Prospective surveillance of 1,527 episodes of bacteremia in the four major hospitals serving a community of 300,000 revealed striking differences among the hospitals. The rate of community-acquired bacteremia ranged from 1.9 to 6.8 per 1000 discharges; the rate of nosocomial bacteremia ranged from 0.9 to 9.8 per 1000 discharges. Death rates attributed to nosocomial bacteremias varied among the hospitals by as much as 40-fold. Nosocomial bacteremias were less frequent at two community non-teaching hospitals than at two teaching hospitals. Although fewer blood cultures were obtained at the nonteaching hospitals, the ratio of blood cultures obtained to deaths attributed to bacteremic infection was highest at these hospitals, suggesting that physicians recognized the importance of obtaining blood cultures in critically ill patients. The potential usefulness of bacteremia surveillance is reviewed. It is suggested that hospitals serving a single community might constitute an appropriate unit for such surveillance [Infect Control 1981: 2(3):219-226.]

Catheter-associated urinary tract infections remain the most common hospital-acquired infection. Regular bacteriologie monitoring of urine from catheterized patients has been advocated as a measure for reducing the morbidity associated with this infection. To assess the effectiveness of this measure we reviewed the records of 100 catheterized patients hospitalized before implementation of a monitoring program and 200 such patients admitted after a daily monitoring program was operational. We found that culturing urine from catheterized patients was infrequent prior to monitoring but, when done, patients usually were febrile, cultures usually were positive, and patients were treated. Monitoring identified more cases of bacteriuria, but less than half of the patients so identified were treated. Being febrile was associated with receiving antibiotics. Infection rates increased with duration of catheterization; long periods of catheterization typically occurred on the neurosurgical, orthopedic, and medical services. Daily bacteriologie monitoring of all catheterized patients is relatively inefficient and does not predictably lead to therapeutic intervention in infected patients. The cost:benefit ratio of this measure might be decreased by applying it to selected patients chosen on the basis of risk factors, including hospital service assignment (Infect Control 1981; 2(3):227-232.)

During a five-week period, Pseudomonas paucimobilis was isolated from maxillary sinus irrigation washes of four patients who attended an ear, nose and throat clinic. The saline irrigation solution was found to be contaminated with the same organism. Further investigation demonstrated the organism in a majority of hospital sinks surveyed. Although P. paucimobilis was isolated from clinical specimens, the presence of the organism did not appear to have clinical significance [Infect Control 1981; 2(3): 233-235.]

Virus transmission within the hospital is related to trans-missibility of the virus and susceptibility of the population at risk. General guidelines for the use of cohort isolation, for the control of virus transmission in the hospital, and for the use of the communicable disease survey for pediatric patients and visitors to the hospital are outlined. We also present a brief review of how to collect and transport specimens for virus isolation to assist the infection control practitioner and the clinician, and conclude with recommendations for future investigations in the areas of virology and infection control [Infect Control 1981; 2(3):236-245.]