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Context: A laboratory information system (LIS) is a useful tool for the management of laboratory processes and data, as well as for improving quality., Objective: To examine the association between the implementation of a LIS with the outpatient and inpatient revenues of a general hospital., Design: This study analyzed the outpatient and inpatient revenue data of all 212 general hospitals in South Korea; data were obtained from the Korean National Health Insurance Corporation during the period from 1996 through 1999. The mixed model was used for the repeated measure data. The following listed variables were used in the analysis: LIS implementation status, the population size, the state of competition, average local income, the hospital location, the hospital size, whether or not the hospital was a teaching hospital, whether the hospital was private or public, and the effect of the implementation time., Results: The revenues from both the outpatient and inpatient departments were significantly higher 1 year after implementing a LIS, even after controlling for confounding variables., Conclusions: Although the causality needs to be clarified, the implementation of a LIS was found to be significantly associated with higher outpatient and inpatient revenues.

We investigated an outbreak of Acinetobacter baumannii in an intensive care unit and in the surgery, medicine, neurology, and urology wards of the Kosin University Gospel Hospital in Busan, Korea. The outbreak involved 36 cases of infection by A. baumannii producing the OXA-23 beta-lactamase over an 8-month period and was caused by a single pulsed-field gel electrophoresis clone. The epidemic isolates were characterized by a modified cloverleaf synergy test. Isoelectric focusing of crude bacterial extracts detected one nitrocefin-positive band with a pI value of 6.65. PCR amplification and characterization of the amplicons by direct sequencing indicated that the epidemic isolates carried a bla(OXA-23) determinant. The epidemic isolates were characterized by a multidrug resistance phenotype that remained unchanged over the outbreak, including penicillins, cephamycins, extended-spectrum cephalosporins, carbapenems, monobactams, and aminoglycosides. This study shows that the bla(OXA-23) resistance determinant may become an emerging therapeutic problem.

Among the 51 clinical isolates collected from a university hospital in Korea, nine isolates were resistant to cephamycins. Nine isolates were shown to produce CMY-11 and these also included three isolates producing TEM-1. The results from ERIC-PCR revealed that dissemination of CMY-11 was due to outbreaks of resistant species and to the intra-species spread of resistance to cephamycins in Korea. CMY-11 beta-lactamase genes from nine clinical isolates that were responsible for resistance to cephamycins (cefoxitin and cefotetan), amoxicillin, cephalothin and amoxicillin-clavulanic acid, were cloned and characterised. A sequence identical to the common regions in In6, In7 and a novel integron from pSAL-1 was found upstream from bla(CMY-11) gene at nucleotide 1-71. Eighteen nucleotides between position 71 and 72 were inserted into the bla(CMY-11) gene.