The adult health care provider who is susceptible to varicella zoster virus (VZV) represents a risk to her or himself and to patients. Nineteen percent of employees at this Children's Hospital had no or uncertain prior experience with VZV, and of these, 28% were found to be VZV susceptible, representing 5% of the total population of 2,730 hospital employees. During the 12 months of study, six of the potential 135 to 137 VZV-susceptible individuals acquired varicella. VZV-susceptible health care providers should be aware of their potential to both acquire and transmit VZV.

The results are reported of a 4-year prospective study of the incidence of primary cytomegalovirus (CMV) infection in the nursing staff of a specialist obstetric hospital. The absence of seroconversion found in personnel attending patients with confirmed CMV-infection justifies reassuring staff members in “high-risk” areas of the adequacy of the methods used to combat cross-infection . On the other hand, a low rate of seroconversion (1.2% per annum) in the staff who nurse normal mothers and “rooming-in” babies emphasizes the need for die rigorous observance of hygienic precautions by all personnel in all areas. The results of this Australian investigation are discussed in relation to the northern hemisphere experience of CMV-seroconversion in pediatric nurses.

A prospective multicenter study of 1,032 cesarean sections was performed to identify risk factors for postoperative wound infection. The overall rate of wound infection was 6.6% (3.8% in elective cases and 7.5% following nonelective operations), with considerable interhospital variation. Obesity was recognized as a patient-related risk factor, while risk factors inherent to the obstetric situation were duration of ruptured membranes prior to operation, fetal and labor monitoring by intrauterine devices, and omission of the use of plastic draping and redisinfection of the skin before closure. Logistic regression analysis was used to estimate the influence of these factors on the probability of wound infection. Certain risk factors associated with and overrepresented in nonelective operations would explain the increased infection rates in these, and the observed interhospital variations did not differ from the expected rates when the distribution of other risk factors was considered.

Although Bacillus cereus is a well-known cause of food-borne illness, hospital-related outbreaks of food-borne disease due to B. cereus have rarely been documented. We report a hospital employee cafeteria outbreak due to foods contaminated with B. cereus in which an outside caterer was employed to prepare the suspect meals. Data were collected from 249 of 291 employees who had eaten either of the two meals. With a mean incubation period of 12.5 hours, 64% (160 of 249) of employees manifested illness. Symptoms, which averaged 24.3 hours in duration, included diarrhea (96.3%), abdominal cramps (90%), nausea (50.6%), weakness (24.7%), and vomiting (13.8%). Eighty-seven employees sought medical attention, 84 of whom were seen in an emergency room. Although a significant difference was not demonstrated in food-specific attack rates, B. cereus was cultured from both rice and chicken items that were served at both meals. Sixty-three employees submitted stools for culture that grew no enteric pathogens, but none were examined for B. cereus. This food-borne outbreak demonstrates: (1) the need for hospital kitchen supervisors to ensure proper handling of food when outside caterers are employed; (2) that significant differences in food-specific attack rates may not be demonstrated in outbreaks, which may be related to several factors; and (3) the importance of notifying microbiology laboratory personnel when B. cereus is a suspect enteric pathogen, since many laboratories do not routinely attempt to identify this organism in stool specimens.

In Bergey's manual, animal and human corynebacteria are a group of aerobic and facultatively anaerobic gram-positive or slightly curved bacilli that are generally nonmotile, catalase-positive, and non-acid fast. The best known and most clinically significant pathogen in the genus Corynebacterium is C. diphtheriae. However, other members of this genus are frequently encountered in the clinical laboratory and usually represent colonization or commensal contamination, since most other corynebacteria are of low virulence and questionable clinical significance. Frequently described as “diphtheroids,” such organisms are usually dismissed as contaminants and are not speciated or subjected to susceptibility testing. The JK diphtheroids may be differentiated from clinically unimportant “diphtheroids” by their resistance to beta-lactam antibiotics and their distinctive morphologic and cultural characteristics (Table 1).