Five years of prospective surveillance of nosocomial infections in a Saudi Arabian general hospital

To determine the incidence of nosocomial infection by service and site and the distribution of pathogens involved during a five year period. Hospital - wide, Intensive Care Unit and Burns Unit of Qatif Central Hospital. Patients with proven nosocomial infections. Analysis of patient's data collected by active surveillance using a combination of case finding methods. The overall rate of nosocomial infection was 2.2%. According to the hospital services the rates of nosocomial infection ranged from 0.8% to 28%. The highest rates were seen in the Burns Unit [28%] and Intensive Care Unit [24%]; the major sites of nosocomial infections were urinary tract [29%], post operative wound infection [24%], respiratory tract infection [18%] and blood-stream infection [11%] Pseudomonas spp. was the most frequently isolated nosocomial pathogen [18.9%], followed by S. aureus, [16.5%] Klebsiella spp. [13.5%], E coli [9%], Candida spp. [5.5%], Coagulase negative staphylococci [5.3%] and Enterococci [5.5%]. Nosocomial infection is a problem in Burns Units and in high dependency areas. In Saudi Arabia, like other countries, prospective active surveillance and dissemination of information to health care staff may identify areas where infection control prevention effort should be focused

patterns of oropharyngeal microflora in patients with homozygous sickle cell disease

A controlled prospective study was carried out between 16 July 1991 and 31 January 1992 to evaluate the oropharyngeal flora in homozygous sickle cell disease [SS]. Throat swabs for cultures were taken from 163 asymptomatic SS patients attending sickle cell clinics [90 children and 73 adults]. Throat swabs were also taken from 84 asymptomatic healthy individuals as a control group [44 children and 40 adults]. Group A beta hemolytic Streptococci were isolated from 16.6% of children with SS compared to 4.5% of children without SS [P<0.05]. Staphylococcus aureus was isolated from 16.4% of adults with SS compared to 0% of adults without SS [P<0.0001]. Group G beta hemolytic Streptococci and nongroupable Streptococci were also isolated from 11% and 13.7% of adults with SS compared to 0% and 2.5% of adults without SS respectively. Several other organisms were isolated only from SS patients. We conclude that the oropharyngeal flora of patients with SS is disturbed. This disturbance may contribute to morbidity of these patients

Bronchopulmonary infection due to moraxella [branhamella] catarrhalis at Qatif Central Hospital

Moraxella [Branhamella] catarrhalis is now recognized as an important cause of respiratory tract infections. Over a two year period, Moraxella [Branhamella] catarrhalis was isolated in pure culture from 3.4% of the sputums collected from patients with symptoms of acute respiratory tract infections. It was the third most important pathogen isolated after Haemophilus influenzae and Streptococcus pneumoniae; 77% of the patients had an underlying chronic pulmonary condition. Prevalence, antibiotic sensitivity, and treatment options, will be discussed

Pattern of bacteriuria in patients with sickle cell disease in Qatif central hospital

Of 420 sickle cell disease patients admitted to Qatif Central Hospital who were investigated for bacteriuria, 49 showed significant bacteriuria, giving a bacteriuria rate of 11.6%. The highest incidence of bacteriuria was in patients under 20 years. The commonest organisms isolated were E. coli Klebsiella-Enterobacter, Acinetobacter and Pseudomonas. The sensitivity pattern showed a high rate of resistance to ampicillin. Amoxycillin clavulonate, nalidixic acid and norfloxacin are recommended as the drugs of choice for 'blind' therapy of suspected urinary tract infection in patients with sickle cell disease in this hospital. Complications of urinary tract infection in sickle cell disease patients may be fatal, therefore a knowledge of the pattern of bacteriuria and antibiotic susceptibilities in the hospital population is vital in the management of patients with this haemoglobinopathy

Aeromonas hydrophila septicaemia and meningitis in a neonate

A 13-day-old boy developed septicaemia and meningitis caused by Aeromonas hydrophila. Treatment with aminoglycosides and cephalosporins was not effective, although, in vitro the organism was susceptible to both antibiotics. The patient improved after combination therapy with co-trimoxazole and piperacillin. The illness was complicated by hydrocephalus. No obvious source of infection was found