Breast milk causing neonatal sepsis and death.

Breast milk can occasionally transmit serious viral and bacterial infections to preterm infants. We present three cases of late-onset neonatal sepsis, including one that resulted in death, occurring in preterm infants. The likely source of the microorganisms in all three cases was expressed breast milk.

Survey of the management of acute asthma in children.

Acute asthma is one of the most common reasons for children presenting to the emergency department. International guidelines for the management of acute paediatric asthma are widely available. In this study we examined how acute asthma in children is managed across hospitals in Ireland and compared Irish practice with standard international guidelines. We surveyed 54 paediatricians across 18 centres in Ireland. A total of 30 (55.5%) individual paediatricians across 17 (94%) centres replied. The majority of centres had a written protocol for the management of acute asthma. A large number of centres use MDI and spacer devices in acute management although doses used varied widely. Only 29% of centres had written asthma action plans available from the emergency department and 53% had plans available from the ward. Irish practice is largely inline with established guidelines. A national asthma strategy could further help to improve asthma care.

A cryptic plasmid from Nocardia orientalis NRRL 2452, a vancomycin producer.

A plasmid was found in Nocardia orientalis (formerly Streptomyces orientalis). Physical characterization of the plasmid DNA indicates a size of 33.5 kb and a single cleavage site for EcoR I. The presence of plasmid, and variation in its copy member, did not directly affect vancomycin resistance or production levels. The plasmid represents the first to be isolated and characterized from a glycopeptide-producing nocardia.