The Journal of hospital infection
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Methicillin-resistant Staphylococcus aureus (MRSA) infection in a cystic fibrosis (CF) unit was investigated. Two typing methods, phage-typing and restriction fragment length polymorphism (RFLP) by pulsed-field gel electrophoresis (PFGE) and phylogenetic analysis, showed that nonsocomial transmission of MRSA from the general hospital population had occurred. ⋯ However, transmission between two family members did not occur indicating a minimal risk of MRSA acquisition from social contact compared with hospital admission. This study supports policies for limiting CF-patient admission to hospital but transmission of MRSA does not appear to be a reason for limiting social contact with other CF patients.
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A one year prospective, observational survey was performed to evaluate the abnormal carriage of multi-resistant Klebsiella pneumoniae and/ or Acinetobacter baumannii, to determine associated risk factors for carriage, and to correlate the abnormal carriage with infectious morbidity and mortality in the intensive care unit (ICU) of a University Hospital. Two hundred and ninety-eight patients who stayed in the ICU > 48h, and were not neutropenic, were studied. Salivary and rectal samples were obtained on admission and weekly until discharge. ⋯ Mortality was significantly greater in the carrier group (43 vs 25%, P = 0.0006). Post hoc stratification suggested that abnormal carriage only influenced mortality in patients showing a low severity of illness score on admission to ICU. Abnormal carriage was found in the most severely ill patients, predisposed to secondary nosocomial infections, and could influence mortality in the less severely ill.
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To evaluate the ability of the Simplified Acute Physiology Score (SAPS) to predict the occurrence of hospital-acquired infections in intensive care unit (ICU) patients, we conducted a cohort study in an eight-bed combined ICU. From January 1991 to December 1992, 690 patients were admitted in the ICU and 656 stayed at least 48 h. Patients' severity of illness was estimated within the first 24 h of the ICU stay using the SAPS. ⋯ Significantly more infections occurred in the patients with a SAPS > 10 points (20.9% vs. 5.1%, P < 0.0001). Sensitivity, specificity, positive and negative predictive values for a SAPS > 10 points were 88, 40, 21, and 95%, respectively. Our results suggest that 95% of patients at low risk for developing hospital-acquired infections could be identified on admission with the use of severity scoring systems such as SAPS < or = 10 points.
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The supply of food to patients and staff is the responsibility of hospital support services. This article considers the provision of catering services and the production of safe food in hospitals in the UK. The responsibilities of food handlers and the role of the infection control team, the environmental health officer and the occupational health staff are also described.