RESUMO
We investigated Bacillus cereus-positive tracheal aspirates from infants on ventilators in a neonatal intensive care unit. Multilocus sequence typing determined a genetic match between strains isolated from samples from a case-patient and from the air flow sensor in the ventilator. Changing the sterilization method for sensors to steam autoclaving stopped transmission.
Assuntos
Bacillus cereus/isolamento & purificação , Contaminação de Equipamentos/prevenção & controle , Infecções por Bactérias Gram-Positivas/diagnóstico , Infecções por Bactérias Gram-Positivas/prevenção & controle , Ventiladores Mecânicos/microbiologia , Bacillus cereus/genética , Desinfecção/métodos , Infecções por Bactérias Gram-Positivas/transmissão , Humanos , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Tipagem de Sequências Multilocus , EsterilizaçãoRESUMO
Neisseria gonorrhoeae infection in a prepubertal child is virtually diagnostic of sexual abuse, provided perinatal infection has been excluded. Therefore, it is imperative that Neisseria gonorrhoeae be correctly identified. We present two cases of false positive Neisseria gonorrhoeae meningitis encountered at two different children's hospitals. Both cases were evaluated by the child protection teams prior to establishing the correct diagnosis.
Assuntos
Abuso Sexual na Infância/diagnóstico , Gonorreia/diagnóstico , Anamnese/métodos , Neisseria gonorrhoeae/isolamento & purificação , Exame Físico/métodos , Evolução Fatal , Feminino , Humanos , Lactente , Masculino , Anamnese/normas , Pediatria/métodos , Exame Físico/normasRESUMO
OBJECTIVE: To determine the source of an outbreak of Salmonella javiana infection. DESIGN: Case-control study. PARTICIPANTS: A total of 101 culture-confirmed cases and 540 epidemiologically linked cases were detected between May 26, 2003, and June 16, 2003, in hospital employees, patients, and visitors. Asymptomatic employees who had eaten in the hospital cafeteria between May 30 and June 4, 2003, and had had no gastroenteritis symptoms after May 1, 2003, were chosen as control subjects. SETTING: A 235-bed academic tertiary care children's hospital. RESULTS: Isolates from 100 of 101 culture-confirmed cases had identical pulsed-field gel electrophoresis patterns. A foodhandler with symptoms of gastroenteritis was the presumed index subject. In multivariate analysis, case subjects were more likely than control subjects to have consumed items from the salad bar (adjusted odds ratio [aOR], 5.3; 95% confidence interval [CI], 2.3-12.1) and to have eaten in the cafeteria on May 28 (aOR, 9.4; 95% CI, 1.8-49.5), May 30 (aOR, 3.6; 95% CI, 1.0-12.7), and/or June 3 (aOR, 4.0; 95% CI, 1.4-11.3). CONCLUSIONS: Foodhandlers who worked while they had symptoms of gastroenteritis likely contributed to the propagation of the outbreak. This large outbreak was rapidly controlled through the use of an incident command center.