A nursery outbreak caused by Serratia marcescens--scalp-vein needles as a portal of entry.

Serratia marcescens rarely causes infections in newborn infants. We recently studied an epidemic caused by a multiply-resistant, serotype 014:H12 Serratia marcescens that involved 42 infants. Cutaneous abscesses at previous intravenous infusion sites occurred nine times, usually required surgical drainage, and were the most striking infections during the outbreak. Six infants developed Serratia bacteremia and two died with Serratia meningitis; 34 patients were colonized with Serratia but remained uninfected. An epidemiologic investigation of the 83 infants at risk in the nursery assessed factors predisposing them to colonization or infection with the epidemic organism. Colonization of the throat, umbilicus, gastrointestinal tract, or skin was frequent among infants as was carriage of Serratia on nursey employees' hands. Infected and colonized infants were the most important reservoir for Serratia in the nursery and cross-infection between infants readily occurred. Scalp-vein needles appeared to provide a portal of entry of Serratia in colonized infants, predisposing them to abscess formation and bacteremia.

Sahel nutrition survey, 1974.

In time of food shortage, accurate assessment of nutrition status is important so that effective aid may be directed to those in greatest need and, in the future, the impact of this aid on the nutritional situation may be assessed. Using a population proportional sampling method and the index weight for height (which is relatively independent of sex, race, and age) as a criterion of nutritional status, CDC investigators determined that about 10% of the sampled population (aged about 6 months through 6 years) in Mali, Mauritania, Niger, and Upper Volta and over 20% in the sampled population in Chad were severely and acutely undernourished. Apparently younger children were affected first, but as the food shortage became more severe the prevalence of undernourished older children increased. This method of nutrition surveillance has proven itself during a stressful period and should be considered a fundamental tool when rapid assessment of acute undernutrition in children in developing nations is required.