Nosocomial infections in a neonatal intensive care unit

Nosocomial infections in a neonatal intensive care unit

Material for the Review section, including books, monographs, reprints of articles, and audiovisuals, should be sent to Sego Matsumiya, R.N., Infectio...

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Material for the Review section, including books, monographs, reprints of articles, and audiovisuals, should be sent to Sego Matsumiya, R.N., Infection Cantroi Nurse, Veterans Administration Medical Center, 500 Foothill Blvd., Salt Lake City, UT 84148.

rature Nosocomial

infections

in a neonatal

in, and J Freeman: J Infect Dis 144:449-459, 1981. Reprint requests: Dr. Donald A. Goldmann, Division of Infectious Diseases, Children’s Hospital Medical Center, 300 Longwood Avenue, Boston, MA 02115.

A 5-year study of nosocomial infections was conducted in a neonatal intensive care unit at Children’s Hospital Medical Center in Boston. An attempt was made to determine what host and therapeutic factors are associated with nosocomial infections. From January 1974 to February 1977, 5.2% of the infants had at least one major nosocomial infection. They were cared fcx in a crowded hectic unit that lacked basic infection control features. Risk factors for infections included low birth weight, patent ductus arteriosus, surgery, and multiple supportive measures. In February 1977, a new spacious nosocomial intensive care unit opened, with a threefold increase in space per infant, convenient sinks, isolation facilities, and a 50% increase in nursing staff. With these alterations, the nosocomial rate of major infections dropped to 0.9%. Host and therapeutic factors were comparable in the old and new nurseries. The authors conclude that the improvements in staffing and environment were instrumental in lowering the nosocomial rates. lnfectians

among

patients

in nursing

homes

Garibaldi, S Brodine, and S Matsumiya: New Engl J Med :731-735, 1981. Reprint requests: Dr. Richard Garibaldi, sion of fnfectious Diseases, University of Connecticut Health Center, Farmington, CT 06032.

One-day surveys were conducted in seven skilled-care nursing homes in Salt Lake City, Utah, to review infection control policies and to

determine the prevalence of infections. These nursing homes did not have well-de~~elo~ed infection control programs. There were high patient-to-staff ratios, staffing by mostly nonprofessional personnel, frequent job turnover for employees, infrequent compensation for sick leave, and no general policies on immunizations for patients or staff. The prevalence of infections among 532 patients was 16.2%. Infected decubitus ulcers, conjunctivitis, symptomatic urinary tract infections, and lower respiratory tract infections were the most common types. Eighty-five percent of patients with indwelling urinary catheters had asymptomatic bacteriuria; many were colonized with antibiotic-resistant bacteria. Clustering of cases of upper respiratory tract infections, diarrhea, conjunctivitis, and specific types of bacteriuria suggested that localized outbreaks of infections occurred frequently. The authors suggest the high prevalence of infectious diseases and clustering of cases may reflect an increased susceptibility of patients in nursing homes to infections, high employee turnover, or lack of attention to infection control practices. They suggest fmther studies be done and guidelines be established to minimize the risks of infection For these patients. Infections after elective bypass sur lower limb ischemia: The ~~flwe~~e preoperative transcutaneous arterio MD Landreneau and S Raju: Surgery 90:956-961, 1961. Reprint requests Seshadri Raju, M.D., 2500 N. State St., Jackson, MS 39216.

Investigators in the Department of Surgery at University of Mississippi -Medical Center and the Veterans Administration Hospital in Jack-