David Ingall

Proteus mirabilis infections in a hospital nursery traced to a human carrier.

Abstract Serious infections due to Proteus mirabilis occurred in 11 full-term newborn infants in a hospital nursery over a four-year period. Bacteremia was demonstrated in 10, meningitis in six, and osteomyelitis in two. Four of the babies died of the infection. The usual factors predisposing to neonatal infection were absent. Epidemiologic investigations pointed to one nurse as the source. The organisms were most probably transmitted to the infants by manipulation of the umbilical cord during the admitting procedures. P. mirabilis was cultured from the hands, vagina and rectum of the nurse and from the umbilicus of seven of 12 consecutive newborn infants whom she admitted, including one who became ill with bacteremia. Among the several markers of P. mirabilis studied, susceptibility to tetracycline best delineated the epidemic strains from others cultured during a study of colonization among patients in the nursery affected, and in another where there had been no infections.

Placental transfusion as an intrauterine phenomenon in deliveries complicated by foetal distress.

The details of the deliveries of 10 infants whose cords were clamped before the onset of respiration and within one minute of delivery of the chin but whose residual placental volumes were unexpectedly low are compared with 20 control infants whose cords were clamped under similar conditions but who had the expected residual placental volumes. The only statistically significant difference between these groups was in the high number of patients with foetal distress and low Apgar scores in the former group. It is concluded that placental transfusion occurred before delivery in these patients and that foetal asphyxia facilitated this transfusion, which may be the underlying mechanism of neonatal erythrocythaemia or transient tachypnoea of the newborn.

Evaluation for genetic damage in offspring of women with high-level gonadal irradiation.

ALMOST all estimates of the existence, nature and magnitude of radiation-induced damage in man have been inferred from animal experimentation. The few reports on the possible mutagenic effects of r...