominal infections (14%) and infections from surgical wounds (14%). The existence of peripheral catheter was the main risk factor. All the strains of E. faecalis were susceptible to the glycopeptides. Two strains of Enterococcus faecium were not susceptible to vancomycin and one of these was not susceptible to teicoplanin. Mortality was from 21-27.5%. CONCLUSIONS: Enterococcus spp. is frequently isolated in nosocomial infections, although in approximately half the cases it is associated with other bacteria. For this reason, it is not always possible to determine its pathogenic contribution. The isolated strains, except two strains of E. faecium, are susceptible to vancomycin. A relation exists between high resistance to aminoglucosides and resistance to fluoroquinolones.

Enterococcus↗

Pulsed-field gel electrophoresis for differentiation of hospital isolates of Klebsiella pneumoniae.

Restriction enzyme analysis by pulsed-field gel electrophoresis (PFGE) was developed for differentiation of hospital isolates of Klebsiella pneumoniae. Restriction patterns generated by SpeI digestion of genomic DNAs of 36 isolates from patients in two major teaching hospitals established 34 PFGE types. All strains were typable by this technique and the SpeI restriction patterns were reproducible, stable and easy to interpret. As PFGE profiles generated were heterogenous, the incidence of cross-infection appeared to be low in each of the hospitals. The higher discriminatory power of PFGE when compared to conventional restriction endonuclease analysis (REA) suggests that this technique will be very useful for epidemiological investigations of nosocomial K. pneumoniae outbreaks.

Cross Infection↗

Comparative susceptibility of hospital isolates of gram-negative bacteria to antiseptics and disinfectants.

The sensitivity of hospital isolates of Gram-negative bacteria to cationic antiseptics, mercuric chloride and two organomercury compounds has been measured. A comparison was made with laboratory strains of known sensitivity which acted as standards. All strains of Escherichia coli showed a uniformly high sensitivity to chlorhexidine diacetate; other organisms tended to be less sensitive to the biguanide. Quaternary ammonium compounds were less effective than chlorhexidine. Resistance to mercuric chloride was observed frequently, but there was little evidence of organomercurial resistance except in Pseudomonas aeruginosa isolates.

Anti-Infective Agents, Local↗

Detection of apramycin resistant Enterobacteriaceae in hospital isolates.

Apramycin is a recently developed aminoglycoside restricted to veterinary therapy. Production of a 3-aminoglycoside acetyltransferase type IV (AAC(3)-IV) conferring cross-resistance to this drug and to gentamicin was detected in 1984 in France in bacteria of bovine origin. This mechanism of resistance was apparently confined to animals. We have studied 17 strains resistant to apramycin and gentamicin isolated in 5 hospitals in Belgium. Conjugative plasmids encoding an AAC(3)IV were present in 14 isolates. Comparison of the restriction fingerprints revealed 6 different plasmid patterns: 8 plasmids belonged to 2 groups sharing extensive intragroup homology and 4 were not related to the other replicons. These results indicate dissemination of plasmids within and between hospitals, but also of the gene encoding an AAC(3)IV.

Animals↗

Managing space and marking time: mothering severely ill infants in hospital isolation.

In this study, mothers retrospectively describe their experiences of prolonged protective isolation with infants hospitalized for severe combined immune deficiency. Mothers (N = 5) spent approximately 10 hours every day for 10.5 months in an 11-foot-square isolation room. Dressed in masks and surgical garb, they cared for their infants but were prohibited from engaging in skin contact. Although the rooms' characteristics and regulations remained fixed, mothers' sociospatial experiences varied dramatically over the course of the infants' treatment trajectories. The findings illustrate how place, space, and time affect women's well-being and their social and mothering relations in health care settings.

Adult↗

Commissioning a new hospital isolation unit and assessment of its use over five years.

Experience in commissioning and running a new hospital isolation unit, together with some problems and their solutions are described. The main problems were low bed-occupancy and insufficient work for the staff. This was solved by admitting both infected and non-infected cases including immunosuppressed. An assessment of the unit and benefits derived after 5 years use was made. A reduction in outbreaks of hospital infection and in ward closures resulting from infection was demonstrated.

Adult↗