We estimated the nationwide burden of nosocomial S. aureus bloodstream infection (SA-BSI), a major cause of nosocomial infection, in South Korea. To 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. Three 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 $20,494 for MRSA-BSI and $6,914 for MSSA-BSI. Total additional annual cost of nosocomial SA-BSI was $67,192,559. In view of the burden of nosocomial SA-BSI, a national strategy for reducing nosocomial SA-BSI is urgently needed in South Korea.

Choi HK, et al. J Korean Med Sci. 2011 Jul;26(7):859-864. http://dx.doi.org/10.3346/jkms.2011.26.7.859

Background: Severe fever with thrombocytopenia syndrome (SFTS) is an acute, febrile, and potentially fatal tick-borne disease caused by the SFTS Phlebovirus. Here, we evaluated the effects of steroid therapy in Korean patients with SFTS. Methods: A retrospective study was performed in a multicenter SFTS clinical cohort from 13 Korean university hospitals between 2013 and 2017. We performed survival analysis using propensity score matching of 142 patients with SFTS diagnosed by genetic or antibody tests. Results: Overall fatality rate was 23.2%, with 39.7% among 58 patients who underwent steroid therapy. Complications were observed in 37/58 (63.8%) and 25/83 (30.1%) patients in the steroid and non-steroid groups, respectively (P < .001). Survival analysis after propensity score matching showed a significant difference in mean 30-day survival time between the non-steroid and steroid groups in patients with a mild condition [Acute Physiology and Chronic Health Evaluation II (APACHE II) score 5 days), and non-steroid groups, were 18.4, 22.4, and 27.3 days, respectively (P = .005). Conclusions: After steroid therapy, an increase in complications was observed among patients with SFTS. Steroid therapy should be used with caution, considering the possible negative effects of steroid therapy within 5 days of symptom onset or in patients with mild disease (APACHE II score <14).

The clinical characteristics and the effect of viral RNA loads on fatality in 56 patients with severe fever with thrombocytopenia syndrome (SFTS) were analyzed. The non-survival group (12 patients) demonstrated a significantly higher mean age (77 years) than the survival group (44 patients, 65 years) (p = 0.003). The survival rates were 91.7% and 8.3% in patients with Ct values ≥30 and differed significantly (p = 0.001) in the survival and non-survival groups, respectively. The survival rates were 52.4% and 47.6% in patients with viral copy numbers ≥10,000 and 94.3% and 5.7% in patients with viral copy numbers <10,000 in the survival and non-survival groups, respectively (p = 0.001). In a multivariate analysis, viral copy numbers and initial Acute Psychologic Assessment and Chronic Health Evaluation II (APACHE II) scores were identified as the factors affecting fatality (p = 0.015 and 0.011, respectively). SFTS viral RNA loads can be useful markers for the clinical prediction of mortality and survival.

Few studies have shown the combined impact of sitting time and physical activity on quality of life in older people. This cross-sectional study, using data from the 2016–2018 Korean National Health and Nutrition Examination Survey, examines the association between sitting time and physical activity and health-related quality of life (HRQoL) in Korean adults aged ≥ 65 years. HRQoL was assessed using the EuroQol-5 Dimension (EQ-5D, three-level version). We divided subjects into groups based on sitting time and physical activity and analyzed the combined association of sitting time and physical activity with HRQoL. The association between longer sitting time (≥8 h) and HRQoL was analyzed using multiple logistic regression. In total, 4276 participants were included. Prolonged sitting time was associated with all of the EQ-5D dimensions: mobility (odds ratio [OR]: 1.43, 95% confidence interval [CI]: 1.22–1.68), self-care (OR: 1.65 [95% CI 1.25–2.17]), usual activities (OR: 2.07 [95% CI 1.69–2.52]), pain/discomfort (OR: 1.57 [95% CI 1.34–1.84]), and anxiety/depression (OR: 1.49 [95% CI 1.17–1.91]). The prolonged sitting time/inactive group had higher ORs for all the EQ-5D dimensions than the low sitting time/active group. Prolonged sitting time was associated with low HRQoL in elderly Korean adults; physical activity could weaken the negative influence of prolonged sitting time on HRQoL.

Lee BH, et al. J Korean Med Sci. 2015 Jul;30(7):871-875. https://doi.org/10.3346/jkms.2015.30.7.871