A well-characterized unusual Pseudomonas species contaminated the piped disinfectant system of a newly-opened laminar air flow intensive care facility. This organism was frequently isolated (104-106 cfu/ml) from phenolic diluted 1:256 in the system, and could also be recovered (0.01-0.2 cfu/ml) from undiluted phenolic. During the 20-month period when this unusual Pseudomonas was present, none of the severely compromised, granulocytopenic oncology patients treated in the intensive care facility were either colonized or infected with this Pseudomonas sp. Eradication of the organism from the system proved difficult and was accomplished by removing a contaminated reservoir of diluted phenolic disinfectant followed by transient cleansing of the system with very high concentrations (84,000 ppm) of chlorine. This experience demonstrates that phenolics should be added to the list of disinfectants which can harbor Pseudomonas spp. in the clinical setting.

Serratia marcescens is recognized as an important and potentially hazardous nosocomial pathogen. The organism has been implicated here as the first reported case of S. marcescens meningitis associated with skin disinfection. A quaternary ammonium compound (QAC—Benzalkonium Chloride), was used to sterilize the skin prior to injection in a physician's office. Epidemiological studies were initiated. Six spray bottles containing disinfectant, the opened stock bottle of QAC, and an unopened bottle of disinfectant were all cultured. S. marcescens was noted growing in the spray bottles as well as in the opened stock bottle. Anti-biograms of the patient and epidemiological isolates are essentially the same. It is our contention as well as that of the Centers for Disease Control that an appropriate skin disinfectant such as Tincture of Chlorhexidine, Iodophors, or Tincture of Iodine should be used, and that physicians performing surgical techniques in the office be aware of the potential hazard of contamination. The consequences of nosocomial infection with resistant organisms warrant every precaution by health care professionals.

One hundred fifty Hickman right atrial catheters were inserted into 143 patients and were followed prospectively until removal. Primary indications for their use were: cancer chemotherapy (45), parenteral nutrition (35), antibiotic therapy (63), and miscellaneous (7). The overall catheter-associated infection rate was 12.0%. Since the mean duration of catheterization was 125 days, the infection/duration rate was 1.0/1,000 days of use. The risk of infection differed significantly according to the primary indication for catheterization: parenteral nutrition > antibiotic therapy > cancer chemotherapy. The increased risk of catheter-associated infection attributable to duration of catheterization was additive, and the per day risk of such infections remained constant regardless of duration. Nearly two-thirds of patients were discharged home with catheters in place, without adversely affecting infection risk.

In 1980 an investigation was conducted due to an apparent cluster of fevers following transurethral resections of the prostate (TURP), where the presence of prostatitis or urinary tract infections (UTIs) could not account for most cases, and the usage of antimicrobials did not prevent them. When unused, prepackaged, sterilized samples from 13 lots of triple lumen catheters were analyzed, four were found to contain high levels of endotoxin (ET), with a range of 49,150-≥ 6.25 ng/catheter. Additionally, these lots were highly pyrogenic to rabbits. The maximum incidence of febrile patients (42%) correlated with usage of catheters from the lot where ET levels were the highest. The febrile rate for a second urologist, who used single lumen catheters, was less (12/33 v 0/12). Further consideration should be given to sterile operative equipment which may still be pyrogenic.

The purpose of suctioning is to remove unwanted materials from a body cavity. Th e waste material is mixed with air in the suctioning tubing and drawn into a collection receptacle (canister). After the liquid and air enter the canister, the liquid drops into the canister and the air is discarded into the vacuum system. The vacuum system may be a central or a portable system.

Flavobacterium meningosepticum, found as a saprophyte in water, soil and the hospital environment, has a relatively short history as a human pathogen. In 1944 Shulman and Johnson reported a case of meningitis in a premature infant due to an unidentified gram-negative bacillus. The term Flavobacterium meningosepticum for that organism was proposed by King in 1959 in her study of a group of previously unclassified bacteria associated with meningitis in infants. The term Flavobacterium—“yellow bacteria”—describes the yellow pigment often associated with members of this genus and meningosepticum describes the strains associated with infant meningitis. Although F. meningosepticum is not commonly considered a human pathogen, it has caused a variety of nosocomial infections including meningitis, postoperative bacteremia, and endocarditis. Most hospital outbreaks of F. meningosepticum infection involve meningitis in newborns and have been linked to environmental sources, mainly water-containing equipment. These outbreaks of neonatal meningitis tend to be severe with a high mortality rate and serious neurological sequelae in surviving patients.

As with any serious disease whose etiology is not understood, acquired immunodeficiency syndrome (AIDS) is currently causing considerable concern throughout the United States. Stories about individual cases and about research progress in unraveling the etiology and control of AIDS, appear in the news media almost daily.