Scientific paper| Volume 124, ISSUE 3, P363-367, September 1972

Epidemic gram-negative septicemia in surgical patients

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      Hospital epidemics of gram-negative infections threaten surgical patients. Septicemia developed in thirteen patients after various surgical procedures in a private urban hospital in September and October 1970, and twelve of these patients yielded gram-negative organisms upon blood culture.
      Clinical signs of thrombophlebitis associated with positive blood cultures in the absence of other reasonable clinical sources of sepsis suggest that intravenous infusion methods were responsible. Patterns of antibiotic resistance and prevalence of usage indicate at least a background of inappropriate antibiotic therapy in the institution as a whole.
      The following recommendations are suggested to obviate future epidemics: (1) laboratory guidance for treatment of hospital infections; (2) careful surveillance of infections in hospitalized patients; (3) meticulous aseptic skin preparation prior to venous cannulations; (4) utilization of stainless steel needles in peripheral veins for short-term needs (that is, forty-eight hours or less) for standard operative procedures; (5) utilization of large caliber upper torso central veins when more durable and reliable long-term venous routes are needed for extensive surgical procedures.
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