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The results of blood cultures and clinical data of 101 neonates with 110 episodes of septicaemia during a 7-y study period were reviewed. The overall incidence of culture-proven sepsis within the study period was 6.0 per 100 neonatal intensive care unit admissions and the mortality rate was 14%. Three groups of pathogens accounted for 70% of all isolates: coagulase-negative staphylococci (27%), aerobic Gram-negative rods (24%) and Enterococcus faecalis (19%). Group B streptococcus was the major pathogen of very early-onset septicaemia (within 24 h of birth), whereas late-onset infections were most commonly caused by coagulase-negative staphylococci. Birthweight

Objectives:To investigate and describe an outbreak ofSerratia marcescensin a neonatal intensive care unit (NICU) and to report the interventions leading to cessation of the outbreak.Setting:A 2,168-bed, tertiary-care, university teaching hospital in Vienna, Austria, with an 8-bed NICU.Design:We conducted a case–control study to identify risk factors for colonization and infection withS. marcescens. A case-patient was defined as any neonate in the NICU with a positive culture forS. marcescensbetween October 1, 2000, and February 28, 2001. Polymerase chain reaction was applied to type isolates.Methods:During unannounced observations, the NICU was examined and existing policies were reviewed. Staff were reinstructed in hand antisepsis and gloving policies. Admissions were halted on December 27. During previously planned technical maintenance of the ward, the NICU was closed for 10 days and thorough aldehyde-based disinfection of the NICU was performed.Results:Ten neonates met the case definition: 6 with infections (among them 3 with cerebral abscesses) and 4 with asymptomatic colonization. Previous antibiotic treatment of the mothers with cefuroxime was the single significant risk factor for colonization or infection (P= .028; odds ratio, 17; 95% confidence interval, 1.3 to 489.5).Conclusions:S. marcescenscan cause rapidly spreading outbreaks associated with fatal infections in NICUs. With aggressive infection control measures, such outbreaks can be stopped at an early stage. Affected neonates themselves may well be the source of cross-infection to other patients on the ward. Antibiotic treatment of mothers should be reevaluated to avoid unnecessary exposure to antibiotics with the potential of overgrowth of resistant organisms.

Recently, contamination of sensor-operated faucets (SOFs) withPseudomonas aeruginosawas observed. To evaluate odds ratios, we conducted a case–control study in which handle-operated faucets served as controls. No statistically significant difference inP. aeruginosacounts was observed between SOFs and regular faucets in our study (odds ratio, 0.0; 95% confidence interval, 0.0 to 39.0; two-sidedPexact = .99).

In an illustrative sequence of exercises, we teach our students how to don, use, and take off sterile gloves correctly and how to wash hands properly. During this sequence, the effect of a good handwashing technique as well as the effect of failures in aseptic technique with gloves is made directly visible by the use of finger paints. This technique helps medical staff to visualize microbial contamination of the hands and to increase the awareness of breaks in aseptic technique.