Epidemic XXXX in a neonatal intensive care unit: importance of the gastrointestinal tract as a reservoir.

@entity1 @entity5134 @entity295 @entity55 @entity3082 @entity693 @entity2737 @entity281 @entity2024 @entity204 @entity2335
Between a March and December of 1979, and outbreak of @entity281 due to multiply antibiotic resistant @entity5134 took place in a 50-bed neonatal intensive care unit. Fifteen neonates suffered major @entity281 ( @entity295 , @entity693 and @entity55 ) with one @entity204 , and 20 suffered minor @entity281 ( @entity2024 , @entity2335 , @entity2737 ). Epidemiologic investigation failed to reveal a common source; @entity5134 , however, ws isolated from an employee's hand, emollient skin cleanser, suction tubing, and three in-use manual @entity1 resuscitation bags. The skin cleanser and equipment-cleaning agents were ineffective against @entity5134 . Asymptomatic, colonized @entity1 were the major reservoir of @entity5134 . These @entity1 were identified by daily cultures of the nose, umbilicus and rectum. The rectal swab most commonly (76%) yielded first-positive cultures in previously uncolonized @entity1 , and was ultimately positive in 92% of colonized @entity1 . A control program was begun by: 1) removing all inanimate sources of @entity5134 ; and 2) cohorting @entity1 and staff into a @entity5134 -exposed group and a new @entity1 group. The new @entity1 group of @entity1 was surveyed by daily triple-site cultures for colonization and subsequent transfer to the @entity5134 -exposed group. After four months, the @entity3082 was controlled and the organism eradicated from the neonatal intensive care unit.
