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Ineffectual disinfection of inhalation equipment between therapy sessions of different patients has been reported to produce serious outbreaks of infection. The role of properly disinfected equipment that becomes colonized during use was assessed. In the Vancouver General Hospital gram-negative bacilli in the nebulizer water were demonstrated in 10.5% of nebulizers being used for periods of 24 to 72 hours. In at least 15% of patients exposed to contaminated nebulizers the organism was recovered from the respiratory tract 48 hours after removal of the equipment. Only one out of 85 patients exposed to contaminated nebulizers developed pneumonia, and in this instance a clear history of aspiration of vomitus was present. The low incidence of pneumonia may be related to the high percentage of nebulizers contaminated by organisms of low virulence and might be much greater in hospitals where more highly pathogenic organisms are commonly found as nebulizer contaminants. Fifteen patients with pneumonia prior to exposure to a contaminated nebulizer failed to show any evidence of superinfection.

Between 1951 and January 1972 listeriosis was diagnosed bacteriologically in 101 Canadian patients. This study adds 80 cases to the 21 reported from Metropolitan Toronto by Sepp and Roy in 1963. The Laboratory Centre for Disease Control, Ottawa, collated epidemiological and clinical data. Serotypes of Listeria monocytogenes included 4b (53), 1 (15), 1b (6), 1a (2), 2 and 3. Clinically, 54 patients had meningitis and 23 septicemia. The mortality rate was 30%.Between 1954 and January 1972 listeriosis affected 15 British Columbian patients: nine were male and six female; 12 were less than 1 or more than 45 years old. Among the patients were a pregnant mother and the son to whom she gave premature birth. A day-old infant and an elderly man died.

The incidence of PKU in British Columbia in the 1950-1971 period is 1/18,750 which corresponds to that found in two other Canadian studies.(2, 3) Evidence is presented which shows a trend toward a decline in incidence; however, this is not statistically significant. There is a preponderance of male cases in all age groups.

Toxigenic Corynebacterium diphtheriae was grown from skin lesions of 44 indigent patients seen at the emergency or out-patient departments of this hospital, 43 of them within the last 16 months of the study period. In all cases staphylococci or hemolytic streptococci were also present in the wounds. An increase in the incidence of clinical diphtheria occurred in the few months preceding and overlapping the period of recognition of the cutaneous infections. The gravis strains, which accounted for the majority of the infections, were sensitive to erythromycin and to penicillin, but were relatively resistant to cloxacillin.

In the investigation of several blood stream infections following open-heart surgery, sutures and other material that had been exposed and handled in the sterile field were examined bacteriologically. One hundred and seventy-five open-heart operations were carried out during the study period and a high percentage of the specimens cultured yielded viable staphylococci and diphtheroids. Glove powder, textile fibres, and skin squames were found in the dust that collected in the room during the operations and staphylococci were frequently recovered from this source, and from the floor. Although the air supply to the theatre appeared to be of good quality, it is suggested that air currents within the room had caused dissemination of this foreign material and had probably contributed to wound infections.