Nosocomial infection in an Intensive Care Unit in a private hospital

The nosocomial infection rate in an Intensive care unit (ICU) of a private hospital was assessed during an 18-month survey. From 629 admissions to the ICU, 139 hospital-acquired infections were identified. The rate was 22.1 percent compared to the overall nosocomial infection rate of 15.3 percent for the entire hospital. In the ICU, the main infections occurred in the respiratory tract, 41 (29.5 percent), followed by surgical wounds, 35 (25.2 percent), urinary tract, 28 (20.1 percent) and the blood stream, 24 (17.3 percent). From 165 bacterial isolates, 80 percent of isolates were gram-negative rods, with P aeruginosa, 48 (36.6 percent), being the predominant gram-negative isolate followed by Klebsiella pneumoniae, 27 (20.6 percent), and Enterobacter sp, 22 (16.8 percent). The main gram-positive isolates were S aureus, 23 (41.8 percent), coagulase-negative Staphylococci, 17 (30.9 percent), and Enterococci, 11 (20.0 percent). Of the 23 S aureus strains, 15 (65.2 percent) were methicillin-resistant (MRSA), (8 MRSA were from surgical wounds, 5 from the respiratory tract and 2 from infected urine). Only 2 of the 17 (11.8 percent) coagulase-negative staphylococci were methicillin-resistant, and both were isolated from wounds. Resistance to ampicillin and augmentin (amoxicillin-clavulanic acid) was high, 81.9 percent and 55.4 percent, respectively. Gentamicin, azteronam, piperacillin-tazobactam showed resistance rates of less than 15 percent. Infection control measures aimed at reducing nosocomial infections at the hospital are often frustrated by apathy of hospital administrators who apparently are insensitive to the high nosocomial infection rate. Effort by the infection control team through seminars, lectures and newsletters have begun to show improvements in attitude and awareness of staff to infection control and preventative measures within the institution. (AU)

A field survey of molluscicide-degrading microorganisms in the Caribbean area

Employing a bacteriologic medium in which the sole nitrogen source was the organic molluscicide, Bayluscide, isolations were made of organisms from more than 40 field and laboratory sites in Puerto Rico, the Dominican Republic, St. Lucia, and Venezuela. Materials were subcultured four times, then selected strains isolated from the snail Biomphalaria glabrata were subjected to standard diagnostic procedures. In all, 6 different bacterial strains were identified as members of the genus Psuedomonas and 2 as members of the genus Aerobacter. Distribution of molluscicide-utilizing bacteria was practically universal, being found in water, sediment, and snail intestine contents. Bacteria were isolated with 15 species of mollusc tested for the presence of such organisms. The possible significance of molluscicide-degrading organisms, relative to snail control projects is discussed (Summary)