Cryptosporidiosis in a hospital-associated day care center.

Cryptosporidium was identified in the stools of infants and toddlers during an outbreak of diarrheal illness at a hospital-associated day care center. Stools from 42 of 54 children were examined for parasites, Salmonella, Shigella, Campylobacter and rotavirus; 27 children (64%) had Cryptosporidium. One child also had Salmonella and two other children were also found to have Giardia. Information regarding the severity and duration of symptoms was obtained from parents by means of a questionnaire. The most frequently reported symptoms included diarrhea, fever, anorexia and malaise. Of 9 children whose stools were examined during the time they were reported by parents to be symptomatic, 8 were positive for Cryptosporidium oocysts. Symptoms lasted from 1 day to 4 weeks and children excreted oocysts for up to 48 days after the onset of symptoms. Staff at the facility and family members were also affected. Cryptosporidiosis should be considered in the differential diagnosis of young children with diarrheal illness, especially those attending a day care facility.

Proposed quality control and interpretive criteria for disk diffusion susceptibility testing with enoxacin.

The standardized disk diffusion test, in which a 10-micrograms enoxacin disk is used, was performed and microbroth dilution MICs were determined to establish individual test control values with Escherichia coli ATCC 25922, Pseudomonas aeruginosa ATCC 27853, Staphylococcus aureus ATCC 25923, and S. aureus ATCC 29213. In addition, regression analysis correlating inhibitory zone diameter with MICs for approximately 400 gram-negative clinical isolates was performed. Based on linear regression and error rate-bounded analyses, criteria for the category calls of isolates are proposed.

Urine as a holding medium for Neisseria gonorrhoeae.

An earlier technique for culturing of Neisseria gonorrhoeae from uncentrifuged first-voided urine from males demonstrated a sensitivity of 92-99% as compared with the gram stain of urethral exudate and the urethral swab culture. In this study the utility of urine as a holding medium for N. gonorrhoeae was tested. Determination of a reliable minimal survival time for N. gonorrhoeae in urine was made by collection of 2-60 ml of first-voided urine prior to treatment from 97 men known to have genitourinary gonorrhea. The urine specimens were held at room temperature (approximately 22 C), while separate modified Thayer-Martin culture plates were inoculated from each specimen immediately after collection and at carefully timed intervals up to 48 hr afterward. N. gonorrhoeae was recovered from 95% of the urine specimens for up to 12 hr after the specimens were collected.

Efficacy of an enzyme immunoassay with uncentrifuged first-voided urine for detection of gonorrhea in males.

An enzyme immunoassay (Gonozyme; Abbott Laboratories, North Chicago, Ill.) for detection of Neisseria gonorrhoeae antigens was used to screen 184 urethral or uncentrifuged first-voided urine or both specimens from males and 78 cervical specimens. When compared with culture, the sensitivity and specificity of Gonozyme for cervical and urethral specimens were comparable to those in published reports. The sensitivity and specificity for urine specimens were 91.6 and 97.9%, respectively.

In vitro activities of enoxacin and 17 other antimicrobial agents against multiply resistant, gram-negative bacteria.

Enoxacin (CI-919) was evaluated for activity against 120 multiply resistant clinical isolates of the family Enterobacteriaceae and Pseudomonas aeruginosa. The MIC of enoxacin for 95% of the strains tested was less than or equal to 2 micrograms/ml. Approximately 90% of the isolates were susceptible to enoxacin, norfloxacin, ceftazidime, moxalactam, cefotaxime, cefoperazone, and amikacin. Marked resistance to the other seven antimicrobial agents tested was observed.

Rapid antimicrobial susceptibility testing of Gram-negative clinical isolates with the AutoMicrobic system.

Comparisons of the antimicrobial susceptibility patterns of clinical isolates of the family Enterobacteriaceae and Pseudomonas aeruginosa were made by using Kirby-Bauer disk diffusion, the MicroMedia system broth microdilution, and the AutoMicrobic system. The Kirby-Bauer system compared favorably with the MicroMedia system (95% essential correlation with 90% complete agreement). The AutoMicrobic system also compared favorably with both the Kirby-Bauer system (93% essential correlation with 87% complete agreement) and the MicroMedia system (97% essential correlation with 85% complete agreement). These data indicate that the AutoMicrobic system results are comparable to those of the MicroMedia and the Kirby-Bauer systems. Furthermore, the AutoMicrobic system offers a more rapid system (6 to 10 h), than the traditional systems, without sacrificing accuracy (16 to 24 h).

Staphylococcus aureus colonization and infection in newborn nursery patients.

The correlation between Staphylococcus aureus colonization and infection among newborns was studied during a four-year period. Of the 9,423 newborns cultured, 24% were colonized at the time of discharge and in 2% of these an infection developed, whereas only 0.2% of the noncolonized newborns experienced a staphylococcal infection. The weekly colonization rates ranged from 0% to 62%, and outbreaks of infections (two or more concurrent) occurred periodically when the colonization rates ranged from 11% to 57%. Colonization rates per se did not serve as an indicator of an actual or potential outbreak of infection. Instead, the occurrence of two or more concurrent cases of staphylococcal infection or presumptive evidence of an outbreak seems to be a more reliable indicator than colonization monitoring.

Identification of Neisseria gonorrhoeae by genetic transformation: a clinical laboratory evaluation.

Transformation of a Neisseria gonorrhoeae auxotroph (uracil and arginine deficient) to prototrophy was attempted with wild-type deoxyribonucleic acid from 71 random clinical N. gonorrhoeae cultures. Of these 71 cultures, 97.1% transformed the nutritionally deficient mutant to prototrophy. The procedure was reliable and economical and offered several distinct advantages over other methods used for the confirmation of N. gonorrhoeae.

Influence of operating room surface contamination on surgical wounds: a prospective study.

The influence of operating room contamination on wound infection rates in clean, clean-contaminated, contaminated, and septid procedures was studied by a prospective randomized study of 2,020 surgical wounds. Operating room surface contamination was assessed by the RODAC bacterial plate method. Control rooms uniformly received Wet-Vac cleaning between operations. Experimental rooms were not cleaned between consecutive clean operations, but were cleaned after contaminated operations. The difference in surface contamination between groups of experimental and control rooms was found to be significant at the P less than .05 level. Patients operated on in experimental and control rooms were followed up postoperatively to assess whether they experienced wound infection. No statistically significant differences in wound infection rates were found between experimental and control room operations as total groups, clean procedures, or operations of long duration.