A nosocomial outbreak of Salmonella enteritidis infection due to the consumption of raw eggs
In the 10 years from 1976 to 1986, the reported number of Salmonella enteritidis infections increased six-fold in the northeastern United States. S. enteritidis infections were specifically linked to consumption of foods containing eggs. The largest hospital outbreak of S. enteritidis food poisoning ever to occur in the United States is described. In July and August 1987, 404 of the 965 patients (42 percent) at a New York City municipal hospital and nursing home became ill. Nine of the patients died from the salmonella infection. The diagnosis of salmonellosis was based upon stool cultures, which were obtained from 92 percent of the patients at the facility. Laboratory records were reviewed to estimate the rate of salmonellosis before the outbreak, the kitchen was inspected, and nine other city hospitals that received food from the same distributer were contacted about salmonellosis in their patients. It was determined that more patients on a low-sodium diet got sick than patients on other diets; S. enteritidis was then found in leftover low-sodium tuna-macaroni salad. The food poisoning was finally traced to mayonnaise prepared from raw eggs; the mayonnaise was then used in the salad. The contaminated eggs had been obtained from a farm where 69 percent of the hens' ovaries that were cultured were found to be positive for salmonella of the type including S. enteritidis. It is not known exactly how the eggs become contaminated. After this serious outbreak, the New York State Department of Health recommended that all health facilities in the state stop using raw or less-than-fully-cooked eggs in foods served to elderly patients, individuals with immune function, as well as other institutionalized persons. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: The New England Journal of Medicine
Risk factors for infection with plasmid-mediated high-level tetracycline resistant Neisseria gonorrhoeae
Neisseria gonorrhoeae (N. gonorrhoeae) is the most frequently reported class of sexually transmitted bacteria in the US. The disease caused by N. gonorrhoeae is treated with antibiotic drug therapy. Some strains of bacteria can over time change their genetic structure and become resistant to previously effective antibiotic treatments. Tetracycline, the antibiotic treatment of choice for N. gonorrhoeae, is not effective against a newly emerged tetracycline-resistant N. gonorrhoeae (TRNG). It is suggested that the increased use of tetracycline in the treatment of Chlamydia, another sexually transmitted bacterial infection, may be responsible for the development of this tetracycline-resistant strain of gonorrhea. In New York City the number of patients treated with tetracycline has increased by 32 percent between 1983 and 1987. To determine whether increased tetracycline use is associated with the development of TRNG, 547 patients testing positive for N.gonorrhea were evaluated. TRNG was detected in 51 women (9 percent). Women who used tetracycline within the previous one to five months were two times more likely to have a tetracycline-resistant strain of gonorrhea. It is suggested that the current recommendations of the Centers for Disease Control regarding tetracycline in the treatment of suspected Chlamydia infections be revised.
Publication Name: Sexually Transmitted Diseases
Neisseria gonorrhoeae resistant to ciprofloxacin and ofloxacin
Antibiotic-resistant strains of Neisseria gonorrhoeae have become more common in the 1990's, complicating attempts to control the spread of gonorrhea. The CDC recommends fluoroquinolone and cephalosporin antibiotics. In the Philippines, 73% of gonorrhea strains are now resistant to ciprofloxacin and ofloxacin, two powerful, commonly used drugs. Outbreaks of drug-resistant gonorrhea in Australia have been linked to foreign prostitutes. Continued screening with bacterial culturing and drug susceptibility testing are necessary to identify drug-resistant outbreaks.
Publication Name: Sexually Transmitted Diseases
- Abstracts: Postoperative infections traced to contamination of an intravenous anesthetic, propofol. Control of vancomycin-resistant enterococcus in health care facilities in a region
- Abstracts: A seroepidemiologic survey of the prevalence of herpes simplex virus type 2 infection in the United States. Early progression of disease in HIV-infected infants with thymus dysfunction
- Abstracts: Strategies for the combination therapy of HIV infection. Differences in the interaction of HIV-1 and HIV-2 with CD4
- Abstracts: The role of ultrasonography and amniocentesis in the evaluation of pregnancies at risk for neural tube defects
- Abstracts: A prospective study of human immunodeficiency virus type 1 infection and the development of AIDS in subjects with hemophilia. part 2