The Walter Reed Army Medical Center has experienced an influx of traumatically injured patients either infected or colonized with Acinetobacter baumannii. Using multilocus polymerase chain reaction (PCR) and mass spectrometry to genotype isolates, we found an atypical and evolving strain distribution, distinct from those found at nonmilitary hospitals in the United States.

A high prevalence of methicillin-resistant Staphylococcus aureus (MRSA) carriage at hospital readmission among previous MRSA carriers warrants screening and preemptive isolation precautions. The replacement of culture on chromogenic agar with rapid quantitative polymerase chain reaction for readmission screening reduces the number of unnecessary preemptive isolation-days by 54% (from 6.88 to 3.14 isolation-days) and related costs by 45% (from US$113.2 to US$62.1) for patients who test negative for MRSA.

The duration of surgical procedures and the 75th percentiles of those durations are considered in calculation of the US National Nosocomial Infection Surveillance (NNIS) system risk index score. To compare the durations of neurosurgical procedures in a hospital in western France with the durations in the NNIS data, 6,136 neurosurgical patients were followed up to determine surgical site infection rates. The surgical site infection rate was 1.9%, and the 75th percentile durations were lower than those in the NNIS data. The values from the NNIS data are thus inadequate for this neurosurgical center.

In September 2006, we investigated a cluster of 9 patients who developed Enterococcus gallinarum infection after total knee arthroplasty. Isolates recovered from these patients were from the same outbreak strain. Although all 9 patients were monitored by the same healthcare personnel, were given spinal anesthesia, and had the same specific type of wound irrigation procedure performed during their hospitalization, the source or sources of these infections were not identified.

We investigated a cluster of methicillin-resistant Staphylococcus aureus infections in college football players. Risk factors included a history of recurrent skin infections and contact with the skin lesions of persons outside college. The infections were controlled through treatment of carriers with topical mupirocin, chlorhexidine body washes, and enhancement of personal hygiene practices. Varsity and professional teams need to consider similar preventive measures.

We describe the trends in the incidence of methicillin-resistant Staphylococcus aureus nosocomial infection in intensive care units in Lyon hospitals from January 1, 2003, through December 31, 2006. The incidence rate decreased from 1.77 cases per 100 ICU patients in 2003 to 1.16 cases per 100 ICU patients in 2006, a reduction of 38.0% (P = .05).

One rapid membrane chromatography test and 2 immunofluorescence tests were compared with polymerase chain reaction as tools for the diagnosis of influenza in 277 patients treated in an emergency department. The sensitivity on days 1-3 of symptoms was 71% for the rapid membrane chromatography test, 70% for the first immunofluorescence test, and 79% for the second immunofluorescence test. Rapid tests are useful for round-the-clock identification of influenza, with follow-up polymerase chain reaction used for confirmation.

A retrospective review of hospital records for Acinetobacter baumannii infection at a US Army combat support hospital revealed a monthly infection rate ranging from 20.5 to 0 cases per 1,000 patients admitted. The rate correlated with the mean census of host-nation patients in the intensive care unit, the mean census of host-nation patients on the wards, and length of stay in the intensive care unit.

A history of hospital admission in the prior year was the most sensitive predictor of methicillin-resistant Staphylococcus aureus or vancomycin-resistant Enterococcus colonization at admission to a Veterans Affairs Medical Center (VAMC) but missed more than one-third of carriers and required screening more than one-half of admitted patients.

We studied uninsured patients admitted to Rhode Island Hospital from January 1 through June 30, 2005, and from January 1 through June 30, 2006. The mean total hospital charge for an uninsured patient with a hospital-acquired infection was $18,487; for those without such an infection, it was $4,951 (P < .001). Multivariable linear regression revealed that a hospital-acquired infection accounted for 11.8 excess hospital days (P = .001). Length of stay was the only independent variable associated with total excess hospital charges.

The extent to which the use of alcohol-based handrub for hand hygiene has been adopted by US hospitals is unknown. A survey of infection control coordinators (response rate, 516 [72%] of 719) revealed that most hospitals (436 [84%] of 516) have adopted alcohol-based handrub. Leadership support and staff receptivity play a significant role in its adoption.

A retrospective case-control study was performed to determine the risks and outcomes associated with pediatric cardiothoracic surgical site infection. Undergoing more than 1 cardiothoracic operative procedure, having preoperative infection, and undergoing surgery on a Monday were significant risk factors. Cardiothoracic surgical site infection increased hospital and pediatric intensive care unit length of stay. Deep surgical site infection significantly increased mortality.

A retrospective, propensity-matched cohort study was conducted to determine the mortality rate in patients with healthcare-associated infection (HAI) due to multidrug-resistant (MDR) Acinetobacter baumannii. The 28-day mortality rate for patients with MDR A. baumannii HAI was not significantly different than that for patients with non-MDR A. baumannii HAI. The median length of hospital stay before diagnosis of HAI was 4.5 days longer for patients with MDR A. baumannii infection than for patients with non-MDR A. baumannii infection (P <.001).

We determined the rate of nosocomial viral respiratory infection in infants and the effect of an infection control program during 4 winter seasons. The rate of nosocomial viral respiratory infection decreased from 6.09 episodes per 100 patients admitted during the first study year to 1.46 episodes per 100 patients admitted during the last study year.

An outbreak of central venous catheter-associated bloodstream infections was reported in a hospital in Ecuador. Commercially produced ampoules of water for injection were found to be contaminated with Burkholderia cepacia and Myroides odoratus. Removal of these ampoules yielded a 10-fold reduction in the incidence of catheter-associated infection.

The mite Dermanyssus gallinae may cause pruritic dermatitis in humans. We describe a case of nosocomial infestation with D. gallinae from an abandoned pigeon nest suspended on the front wall of the Hôpital Henri Mondor near a window. Close surveillance and regular destruction of pigeon nests could prevent these incidents of infection in humans.

A retrospective analysis of 13,946 Staphylococcus aureus isolates revealed a stable incidence of isolates that were resistant to both clindamycin and erythromycin, but a significantly increasing incidence of isolates that were susceptible to clindamycin and resistant to erythromycin during 1991-1995, 1996-2000, and 2001-2005. The use of macrolides and clindamycin also increased during 1996-2005. The incidence of S. aureus isolates with inducible clindamycin resistance increased steadily and significantly during the period from August 2004 through December 2005.