Alfred L. Florman

Enhancement of bacterial growth in amniotic fluid by meconium.

Summary Growth curves of E. coli (0111:B4), L.monocytogenes (4b), and Staphylococcus aureus (Bartlett) were compared at 37° C. in amniotic fluid alone and in amniotic fluid with sterile meconium. Amniotic fluid supported bacterial growth poorly. However, when sufficient meconium was added to the amniotic fluid to give it a yellow-green color (1 per cent), it became a very good culture medium. This was most striking with E. coli and L. monocytogenes and was apparent by 6 hours. These observations suggest that the fetus who remains in meconium-stained amstained amniotic fluid may be exposed to far greater numbers of bacteria than one whose amniotic fluid does not contain meconium.

Hospital experience with varicella-zoster virus.

Varicella-zoster virus (VZV), one of the most common highly communicable agents of disease, stimulates aggressive infection control measures. In a 1-year period, at one hospital, at least 93 inpatients (82 adult patients, 11 pediatric patients) and 2 hospital staff with active varicella-zoster infections served as potential sources of nosocomial infection. Six incidents of exposure to the virus that occurred without the protection of standard infection control precautions were investigated by the infection control surveillance team. One hundred fifty-six patients and 353 hospital staff were exposed. Fifty-one patients had no history of varicella-zoster infection, but only five were susceptible by serologic testing. One hundred one staff members had no history of varicella-zoster, but only 11 were susceptible by serologic testing. These exposures resulted in three secondary varicella-zoster infections, six courses of varicella-zoster immune globulin prophylaxis and furlough of 13 staff members. Epidemiologic investigation consumed approximately 356 hours of staff time, and management of exposed persons cost approximately

The clinical usefulness of an ongoing bacteremia surveillance program.

41,500. Prospective knowledge of the immune status of health care workers would vastly decrease the time and effort required to control hospital VZV exposures.

GENERALIZED HERPES SIMPLEX IN AN ELEVEN-DAY-OLD PREMATURE INFANT

Surveillance of bacteremic patients within one week of the detection of a positive blood culture provides information of great clinical utility for relatively little effort. In this report one years experience is reviewed to illustrate that an individual hospitals experience with bacteremia may diverge from national norms. Such reviews may also detect recurring errors in medical judgment which may be corrected through proper education.