The possibility of liver involvement in Mycoplasma pneumoniae pneumonia is still controversial. This study investigated 33 adult patients with serologically confirmed M. pneumoniae community-acquired pneumonia (CAP) (median age 31 years) and 38 patients with bacteraemic Streptococcus pneumoniae CAP (median age 54 years), all without pre-existing liver disease. Serum alanine aminotransferase (ALT) levels were elevated in 12 (36.4%) patients with M. pneumoniae CAP (median 53.5 U/L), and in four (10.5%) patients with S. pneumoniae CAP (median 61 U/L) (p 0.025). In most patients with M. pneumoniae CAP, the elevated ALT levels decreased during macrolide therapy, although this decrease was not significant.

A new chromogenic Oxacillin Resistance Screen Agar (ORSA; Oxoid) for the presumptive detection of methicillin-resistant Staphylococcus aureus (MRSA) was compared to a phenyl-mannitol-salt-oxacillin medium (MS-Oxa), blood agar and brain heart-infusion (BHI) on 579 clinical specimens. After 24 h [48h] sensitivity and specificity for ORSA vs. MS-Oxa were 50.8% [68.2%] vs. 53.8% [65.7%] and 95.6% [94.5%] vs. 92.7% [91.8], respectively. Within 24 h, ORSA and MS-Oxa identified 51% and 54% MRSA. It is not feasible to omit BHI in MRSA-screening protocols since 33% MRSA grew in BHI only.

Objectives:To investigate and describe an outbreak ofSerratia marcescensin a neonatal intensive care unit (NICU) and to report the interventions leading to cessation of the outbreak.Setting:A 2,168-bed, tertiary-care, university teaching hospital in Vienna, Austria, with an 8-bed NICU.Design:We conducted a case–control study to identify risk factors for colonization and infection withS. marcescens. A case-patient was defined as any neonate in the NICU with a positive culture forS. marcescensbetween October 1, 2000, and February 28, 2001. Polymerase chain reaction was applied to type isolates.Methods:During unannounced observations, the NICU was examined and existing policies were reviewed. Staff were reinstructed in hand antisepsis and gloving policies. Admissions were halted on December 27. During previously planned technical maintenance of the ward, the NICU was closed for 10 days and thorough aldehyde-based disinfection of the NICU was performed.Results:Ten neonates met the case definition: 6 with infections (among them 3 with cerebral abscesses) and 4 with asymptomatic colonization. Previous antibiotic treatment of the mothers with cefuroxime was the single significant risk factor for colonization or infection (P= .028; odds ratio, 17; 95% confidence interval, 1.3 to 489.5).Conclusions:S. marcescenscan cause rapidly spreading outbreaks associated with fatal infections in NICUs. With aggressive infection control measures, such outbreaks can be stopped at an early stage. Affected neonates themselves may well be the source of cross-infection to other patients on the ward. Antibiotic treatment of mothers should be reevaluated to avoid unnecessary exposure to antibiotics with the potential of overgrowth of resistant organisms.

OBJECTIVES: To investigate and describe an outbreak of Serratia marcescens in a neonatal intensive care unit (NICU) and to report the interventions leading to cessation of the outbreak.SETTING: A 2,168-bed, tertiary-care, university teaching hospital in Vienna, Austria, with an 8-bed NICU.DESIGN: We conducted a case-control study to identify risk factors for colonization and infection with S. marcescens. A case-patient was defined as any neonate in the NICU with a positive culture for S. marcescens between October 1, 2000, and February 28, 2001. Polymerase chain reaction was applied to type isolates.METHODS: During unannounced observations, the NICU was examined and existing policies were reviewed. Staff were re-instructed in hand antisepsis and gloving policies. Admissions were halted on December 27. During previously planned technical maintenance of the ward, the NICU was closed for 10 days and thorough aldehyde-based disinfection of the NICU was performed.RESULTS: Ten neonates met the case definition: 6 with infections (among them 3 with cerebral abscesses) and 4 with asymptomatic colonization. Previous antibiotic treatment of the mothers with cefuroxime was the single significant risk factor for colonization or infection (P = .028; odds ratio, 17; 95% confidence interval, 1.3 to 489.5).CONCLUSIONS: S. marcescens can cause rapidly spreading outbreaks associated with fatal infections in NICUs. With aggressive infection control measures, such outbreaks can be stopped at an early stage. Affected neonates themselves may well be the source of cross-infection to other patients on the ward. Antibiotic treatment of mothers should be reevaluated to avoid unnecessary exposure to antibiotics with the potential of over-growth of resistant organisms.

Recently, contamination of sensor-operated faucets (SOFs) with Pseudomonas aeruginosa was observed. To evaluate odds ratios, we conducted a case-control study in which handle-operated faucets served as controls. No statistically significant difference in P. aeruginosa counts was observed between SOFs and regular faucets in our study (odds ratio, 0.0; 95% confidence interval, 0.0 to 39.0; two-sided P exact = .99).