Influenza A among hospital personnel and patients. Implications for recognition, prevention, and control.

An outbreak of influenza A/Philippines H3N2 at a 1156-bed Veterans Administration Hospital involved 118 hospital personnel and 49 patients. Prospective surveillance methods that had been established within the hospital were not useful in identifying the number of involved individuals. Community indicators of influenza, which were reviewed retrospectively, would not have identified circulating influenza in this population. Control of the outbreak was accomplished using a creative approach that immunized over a third of the physician and nursing staff. This immunization program was successfully used in subsequent years to increase personnel compliance with the Immunization Practices Advisory Committee recommendations to annually immunize hospital personnel.

The prevalence of high-level methicillin resistance in multiply resistant hospital staphylococci.

This study was prompted by observing in the summer of 1975, five lethal septicemias caused by methicillin resistant staphylococci. Among the 17 initial S. aureus strains, only 36% were killed at 250 micrograms per ml of methicillin. One phage type of S. aureus predominated (85, group III). Methicillin resistance was found in 17 of 102 S. aureus and in 28 off 102 S. epidermidis septicemias; the mortality among methicillin resistant S. aureus cases was 52.9%, corresponding to 39.3% for S. epidermidis sepsis. Antibiograms revealed methicillin resistance in 59/400 S. aureus and 94/400 S. epidermidis isolates. Cross-resistance to other drugs was common. It is concluded that the emergence of methicillin and gentamicin-tobramycin resistance among hospital staphylococci represents a serious, persistent problem. Certain microbiologic characteristics of these resistant strains differ from results heretofore reported by others.