ABSTRACT
We describe a nosocomial outbreak of diarrheal disease caused by extended-spectrum ß-lactamase-producing multidrug-resistant Salmonella enterica serovar Typhimurium, focused on a pediatric ward in South Africa. The outbreak peaked between May 2012 and July 2012. Person-to-person transmission was the most likely mechanism of spread of the infection, expedited due to a breakdown in hand-washing and hygiene, suboptimal infection control practices, overcrowding of hospital wards, and an undesirable nurse-to-patient ratio.
Subject(s)
Cross Infection/epidemiology , Cross Infection/microbiology , Disease Outbreaks , Salmonella Infections/epidemiology , Salmonella Infections/microbiology , Salmonella typhimurium/isolation & purification , Adult , Cross Infection/transmission , Diarrhea/epidemiology , Diarrhea/microbiology , Hospitals , Humans , Infant , Salmonella Infections/transmission , Salmonella typhimurium/enzymology , South Africa , beta-Lactamases/metabolismABSTRACT
Isoniazid preventive therapy (IPT) prevents tuberculosis (TB) in immunocompetent children <5 years of age after exposure to an infectious TB source case. Routine IPT has been advocated in all HIV-infected children without TB, but has been controversial. Antiretroviral therapy markedly reduces the risk for TB in HIV-infected children, especially when started early in infancy. In HIV-infected children, as in HIV- uninfected children, we recommend post-exposure IPT after each TB exposure episode; but in HIV-infected children, this should be given irrespective of age or antiretroviral therapy. However, evidence for routine IPT without known exposure to TB in HIV-infected children is not convincing and is therefore not recommended.
