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Current Status of the Operations of Clinical Microbiology Laboratories at Night, on Weekends, and during Public Holidays in Korea: Proposing a Consensus Guideline
J Lab Med Qual Assur 2019;41:111-116
Published online June 30, 2019
© 2019 Korean Association of External Quality Assessment Service.

Namsu Kim1, Jaehyeon Lee1,2, Jihyun Cho3, and Hye Soo Lee1,2

1Department of Laboratory Medicine, Chonbuk National University Hospital, Chonbuk National University Medical School; 2Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju; 3Department of Laboratory Medicine, Wonkwang University Hospital, Iksan, Korea
Correspondence to: Hye Soo Lee, Department of Laboratory Medicine, Chonbuk National University Hospital, Chonbuk National University Medical School, 20 Geonji-ro, Deokjingu, Jeonju 54907, Korea, Tel: +82-63-250-1218 Fax: +82-63-250-1200 E-mail: leehs@jbnu.ac.kr
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract

Background:

Clinical microbiological tests are conducted at night, on weekends, and during public holidays in various manners due to the fact that both manual processes and the form of working type, are not well known. Therefore, we surveyed the current running condition of these laboratories and made some suggestions for better-quality clinical microbiology tests.

Methods:

We conducted a survey, both online and offline, focusing on the operating styles of clinical microbiological tests within laboratories that had participated in an external quality assessment program, conducted by the Korean Association of External Quality Assessment Service (KEQAS).

Results:

Out of 341 laboratories that participated in the microbiology program of KEQAS, 128 replied to our questionnaires. In Korea, various types of operations occur within clinical microbiology laboratories. Those in night duty operate in either shifts or dedicated duties. In the case of weekend shifts, they either operated on single-day schedules (either on a Saturday or a Sunday), or over the entire weekend. For public holidays, the laboratories operated in various manners, depending on the number of days off. Among the clinical microbiological tests conducted at night, on weekends, and during public holidays, Gram staining and inoculations are the most common tasks carried out, with some laboratories conducting antibiotic susceptibility tests as well.

Conclusions:

Rapid reporting of clinical microbiological test results is currently inadequate due to both cost and labor constraints, despite its many advantages. It would be ultimately beneficial for both the patient and the hospital to switch to a 24/7 operating schedule through the utilization of a variety of methods, including cost control, coordination of a fine workforce, and prioritization of tests needing to be reported.

Keywords : Laboratory management, Clinical microbiology reporting, Human resources
꽌濡

吏꾨떒寃궗쓽븰怨쇱뿉꽌 떎떆븯뒗 寃궗, 듅엳 엫긽솕븰씠굹 硫댁뿭, 삁븸寃궗뒗 옄룞솕媛 옒 릺뼱엳뼱 빞媛, 二쇰쭚 諛 쑕씪뿉룄 寃궗媛 吏꾪뻾릺誘濡 吏꾨즺뿉 留롮 룄씠 릺怨 엳떎. 洹몃윭굹 엫긽誘몄깮臾쇨궗뒗 닔옉뾽쑝濡 떆뻾릺뒗 寃궗쓽 鍮꾩쨷씠 넂쑝硫, 옄룞솕맂 寃궗씪 븷吏씪룄 寃궗怨쇱젙쓽 留롮 遺遺꾩쓣 닔옉뾽쑝濡 떆뻾븯怨 엳湲 븣臾몄뿉 援궡 엫긽誘몄깮臾쇨궗떎쓽 빞媛, 二쇰쭚 諛 쑕씪쓽 洹쇰Т삎깭 諛 醫낅ぉ 湲곌뿉 뵲씪 떎뼇븯떎.

엫긽誘몄깮臾쇨궗쓽 鍮좊Ⅸ 寃궗 諛 蹂닿퀬뒗 솚옄 吏꾨즺쓽 吏덉쓣 넂씪 肉먮쭔 븘땲씪 냼紐⑤릺뒗 鍮꾩슜쓣 슚怨쇱쟻쑝濡 궙異붽쾶 븳떎뒗 留롮 뿰援ш껐怨쇰뱾씠 엳떎. 삁븸 諛곗뼇 뼇꽦씤 솚옄 99紐낆쓣 긽쑝濡 떆뻾븳 議곗궗뿉꽌 洹몃엺뿼깋쓽 turnaround time (TAT)씠 1떆媛 誘몃쭔씤 寃쎌슦 1떆媛 씠긽 맂 寃쎌슦瑜 鍮꾧탳뻽쓣 븣 移섎챸瑜좎씠 媛곴컖 10.1% 19.2%濡 쑀쓽븳 李⑥씠媛 蹂댁씤떎怨 蹂닿퀬븯 떎[1].

삉븳 誘몄깮臾쇰룞젙寃궗 빆깮젣 媛먯닔꽦 寃곌낵瑜 諛붾줈 蹂닿퀬뻽뜕 290紐낆쓽 솚옄援곌낵 떎쓬궇 蹂닿퀬뻽뜕 284紐낆쓽 솚옄援곗쓣 鍮꾧탳 룊媛븳 뿰援ъ뿉꽌 誘몄깮臾쇨궗寃곌낵쓽 蹂닿퀬떆媛꾩씠 鍮좊쇱닔濡 솚옄쓽 移섎즺媛 鍮⑤━ 떆옉릺硫 씠뒗 移섎즺슚怨쇰 뼢긽떆耳 옱썝씪닔瑜 媛먯냼떆耳곌퀬 沅곴레쟻쑝濡쒕뒗 쓽猷뚮퉬슜 媛먯냼濡 씠뼱議뚮떎뒗 뿰援ш 엳쑝硫[2], 빞媛꾩뿉 寃곌낵瑜 蹂닿퀬븯뒗 寃쎌슦 떎쓬궇 蹂닿퀬븯뒗 寃쎌슦뿉 룊洹 TAT뒗 媛곴컖 39.2떆媛꾧낵 44.4떆媛꾩씠뿀怨 엯썝湲곌컙 10.7씪怨 12.6씪씠뿀쑝硫 룊洹 蹂묒썝鍮꾨룄 $4,927 $6,677濡 李⑥씠媛 諛쒖깮뻽떎뒗 뿰援щ룄 엳떎[3]. 씠쇅뿉룄 寃궗 떆媛 옄泥대 以꾩씠湲 쐞빐 깉濡쒖슫 寃궗湲곗닠쓣 룄엯븯嫄곕굹[4,5], 湲곗〈 寃궗뿉 떎瑜 寃궗瑜 異붽븯뿬 理쒖쥌 蹂닿퀬떆媛꾩쓣 떒異뺤떆궎뒗 諛⑹떇쓣 궗슜븿쑝濡쒖뜥 슚쑉쓣 利앷떆궓 뿰援щ룄 엳떎[6].

씠윭븳 留롮 옣젏쓣 솗蹂댄븯湲 쐞빐 떊냽븳 寃궗 蹂닿퀬泥닿퀎瑜 솗由쏀븯뒗 씪 以묒슂븳뜲, 洹 떆옉젏씠씪 븷 닔 엳뒗 援궡 엫긽誘몄깮臾쇨궗떎쓽 빞媛, 二쇰쭚 諛 쑕씪쓽 슫쁺삎깭뿉 븯뿬뒗 븘吏곴퉴吏 젙솗븳 쁽솴 뙆븙씠 맂 諛붽 뾾쑝硫, 엫긽誘몄깮臾쇨궗 떎쓽 슫쁺뿉 븳 諛⑺뼢 젣떆 寃궗떎 吏 愿由 벑쓽 痢〓㈃뿉 빐꽌룄 뿰援щ맂 諛붽 뾾떎.

씠뿉 援궡 엫긽誘몄깮臾쇨궗떎쓽 빞媛, 二쇰쭚 諛 쑕씪 슫쁺쁽솴쓣 議곗궗븯怨 遺꾩꽍븯뿬 寃궗 諛 뾽臾댄삎깭뿉 븳 湲곕낯쟻씤 젣븞怨 굹븘媛 諛⑺뼢쓣 젣떆븯뿬 엫긽誘몄깮臾쇨궗떎쓽 吏 뼢긽뿉 湲곗뿬븯怨좎옄 븳떎.

옱猷 諛 諛⑸쾿

2014뀈 4썡 1씪遺꽣 11썡 30씪源뚯 븳엫긽寃궗젙룄愿由 삊쉶쓽 젙룄愿由ы봽濡쒓렇옩뿉 李멸븯뒗 341媛 湲곌쓣 긽쑝濡 엫긽誘몄깮臾쇨궗떎쓽 寃궗쓽 닔뻾, 寃궗떎 슫쁺뿉 븳 꽕臾몄쓣 떆뻾븯떎. 꽕臾몄 슦렪 諛 e-mail쓣 넻빐꽌 諛쒖넚븯쑝硫 쉶떊 슦렪 삉뒗 삩씪씤 꽕臾몄“궗 궗씠듃瑜 넻빐 諛쏆븯떎 (Supplemental material 1).

寃곌낵

1. 쓳떟湲곌

꽕臾몄쓣 諛쒖넚븳 珥 341媛 湲곌 以 議곗궗뿉 쓳떟븳 湲곌 128 媛(37.5%) 湲곌씠뿀떎. 쓳떟湲곌쓽 洹쒕え뒗 900蹂묒긽 씠긽 洹쒕え쓽 醫낇빀蹂묒썝씠 22媛(17.2%), 600-900蹂묒긽 洹쒕え쓽 醫낇빀蹂묒썝씠 28媛(21.9%), 300-600蹂묒긽 洹쒕え쓽 醫낇빀蹂묒썝씠 37媛 (29.1%), 300蹂묒긽 誘몃쭔 洹쒕え쓽 醫낇빀蹂묒썝씠 34媛(27.7%), 씪諛 蹂묒썝씠 7媛(5.5%)떎. 쓳떟븳 128媛 湲곌 以 7媛(5.5%) 湲곌 엫긽誘몄깮臾쇨궗瑜 떆뻾븯怨 엳吏 븡븯쑝硫 洹 씠쑀濡 寃궗떎 씤썝遺議깆쓣 瑗쎌븯떎.

2. 룊씪 빞媛 洹쇰Т삎깭 諛 뾽臾댁쓽 踰붿쐞

寃궗떎쓽 룊씪 洹쇰Т뒗 젙洹 洹쇰Т떆媛꾩씤 二쇨컙 洹쇰Т 떦吏 洹쇰Т떆媛꾩씤 빞媛 洹쇰Т 몢 媛吏 삎깭濡 슫쁺릺怨 엳뿀떎. 빞媛 洹쇰Т쓽 삎깭瑜 궡렣蹂대㈃ 넻긽 洹쇰Т 썑 쟾泥 씤썝쓽 떦吏 洹쇰Т삎 깭媛 25媛 湲곌(19.7%), 넻긽 洹쇰Т 썑 씪遺 씤썝쓽 떦吏 洹쇰Т삎깭媛 57媛 湲곌(44.8%), 넻긽 洹쇰Т 諛 3援먮 洹쇰Т삎깭 媛 11媛 湲곌(8.6%), 쟾떞 洹쇰Т삎깭媛 2媛 湲곌(1.6%), 넻긽 洹쇰Т 諛 빞媛 쟾떞 洹쇰Т삎깭媛 27媛 湲곌(21.3%)씠뿀떎 (Table 1).

Table 1 . Type of day and night shift work (total=127).

Working typesNo. (%)
Regular working type0
Regular working types with on-duty, rotated for all workers25 (19.7)
Regular working types with on-duty, rotated for some workers57 (44.8)
Three-shift workers0
Regular working employees, separately run by a three-shift work team11 (8.6)
Staff working night-shift only2 (1.6)
Regular working employees with only one night-shift team27 (21.3)
Other5 (3.9)

쓳떟븳 湲곌 以 109媛 湲곌(88.0%)뿉꽌 엫긽誘몄깮臾쇨궗쓽 寃泥대 젒닔븯怨 엳뿀떎. 젒닔遺꽌濡쒕뒗 寃泥 젒닔떎씠 60媛 湲곌(58.2%)씠 媛옣 留롪퀬 쓳湲됯궗떎씠 38媛 湲곌(36.0%), 엫긽誘몄깮臾쇨궗떎씠 7媛 湲곌(6.8%) 닚쑝濡 굹궗떎.

씪諛 엫긽誘몄깮臾쇨궗 遺臾몄뿉꽌 洹몃엺뿼깋 27媛 湲곌 (24.7%)뿉꽌, 諛곗 젒醫낆 45媛 湲곌(41.2%)뿉꽌 떆뻾븳떎怨 쓳떟븯떎. 誘몄깮臾 룞젙 諛 빆洹좎젣 媛먯닔꽦 寃궗瑜 떆뻾븯뒗 湲곌 1媛 湲곌(0.9%)씠뿀떎.

빞媛 洹쇰Т쓽 寃쎌슦 씪遺 씤썝쓽 떦吏 洹쇰Т삎깭媛 媛옣 留롮븯쑝硫 遺遺꾩쓽 寃泥대 젒닔븯吏留 젒醫 諛 洹몃엺뿼깋 씪遺뿉꽌留 吏꾪뻾릺怨 엳뿀怨 빆깮젣 媛먯닔꽦 寃궗뒗 嫄곗쓽 씠猷⑥뼱吏吏 븡怨 엳뿀떎.

蹂묒썝 洹쒕え蹂꾨줈 遺꾨쪟빐 蹂대㈃ 900蹂묒긽 씠긽쓽 蹂묒썝뿉꽌뒗 쟾泥 씤썝쓽 3援먮 洹쇰Т諛⑹떇씠 22媛 湲곌 以 17媛 湲곌(77.3%) 쑝濡 媛옣 留롮븯怨, 600-900蹂묒긽 洹쒕え쓽 蹂묒썝쓽 寃쎌슦룄 쟾泥 씤썝쓽 3援먮 洹쇰Т諛⑹떇씠 珥 28媛 湲곌 以 17媛 湲곌(60.7%)쑝濡 媛옣 留롮븯떎. 300-600蹂묒긽 洹쒕え쓽 蹂묒썝뿉꽌뒗 珥 37媛 湲곌 以 넻긽 洹쇰Т 썑 쟾泥 씤썝쓽 떦吏 洹쇰Т삎깭 넻긽 洹쇰Т 썑 씪遺 씤썝쓽 떦吏 洹쇰Т삎깭媛 媛곴컖 11媛 湲곌(29.7%)濡 룞씪븳 鍮꾩쑉濡 떎닔瑜 李⑥뻽怨, 300蹂묒긽 誘몃쭔쓽 蹂묒썝쓽 寃쎌슦룄 넻긽 洹쇰Т 썑 쟾泥 씤썝쓽 떦吏 洹쇰Т삎깭 넻긽 洹쇰Т 썑 씪遺 씤썝쓽 떦吏 洹쇰Т삎깭媛 쟾泥 32媛 湲곌 以 媛곴컖 10媛 湲곌 (31.3%)濡 룞씪븳 鍮꾩쑉濡 떎닔瑜 李⑥뻽떎.

3. 二쇰쭚 洹쇰Т삎깭 諛 뾽臾댁쓽 踰붿쐞

二쇰쭚 洹쇰Т쓽 寃쎌슦 쓳떟湲곌 以 12媛 湲곌(9.7%) 二쇰쭚뿉 洹쇰Т븯吏 븡뒗떎怨 븯怨 34媛 湲곌(27.6%) 넗슂씪留 洹쇰Т븯硫, 씪슂씪留 洹쇰Т븯뒗 湲곌 뾾뿀떎. 58媛 湲곌(47.1%) 二쇰쭚 紐⑤몢 洹쇰Т븯굹 뾽臾닿 넗슂씪怨 씪슂씪씠 떖옄쑝硫 19媛 湲곌(15.4%) 二쇰쭚 紐⑤몢 룞씪븳 뾽臾대쾾쐞濡 洹쇰Т븯떎(Table 2).

Table 2 . Type of weekend work (total=123).

Operated dayNo. (%)
Non-operational on weekends12 (9.7)
Only operational on Saturdays34 (27.6)
Only operational on Sundays0
Operational on weekends with different scopes of work between Saturdays and Sundays58 (47.1)
Operational on weekends with the same scope of work on both Saturdays and Sundays19 (15.4)

넗슂씪怨 씪슂씪 紐⑤몢 媛숈 뾽臾대쾾쐞濡 洹쇰Т瑜 븯뒗 湲곌쓽 寃쎌슦 紐⑤뱺 湲곌뿉꽌 寃泥 젒닔瑜 떆뻾븯怨 엳뿀떎. 젒닔 遺꽌濡쒕뒗 寃泥 젒닔떎씠 11媛 湲곌(55.0%), 쓳湲됯궗떎씠 3媛 湲곌(15.0%), 엫긽誘몄깮臾쇨궗떎씠 7媛 湲곌(35.0%)씠뿀떎. 엫긽誘몄깮臾쇨궗 遺臾몄뿉꽌 洹몃엺뿼깋 諛 諛곗 젒醫낆 16媛 湲곌(80.0%)뿉꽌 떆뻾븯怨 엳뿀怨, 諛곗 젒醫낆 12媛 湲곌 (60.0%), 룞젙 諛 빆깮젣 媛먯닔꽦 寃궗瑜 떆뻾븯뒗 湲곌 10 媛 湲곌(50.0%)씠뿀떎.

넗슂씪怨 씪슂씪쓽 뾽臾대쾾쐞媛 떎瑜 寃쎌슦, 넗슂씪 84媛 湲곌(91.3%)뿉꽌, 씪슂씪 64媛 湲곌(58.7%)뿉꽌 寃泥 젒닔瑜 떆뻾븯怨 엳뿀떎. 엫긽誘몄깮臾쇨궗 遺臾몄뿉꽌 洹몃엺뿼깋 넗슂씪 75媛 湲곌(81.5%), 씪슂씪 20媛 湲곌 (21.7%)뿉꽌 떆뻾븯怨 엳뿀怨, 諛곗 젒醫낆 넗슂씪 72媛 湲곌(78.2%), 씪슂씪 38媛 湲곌(41.3%)뿉꽌 떆뻾븯怨 엳뿀쑝硫 룞젙 諛 빆깮젣 媛먯닔꽦 寃궗쓽 寃쎌슦 넗슂씪 71媛 湲곌 (77.1%), 씪슂씪 9媛 湲곌(9.7%)뿉꽌 떆뻾븯怨 엳뿀떎.

二쇰쭚 洹쇰Т쓽 寃쎌슦 넗슂씪 80%뿉 媛源뚯슫 湲곌씠 洹쇰Т瑜 븯怨 엳쑝굹 씪슂씪 60% 젙룄쓽 湲곌留뚯씠 洹쇰Т瑜 븯怨 엳뿀떎. 삉븳 紐⑤뱺 湲곌뿉꽌 寃泥대 젒닔븯怨 엳쑝굹 씪遺 湲곌 留뚯씠 젒醫 諛 洹몃엺뿼깋쓣 떆뻾븯怨 엳뿀떎. 빆깮젣 媛먯닔꽦 寃궗뒗 씪슂씪뿉 鍮꾪빐 넗슂씪뿉 떆뻾릺뒗 湲곌씠 留롮븯떎.

蹂묒썝 洹쒕え蹂꾨줈 遺꾨쪟빐 蹂대㈃ 900蹂묒긽 씠긽쓽 蹂묒썝뿉꽌뒗 二쇰쭚 紐⑤몢 洹쇰Т븯릺 넗슂씪怨 씪슂씪쓽 뾽臾닿 떎瑜 삎깭쓽 슫쁺 諛⑹떇씠 珥 22媛 湲곌 以 15媛 湲곌(68.2%)쑝濡 媛옣 留롮븯怨, 600-900蹂묒긽 洹쒕え쓽 蹂묒썝뿉꽌뒗 二쇰쭚 紐⑤몢 洹쇰Т븯릺 넗슂씪怨 씪슂씪쓽 뾽臾닿 떎瑜 삎깭쓽 슫쁺諛⑹떇씠 珥 26媛 湲곌 以 12媛 湲곌(46.2%)쑝濡 媛옣 留롮븯떎. 300-600蹂묒긽 洹쒕え쓽 蹂 썝뿉꽌뒗 二쇰쭚 紐⑤몢 洹쇰Т븯릺 넗슂씪怨 씪슂씪쓽 뾽臾닿 떎瑜 삎깭쓽 슫쁺諛⑹떇씠 珥 36媛 湲곌 以 21媛 湲곌(58.3%)쑝濡 媛옣 留롮븯떎. 300蹂묒긽 誘몃쭔쓽 蹂묒썝쓽 寃쎌슦뒗 넗슂씪留 洹쇰Т븯뒗 슫쁺諛⑹떇씠 珥 31媛 湲곌 以 9媛 湲곌(29.0%)쑝濡 媛옣 留롮븯떎.

4. 쑕씪 洹쇰Т삎깭 諛 뾽臾댁쓽 踰붿쐞

쑕씪쓽 寃쎌슦 1씪留 돩뒗 寃쎌슦 2씪 씠긽쓽 뿰쑕쓽 寃쎌슦濡 굹늻뼱꽌 꽕臾몄“궗瑜 吏꾪뻾븯떎(Tables 3, 4). 1씪留 돩뒗 寃쎌슦 28媛 湲곌(22.7%)뿉꽌 寃泥 젒닔留 吏꾪뻾븳떎怨 쓳떟븯怨, 17媛 湲곌(13.8%) 二쇰쭚怨 媛숈 諛⑹떇쑝濡, 5媛 湲곌 (4.0%)뿉꽌뒗 二쇰쭚 洹쇰Т諛⑹떇 以 넗슂씪怨 媛숈 諛⑹떇쑝濡, 23 媛 湲곌(18.7%) 씪슂씪怨 媛숈 諛⑹떇쑝濡 슫쁺븳떎怨 쓳떟븯떎. 2씪 씠긽 뿰쑕씤 寃쎌슦, 37媛 湲곌(30.0%) 寃泥 젒닔留 吏꾪뻾븳떎怨 쓳떟븯怨, 13媛 湲곌(10.5%) 二쇰쭚怨 媛숈 諛⑹떇쑝濡, 7媛 湲곌(5.6%)뿉꽌뒗 二쇰쭚 洹쇰Т諛⑹떇 以 넗슂씪怨 媛숈 諛⑹떇쑝濡, 16媛 湲곌(13.0%) 씪슂씪怨 媛숈 諛⑹떇쑝濡 슫쁺븳떎怨 쓳떟븯떎. 洹몃━怨 36媛 湲곌(29.2%)뿉꽌뒗 꽑깮쟻씤 궇吏쒖뿉留 엫긽誘몄깮臾쇨궗떎쓣 슫쁺븳떎怨 쓳떟븯떎.

Table 3 . Type of holiday work (1 day holidays) (total=123).

Scope of workNo. (%)
Not operational on holidays48 (39.0)
Only sample receptions conducted28 (22.7)
Same operations as on weekends17 (13.8)
Same operations as on Saturdays5 (4.0)
Same operations as on Sundays23 (18.7)
Other2 (1.8)

Table 4 . Type of holiday work (for holidays longer than 2 days) (total=123).

Scope of workNo. (%)
Non-operational5 (4.0)
Only sample receptions conducted37 (30.0)
Same operations as on weekends13 (10.5)
Same operations as on Saturdays7 (5.6)
Same operations as on Sundays16 (13.0)
Selective operations36 (29.2)
Other9 (7.3)

蹂묒썝 洹쒕え蹂꾨줈 遺꾨쪟빐 蹂대㈃ 900蹂묒긽 씠긽쓽 蹂묒썝뿉꽌뒗 븯猷⑤쭔 돩뒗 寃쎌슦, 씪슂씪怨 媛숈 諛⑹떇쓽 洹쇰Т삎깭媛 珥 22媛 湲곌 以 7媛 湲곌(31.8%)쑝濡 媛옣 留롮븯怨, 씠 씠긽 쑕씪씪 寃쎌슦 꽑깮쟻씤 궇吏쒖뿉留 寃궗떎쓣 슫쁺븯뒗 諛⑹떇씠 8媛 湲곌(36.4%)쑝濡 떎닔瑜 李⑥뻽떎. 600-900蹂묒긽 洹쒕え쓽 蹂묒썝 뿉꽌뒗 븯猷⑤쭔 돩뒗 寃쎌슦, 뾽臾대쾾쐞媛 媛숈 二쇰쭚 슫쁺諛⑹떇쑝濡 슫쁺븯뒗 寃쎌슦 寃泥 젒닔留 吏꾪뻾븯뒗 蹂묒썝씠 珥 26媛 湲곌 以 媛곴컖 5媛 湲곌(19.2%)쑝濡 媛옣 留롮븯怨 씠 씠긽 쑕씪씪 寃쎌슦 꽑깮쟻씤 궇吏쒖뿉留 寃궗떎쓣 슫쁺븯뒗 諛⑹떇씠 7媛 湲곌(26.9%)쑝濡 떎닔瑜 李⑥뻽떎. 300-600蹂묒긽 洹쒕え쓽 蹂묒썝뿉꽌뒗 븯猷⑤쭔 돩뒗 寃쎌슦, 씪슂씪留 洹쇰Т븯뒗 諛⑹떇씠 珥 36媛 湲곌 以 11媛 湲곌(30.6%)濡 媛옣 留롮븯怨, 씠 씠긽 쑕씪씪 寃쎌슦 꽑깮쟻씤 궇吏쒖뿉留 寃궗떎쓣 슫쁺븯뒗 諛⑹떇씠 12媛 湲곌 (33.3%)쑝濡 媛옣 留롮븯떎. 300蹂묒긽 誘몃쭔쓽 蹂묒썝뿉꽌뒗 븯猷⑤쭔 돩뒗 寃쎌슦굹 씠 씠긽 돩뒗 寃쎌슦 紐⑤몢 寃泥 젒닔留 吏꾪뻾븯뒗 삎깭媛 珥 31媛 湲곌 以 媛곴컖 10媛 湲곌(10.0%), 17媛 湲곌(54.8%)쑝濡 媛옣 留롮븯떎.

5. Cerebrospinal fluid 寃泥댁쓽 寃궗 吏꾪뻾

鍮좊Ⅸ 泥섎━媛 븘닔쟻씤 뇤泥숈닔븸(cerebrospinal fluid, CSF) 寃泥댁쓽 寃쎌슦, 빞媛 洹쇰Т븯뒗 109媛 湲곌 以 96媛 湲곌 (88.0%), 룞씪븳 뾽臾대쾾쐞濡 洹쇰Т븯뒗 二쇰쭚쓽 寃쎌슦 20媛 湲곌 以 19媛 湲곌(95.0%), 뾽臾대쾾쐞媛 떎瑜 二쇰쭚쓽 寃쎌슦 92媛 湲곌 以 87媛 湲곌(94.5%) 벑 遺遺꾩쓽 湲곌씠 젒닔瑜 吏꾪뻾븯怨 엳뿀쑝굹 洹몃엺뿼깋 빞媛 洹쇰Т븯뒗 109媛 湲곌 以 23媛 湲곌(21.1%), 룞씪븳 뾽臾대쾾쐞濡 洹쇰Т븯뒗 二쇰쭚쓽 寃쎌슦 20媛쒓린愿 以 7媛 湲곌(35.0%), 뾽臾대쾾쐞媛 떎瑜 二쇰쭚쓽 寃쎌슦 92媛 湲곌 以 40媛 湲곌(43.4%)留뚯씠 洹몃엺뿼깋쓣 떆뻾븯떎. 寃泥 젒醫낅룄 빞媛 洹쇰Т 109媛 湲곌 以 40媛 湲곌(36.7%), 룞씪 븳 뾽臾대쾾쐞濡 洹쇰Т븯뒗 二쇰쭚쓽 寃쎌슦 20媛 湲곌 以 15媛 湲곌 (75.0%), 뾽臾대쾾쐞媛 떎瑜 二쇰쭚쓽 寃쎌슦 92媛 湲곌 以 66媛 湲곌(71.7%)留뚯씠 젒醫낆쓣 떆뻾븯떎.

怨좎같

蹂 뿰援щ 넻빐 援궡 엫긽誘몄깮臾쇨궗떎쓽 빞媛, 二쇰쭚 諛 쑕씪쓽 寃궗떎 슫쁺삎깭뒗 젙洹 洹쇰Т떆媛꾧낵뒗 떖由 젣븳쟻쑝濡 씠猷⑥뼱吏怨 엳뿀쑝硫 떎뼇븳 삎깭瑜 痍⑦븯怨 엳쓬쓣 븣 닔 엳뿀떎.

씠뒗 媛 蹂묒썝留덈떎 諛쒖깮븯뒗 뾽臾대웾쓽 李⑥씠 異붽 洹쇰Т뿉 뵲씪 諛쒖깮븯뒗 씤嫄대퉬 벑쓽 鍮꾩슜쟻씤 遺遺꾩씠 닔씡怨 留욎 븡뒗 벑 뿬윭 媛吏 뿬嫄댁씠 蹂묒썝留덈떎 떎뼇븯湲 븣臾몄씪 寃껋쑝濡 異붿젙맂떎. 듅엳 씤嫄대퉬 빆紐⑹쓽 寃쎌슦 寃궗떎뿉 洹쇰Т븷 닔 엳뒗 珥 씤썝 닔굹 援먮 洹쇰Т 諛 珥덇낵 洹쇰Т뿉 닾엯븷 닔 엳뒗 씤썝닔뿉 吏곸젒쟻씤 젣븳슂씤씠 맆 닔 엳뒗 遺遺꾩쑝濡 깮媛곷맂떎.

寃泥 젒닔쓽 寃쎌슦 遺遺꾩쓽 蹂묒썝뿉꽌 諛붿퐫뱶瑜 씠슜븳 젒닔 諛⑹떇쓣 梨꾪깮븯怨 엳湲 븣臾몄뿉 쟻 씤썝쑝濡쒕룄 異⑸텇씠 뾽臾대웾쓣 媛먮떦빐 궪 닔 엳뼱 빞媛꾩씠굹 二쇰쭚, 쑕씪 벑 紐⑤뱺 洹쇰Т솚寃쎌뿉꽌 遺遺 떆뻾릺怨 엳떎. 븯吏留 떎젣濡 寃泥댁쓽 젒醫낆씠굹 洹몃엺뿼깋 벑 젒닔뒗 떖由 닔湲곕줈 吏꾪뻾릺뒗 遺遺꾩씠 긽떦 遺遺꾩쓣 李⑥븯뒗 寃궗쓽 듅꽦긽 異⑸텇븳 洹쇰Т씤젰쓣 蹂댁옣諛쏆 紐삵븯뒗 蹂묒썝 寃궗 吏꾪뻾뿉 뼱젮쓣 寃れ쓣 닔諛뽰뿉 뾾쑝硫 寃궗媛 蹂듭옟븷닔濡 씠윭븳 寃쏀뼢 뜑슧 떖솕맆 寃껋쑝濡 깮媛곹빐 蹂 닔 엳떎. 룞젙씠굹 빆깮젣 媛먯닔꽦 寃궗쓽 寃쎌슦뒗 쟾臾몄쓽 씤젰源뚯 븘슂븳 寃쎌슦씠湲곗뿉 떆뻾븯뒗 蹂묒썝蹂대떎 洹몃젃吏 紐삵븳 寃쎌슦媛 뜑 留롮 寃껋쓣 븣 닔 엳떎.

씠윭븳 臾몄젣뒗 沅곴레쟻쑝濡 寃궗뿉 뵲瑜 닔媛 궛젙씠 吏굹移섍쾶 궙寃 梨낆젙릺뼱 엳湲 븣臾몄씤 寃껋쑝濡 蹂댁씤떎. 븵꽌 뼵湲됲븳 寃껋쿂읆 닔湲곕줈 吏꾪뻾릺뒗 寃궗 遺遺꾩씠 留롮 寃껉낵 뜑遺덉뼱 異붽쟻쑝濡 냼紐⑤릺뒗 寃궗떆빟씠굹 諛곗 벑룄 洹 닔웾쓣 삁痢≫븯湲 옒뱺 寃쎌슦媛 留롫떎뒗 젏 삉븳 쁽옱 梨낆젙릺뼱 엳뒗 닔媛媛 쁽떎쟻씠吏 븡 씠쑀씠湲곕룄 븯떎. 뵲씪꽌 寃궗떎쓽 슫쁺뿉 븘슂븳 異⑸텇븳 鍮꾩슜쓽 솗蹂닿 遺덇뒫븳 긽솴쓣 留뚮뱾寃 릺怨 鍮좊Ⅸ 寃궗 寃곌낵쓽 떊냽븳 蹂닿퀬뿉 븳 닔留롮 옣젏뿉룄 遺덇뎄븯怨 떆뻾릺湲 뼱졄寃 留뚮뱶뒗 슂씤씠떎.

CSF 寃泥댁쓽 寃쎌슦 젒닔瑜 떆뻾븯뒗 湲곌 鍮꾩쑉怨 寃궗瑜 吏꾪뻾븯뒗 湲곌 鍮꾩쑉 媛꾩뿉 李⑥씠媛 엳뒗뜲, 씠뒗 寃泥닿 젒닔뒗 릺吏留 씠썑 寃궗媛 吏꾪뻾릺吏 븡뒗 寃쎌슦媛 엳쓬쓣 쓽誘명븳떎.CSF 寃泥대뒗 넻긽쟻쑝濡 梨꾩랬 썑 24떆媛 씠궡뿉 寃궗瑜 吏꾪뻾빐빞 븿뿉룄 遺덇뎄븯怨 쟻젅븳 떆媛 궡뿉 吏꾪뻾릺吏 紐삵븯寃 릺硫 寃궗쓽 쟻젅븳 吏덉씠 蹂댁쬆릺吏 븡湲곗뿉 臾몄젣媛 맆 닔 엳뒗 遺遺 씠硫 諛섎뱶떆 媛쒖꽑씠 븘슂븯떎.

臾몄젣쓽 빐寃곗쓣 쐞빐 닔媛 媛쒖꽑 벑쓣 넻븳 鍮꾩슜쓽 솗蹂닿 媛옣 씠긽쟻씤 諛⑸쾿씠吏留 씤쟻 옄썝쓽 愿由 삉븳 븘슂븳 遺遺꾩씠떎. 씤쟻 옄썝 媛쒕뀗뿉꽌 蹂 븣 씤쟻 옄썝쓽 愿由щ 寃궗옄 닔瑜 뒛由щ뒗 뼇쟻씤 媛쒕뀗肉먮쭔 븘땲씪 寃궗옄 媛쒓컻씤쓽 寃궗뿉 븳 吏덉쟻씤 愿由щ 룷븿븳떎. 誘몄깮臾쇨궗媛 媛뒫븳 씤젰쓣 뒛由щ뒗 諛⑸쾿씠 슦꽑쟻쑝濡 遺덇뒫븷 寃쎌슦 湲곗〈뿉 엫긽솕븰씠굹 삁븸寃궗 遺꾩빞쓽 뾽臾대 떞떦븯뒗 寃궗옄쓽 寃쎌슦룄 援먮 洹쇰Т긽솴뿉꽌뒗 븳젙쟻쑝濡 寃泥댁쓽 젒닔굹 遺쟻빀 寃泥대 遺꾨쪟븯뒗 벑쓽 鍮꾧탳쟻 媛꾨떒븳 뾽臾댁뿉 룄쓣 諛쏆쓣 닔 엳룄濡 븯뒗 寃껊룄 諛⑸쾿 以묒뿉 븯굹媛 맆 寃껋씠떎. 씠윭븳 씤쟻 옄썝愿由щ 쐞빐꽌 뒗 뾽臾댄쓲由꾩쓣 떒怨꾨퀎, 닔以蹂꾨줈 援щ텇븯뿬 吏移⑥쓣 留뚮뱾뼱 쟻슜 븯뒗 寃껋씠 븘슂븯떎[7]. 씠뒗 媛 떒怨꾨쭏떎 뼱뒓 젙룄쓽 닔以쓽 씤젰씠, 뼱뒓 젙룄 씤썝씠 븘슂븳吏 寃궗 뾽臾댄쓲由꾩쓣 湲곕낯 怨④꺽쑝濡 쟻젅븯寃 援щ텇븯뿬 뙆븙븯怨 꽭諛븯寃 議곗젙븯뿬 뾽臾 웾쓣 遺꾩궛떆궎뒗 寃껋쓣 媛뒫븯寃 븷 닔 엳떎.

씠윭븳 諛⑸쾿쓣 넻빐꽌 긽떦닔쓽 湲곌씠 븵꽌 뼵湲됲븳 臾몄젣뱾 濡 씤빐 젒醫 諛 洹몃엺뿼깋 벑쓽 誘몄깮臾쇨궗瑜 빞媛 諛 二쇰쭚 삉 뒗 쑕씪뿉 떆뻾븯怨 엳吏 븡怨 꽭洹 룞젙 諛 빆깮젣 媛먯닔꽦 蹂닿퀬룄 옒 씠猷⑥뼱吏吏 븡뒗 씠 긽솴 遺꾨챸엳 媛쒖꽑씠 媛뒫븯떎怨 깮媛곷맂떎.

씪濡濡 씪蹂몄뿉꽌뒗 꽦怨듭쟻쑝濡 뿰以묐Т쑕젣 諛⑹떇쑝濡 誘몄깮臾 寃궗떎쓣 슫쁺븯뿬 洹 寃곌낵瑜 蹂닿퀬븯뜕 뿰援ш 엳떎. 뿰以묐Т쑕젣 諛⑹떇쑝濡 엫긽誘몄깮臾쇨궗떎쓽 슫쁺諛⑹떇쓣 蹂寃쏀븳 씠쑀뒗 쓽猷뚯젣룄뿉꽌 룷愿꾩껌援ъ젣룄濡쒖쓽 蹂솕, 썝궡 媛먯뿼利앹쑝濡 씤븳 솚옄쓽 썑쑀利앹뿉 븳 諛곗긽 뙋寃 븣臾몄씠뿀떎. 룷愿꾩껌援ъ젣룄濡 닔媛泥닿퀎媛 蹂寃쎈맂 긽솴뿉꽌뒗 媛먯뿼利앹쑝濡 씤빐 엯썝湲곌컙씠 옣湲고솕븷닔濡 異붽쟻씤 鍮꾩슜씠 蹂묒썝쓽 넀떎씠 릺誘濡 媛먯뿼쓣 떒떆媛 궡뿉 씤吏븯怨, 쓳븯뿬빞 븯뒗 떆뒪뀥쑝濡 쟾솚븷 븘슂媛 엳뿀怨, 젣솗젅媛쒖닔닠쓣 諛쏆 엫궛遺媛 硫붿튂떎由 궡꽦 룷룄븣洹(Methicillin-resistant Staphylococcus aureus)뿉 쓽븳 썝궡 媛먯뿼씠 엳뿀쑝굹 寃궗 諛 蹂닿퀬媛 젣븣 씠猷⑥뼱吏吏 븡븘 以묒쬆쓽 썑쑀옣븷瑜 엯 궗嫄댁씠 諛쒖깮븿쑝濡쒖뜥 뿰以묐Т쑕젣 슫쁺諛⑹떇쓣 솗由쏀븯뿬 寃泥 젒닔 寃곌낵蹂닿퀬媛 留ㅼ씪 媛뒫븯寃 븳 怨꾧린媛 릺뿀떎. 뿰以묐Т쑕젣瑜 룄엯븳 썑뿉 썑 삁븸 諛곗뼇 뼇꽦 寃泥댁쓽 理쒖쥌蹂닿퀬源뚯쓽 떆媛꾩씠 理쒕 1.4씪씠 떒異뺣릺뿀쑝硫 삁븸 諛곗뼇 뼇꽦 떆 洹 寃異쒓껐怨쇱쓽 以묎컙蹂닿퀬뿉 뵲瑜 빆洹좎젣쓽 떊냽븳 닾뿬媛 궗留앸쪧 媛먯냼쓽 쑀쓽븳 쁺뼢쓣 誘몄낀떎[8].

援궡뿉꽌룄 以묐룞샇씉湲곗쬆썑援(Middle East respiratory syndrome) 쑀뻾 씠썑濡 媛먯뿼愿由ъ쓽 以묒슂꽦씠 遺媛곷릺怨 엳쑝硫 엫긽誘몄깮臾쇨궗떎 媛옣 以묒슂븳 洹쇨굅瑜 젣떆빐二쇰뒗 遺꽌씠떎. 뵲씪꽌 씪蹂몄쓽 궗濡 媛숈 뿰以묐Т쑕젣 슫쁺諛⑹떇쓽 룄엯뿉 異⑸텇븳 떦쐞꽦쓣 遺뿬븷 닔 엳떎怨 깮媛곷맂떎.

沅곴레쟻쑝濡 엫긽誘몄깮臾쇨궗떎씠 뿰以묐Т쑕젣 諛⑹떇쑝濡 쟾솚 맂떎硫 솚옄 蹂묒썝 紐⑤몢뿉寃 씠씡씠 맆 닔 엳쓣 寃껋씠吏留 븳 踰덉뿉 떖꽦븯뒗 寃껋 留ㅼ슦 뼱졄湲 븣臾몄뿉 젏吏꾩쟻 룄엯쓣 寃넗빐빞 븷 寃껋씠떎. 씪蹂몄쓽 궗濡 媛숈씠 젏吏꾩쟻 룄엯怨 꽭諛븳 以鍮꾧 븘슂븳뜲, 삁瑜 뱾뼱 엫긽誘몄깮臾쇨궗 以 엫긽뿉꽌 移섎즺諛⑹묠쓣 꽑깮븯뒗 뜲 留롮 룄쓣 以 닔 엳뒗 寃궗瑜 슦꽑쟻쑝濡 꽑蹂꾪븯뿬 닚쐞솕븳 썑 癒쇱 쟻슜븯뒗 諛⑹븞룄 痍⑦븷 닔 엳뒗 醫뗭 쟾왂씠씪 깮媛곷맂떎. 듅엳 洹몃엺뿼깋쓽 寃쎌슦 鍮꾧탳쟻 媛꾨떒븳 寃궗 씠硫 뿼깋 遺遺꾩뿉꽌 옄룞솕媛 릺뼱 엳뼱, 愿묐쾾쐞 빆깮젣 꽑깮 뿉 겙 룄쓣 以 닔 엳쑝誘濡 癒쇱 쟻슜븳떎硫 겙 슚怨쇰 蹂 닔 엳쓣 寃껋씠떎.

쇅援뿉꽌룄 엫긽誘몄깮臾쇨궗떎쓽 二 7씪 24떆媛 슫쁺뿉 븳 怨좊쇱씠 떆옉릺怨 씠뿉 븳 臾명뿄씠 蹂닿퀬릺怨 엳떎[9,10]. 떎젣 궡꽦洹좎쓽 利앷 씠뿉 뵲瑜 媛먯뿼愿由, 愿묐쾾쐞 빆깮젣 궗슜怨 硫댁뿭씠 뼲젣맂 솚옄쓽 利앷 벑쓽 蹂솕븯뒗 쓽猷뚰솚寃쎌뿉 쓳븯湲 쐞빐 슦由щ굹씪쓽 엫긽誘몄깮臾쇨궗떎룄 諛쒕쭪異붿뼱 쟻젅븳 쓳쓣 紐⑥깋빐빞 븷 떆젏쑝濡 깮媛곷맂떎.

媛먯궗쓽 湲

蹂 뿰援щ뒗 븳엫긽寃궗젙룄愿由ы삊쉶쓽 2014뀈 븰닠뿰援щ퉬 (2014-05)뿉꽌 吏썝諛쏆븘 씠猷⑥뼱吏 뿰援ъ씠떎.

Supplementary
SUPPLEMENTARY MATERIALS

Supplementary materials can be found via https://doi.org/10.15263/jlmqa.2019.41.2.111.

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