We analyzed national foodborne outbreak data from 1973 through 2001 to determine the proportion of Salmonella Heidelberg outbreaks caused by specific foods. Among 6633 outbreaks with known etiology, 184 (3%) were caused by Salmonella Heidelberg. A vehicle was identified in 101 outbreaks; at least 53 were poultry or egg-related. Three outbreaks were attributed to egg consumption, 17 to consumption of egg-containing foods, 25 to poultry, and 8 to foods containing poultry and eggs. Efforts to reduce illness due to Salmonella Heidelberg shouldensure that poultry and eggs are handled appropriately to minimize contamination and cross contamination.

Central venous catheters have become a mainstay in the care of critically ill patients but, unfortunately, are associated with a significant risk of bloodstream infections. There are 80,000 catheter-related bloodstream infections that occur annually in the United States, with a high human and financial cost. This paper reviews the main tools for prevention and diagnosis of central venous catheter-related bloodstream infections in the intensive care unit. We discuss specific aspects of prevention, including education, hand hygiene, sterile technique, skin cleansing, choice of catheter site, antimicrobial-impregnated catheters, catheter site dressings, antibiotic lock solutions, anticoagulation, catheter changes, and needleless connection devices. An analysis of studies evaluating the use of catheter "bundles" is also included. Diagnostic methods discussed include how to obtain blood cultures, when to culture catheter tips, how to interpret culture results, and the best methods for diagnosis.

No abstract