Articles: intensive-care-units.
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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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Critical care medicine · Dec 1984
Availability of critical care personnel, facilities, and services in the United States.
This survey of 1474 special care units in the United States found that smaller hospitals tended to have only one ICU. The number of ICUs increased with overall hospital size; when a hospital had two ICUs, the second unit was usually for coronary care. Internists directed most of the ICUs, followed in decreasing order by surgeons, family practitioners, anesthesiologists, and pediatricians. ⋯ The number of house officers varied widely according to hospital size, as did the numbers of subspecialty fellows and nonphysician professional and paraprofessional personnel. The availability of services in hospitals also varied according to hospital size, particularly for intra-aortic balloon counterpulsation, CT scanning, and intracranial pressure monitoring. Urban setting more significantly affected size and available services than did geographic region.(ABSTRACT TRUNCATED AT 250 WORDS)
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Seven premature infants contracted asymptomatic hepatitis A while hospitalized in an intensive care nursery (nursery A) from May through August 1981. Fifteen secondary cases occurred between Aug 13 and Oct 14 and included six family members of nursery A infants, five nursery A nurses, and three nurses and a physician at two other nurseries--B and C. Nurseries B and C had each received an infected infant transferred from nursery A in July. ⋯ Review of dates of onset of illness in adults suggested that hepatitis A was transmitted in at least two generations of illness in infants at nursery A. Evaluation of infant handling in nursery A, using a case-control study, suggested that hepatitis A was transmitted among infants by nurses. Asymptomatic infected premature infants can be a source of hepatitis A in nursery infants and personnel and in the community.