The Journal of hospital infection
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An outbreak of 12 cases of infection occurred over a 9-month period in a Regional Referral Neonatal Intensive Care Unit. The pathogen was a gentamicin- and multiply-resistant Klebsiella oxytoca (K55), of high virulence. Seven of 10 neonates with septicaemia died, the majority within 24 h of the onset of infection. ⋯ There is evidence to suggest that in one case the infecting organism was acquired from a contaminated blood gas analyser. It is necessary to use incompatibility grouping and restriction endonuclease digestion for complete characterization of plasmids and their molecular weights. However, the finding that each isolate examined carried the same five plasmids as judged by co-electrophoresis on agarose gels, and expressed the same extent and degree of transferable antibiotic resistance provides evidence to suggest that this outbreak was due to spread of a resistant clone of K. oxytoca (K55).
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Results obtained in two sero-epidemiologic surveys of hospital personnel in Durban were collated to yield information on 423 nurses and 141 domestic staff. The prevalence of antibodies to HBV was 14.9 per cent in 101 white nurses, 52.5 per cent in 322 African nurses and 51.8 per cent in 141 African domestics. This represents a greater than eight times increase for white nurses and a 50 per cent increase for African nurses and domestics over that seen in the equivalent blood donor groups (P less than 0.001 in each case). ⋯ African nurses in adult medical wards showed greatest exposure (57 per cent) closely followed by nurses working in outpatient departments (54 per cent) and as theatre staff (52 per cent). Lower exposure rates (40 per cent) were seen in paediatric and renal unit nurses. This contrasts with results obtained for doctors in the two surveys which indicated that while Indian and white doctors are at significantly higher risk in the African hospital, African doctors are not, and that doctors working in surgical and renal departments are at higher risk than doctors on adult medical wards.(ABSTRACT TRUNCATED AT 250 WORDS)