ABSTRACT
Three neonates and 5 health care workers were identified as colonized with methicillin-resistant Staphylococcus aureus (MRSA) out of 222 individuals screened during an outbreak investigation in an 18-bed neonatal intensive care unit. Two of 3 MRSA neonatal isolates demonstrated identical pulsed-field gel electrophoresis clonal patterns but no clonal association was found among isolates from the 5 employees or between employees and neonates. Increased MRSA-unrelated strain colonization among health care workers supports increased MRSA community prevalence and probable decreased utility of mass screening.
Subject(s)
Carrier State/epidemiology , Carrier State/microbiology , Disease Outbreaks , Health Personnel , Methicillin-Resistant Staphylococcus aureus/classification , Staphylococcal Infections/epidemiology , Staphylococcal Infections/microbiology , Electrophoresis, Gel, Pulsed-Field , Genotype , Humans , Infant, Newborn , Intensive Care Units, Neonatal , Methicillin-Resistant Staphylococcus aureus/isolation & purification , Molecular Epidemiology , Molecular Typing , ParentsABSTRACT
In necrotizing enterocolitis (NEC) the small (most often distal) and/or large bowel becomes injured, develops intramural air, and may progress to frank necrosis with perforation. Even with early, aggressive treatment, the progression of necrosis, which is highly characteristic of NEC, can lead to sepsis and death. This article reviews the current scientific knowledge related to the etiology and pathogenesis of NEC and discusses some possible preventive measures.
Subject(s)
Enterocolitis, Necrotizing/etiology , Infant, Premature, Diseases/etiology , Infant, Premature , Cause of Death , Enterocolitis, Necrotizing/prevention & control , Humans , Iatrogenic Disease/prevention & control , Infant, Low Birth Weight , Infant, Newborn , Infant, Premature, Diseases/prevention & control , Risk FactorsABSTRACT
The use of ultrasound imaging in the neonatal intensive care unit (NICU) has become an essential part of the evaluation and delivery of care for most neonates. Until recently, ultrasound machines were large, expensive, and often not immediately available, particularly at night and during weekends. Additionally, serial studies to define the evolution of an acute clinical situation were often not practical because of the dedicated time required and the expense involved. The recent introduction into our NICU of a high-quality, reasonably priced, and completely portable neonatal ultrasound unit (Sonosite, Bothell, WA) has now made it possible for neonatologists to rapidly obtain the hour-by-hour information that can be extremely helpful in the evaluation of a critically ill neonate. This paper illustrates some of the capabilities of this simplified device, and the value of having continuous on-site ultrasound availability in the NICU.
