Diarrhea due to Vibrio cholera 0139 in Srinagarind Hospital

 The recent epidemic of Cholera Strain Vibrio cholera 0139 were occurred in India and Bengal Surveillance for Vibrio cholera 0139 in Srinagarind Hospital has been done from 11th March 1994 to 5th August, 1994.  One hundred and five patients were infected by this organism. There were three outbreaks of Vibrio cholera 0139 in Srinagarind Hospital.  In the first outbreak from 11-13th March 1994 there were 18 cases of infected patients in the second one in 8-13 June 1994 there were 36 cases and the last one was the 28th July to 5th August, 11 cases were found in only one case of breast feeding was the infant reported to be infected with this organism.  Most of the cases occurred in Amphur Muang, Khonkaen, percentage with a ratio of man : woman, 2:1, and average age was 41 years old (4 days-82 years).  The susceptibility of the organism to Tetracycline, Gentamicin, Nalidixic acid, Neomycin, Ampicillin was good, but there was moderate sensitivity to Chloramphenicol, no response to colistin and Cotrimoxazole Many control programs were done in these outbreaks such as hygeine education, surveillance for infection and the personnel who were carriers and cooked food.  The source of organism in Khon Kaen University was detected in rectal swab C/S of 253 personnel but only 7 cases infection were found and 318 specimens of swab C/S of used water food and vegatables were taken, and 4 specimens were positive for this organism. The implementations for controling of this outbreak were the rapidly indentify and treat, mass media for the communication, including, personal hygiene the used of chlorination etc. the case.

Methicillin – resistant Staphylococcus aureus (MRSA) Outbreaks in Srinagarind Hospital

 MRSA   surveillance  was  routinely  done  in  Srinagarind  hospital,  a  713  bed  university hospital  since  April  1993.  There were  3  MRSA  outbreaks  during  April  1993  to  March  1994.  The  first  outbreak  occurred  in  Accidental  and  Emergency  ward  during  October  to  November  1993  which  16  cases  were  involved .  All  of  the  patients  were  in  the  service  of  surgery.  The  second  outbreak  occurred  in  surgical  ward.  All  5  cases  were in  plastic  surgery  and burn team.  The  last  outbreak  was  in  the  newborn  unit,  six  infants  were  involved.   The  mortality  rate  of   these  outbreaks  was  six  out  of  27  cases.  After  outbreaks  were  identified,  several  interventions  were  used  to  control  infection,  such  as  patient   isolation,  emphasis  on  hand  washing  gloving , downing,  growing  and  masking,  prospective  surveillance  by  sputum   culture  in  patients  who  were  on  respirator  and  early  discharging  of  MRSA  cases.  We  also  introduced  identified  to  have nasal  colonization  with  MRSA  and  6  cases  were  successfully  treated  with  topical  mupirocin.  All  these  outbreaks   were  under  control  by  these  combined  control  measures.