No abstract

The usefulness of a test for slime production as a marker for clinically significant infections with coagulase-negative staphylococci and its implications for therapy were examined. Hospital records were reviewed for 59 patients from each of whom more than one isolate of coagulase-negative staphylococci was obtained. In patients with a prosthetic device, 81% of 59 infectious episodes were due to a slime-positive coagulase-negative staphylococci. In contrast, 22 noninfectious episodes (in which the organisms were contaminants) were equally distributed between episodes due to slime-positive or slime-negative isolates (P = .005). Only 32% of infections caused by slime-positive organisms, in contrast to 100% of infections caused by slime-negative organisms, were improved by treatment with antibiotics alone (P = .02). Prosthetic device removal in addition to antibiotic treatment significantly improved the outcome in patients with infections due to slime-positive organisms when compared with treatment with antibiotics alone (93% vs. 32% improvement; P = .00025).

Our data suggest an increase in community acquisition of MRSA. PFGE demonstrated heterogeneity of MRSA isolates from both the community and the hospital setting.

No abstract

Despite apparent increases in the severity of illness of our patients, overall rates of nosocomial infection remained stable during a decade of study. Rates of nosocomial bloodstream infection increased, in parallel with National Nosocomial Infection Surveillance System data. We found repeated prevalence surveys to be useful in following trends and rates of infection, device utilization, and abnormal laboratory values among patients at our institution. Such methodologies can be valuable and low-cost components of a comprehensive infection surveillance, prevention, and control program and other potential quality-improvement initiatives, because they enable better annual planning of departmental strategies to meet hospital needs.