The Journal of hospital infection
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The use of antiseptics in surgery from Lister to the present day is described. A review of current procedures for preoperative preparation for surgery is given; and some data showing that the effect of chlorhexidine on skin flora is persistent is recorded.
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Food hygiene in British hospitals is reviewed in the context of national trends in food poisoning and changes in food legislation. New methods of large scale catering such as the cook-chill system are considered, and the safe operation of such a system in a typical health district is described. The application of current guidelines for the microbiological quality of cook-chill food is evaluated. The need for careful observance of these principles, together with appropriate microbiological surveillance of the process and the product, is demonstrated.
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Hospital-acquired pneumonias and urinary-tract infections are important causes of morbidity and mortality in surgical patients, and a great deal of effort has been expended on infection control strategies to prevent their occurrence. Prophylactic antibiotics, used either systemically or topically, are not routinely recommended for the prevention of either of these infections. The beneficial effects of these agents are transient, and they are often in association with the acquisition of colonization or infection with resistant bacteria. New approaches for infection control, not involving antibiotic agents, are being developed to lower the infection rates of both hospital-acquired pneumonias and urinary-tract infections to an irreducible minimum.
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Pseudomonas aeruginosa colonizes the respiratory tract of most older patients with cystic fibrosis. The means by which these bacteria are acquired and the risk for patient-to-patient spread among subjects with cystic fibrosis are poorly understood. We studied the spread of Ps. aeruginosa within a hospital environment. ⋯ In all cases the "new" isolate was recoverable only once and was not found during a 2-year follow-up. Three of four sibling pairs with cystic fibrosis shared the same Ps. aeruginosa serotype(s). The risk of sustained cross-colonization by Ps. aeruginosa between patients with cystic fibrosis appears to be minimal, except under conditions of prolonged close contact.