Acquisition of multidrug-resistant Serratia marcescens by critically ill patients who consumed tap water during receipt of oral medication.

We describe an outbreak of multidrug-resistant Serratia marcescens infection and colonization involving adults admitted to a surgical intensive care unit. Examination of the outbreak revealed epidemiological evidence that consumption of tap water from a contaminated faucet during receipt of oral medication was the mechanism of S. marcescens acquisition.

[Anesthesia for surgical emergencies in Catalonia, Spain, in 2003].

Background And Objective: The aim of this arm of the ANESCAT 2003 study was to describe the use of emergency anesthesia in surgical specialties in Catalonia, Spain.

Patients And Method: The data analyzed came from a prospective study of the anesthetic procedures performed in 131 hospitals in Catalonia on 14 randomly chosen days in 2003. Emergency anesthetic procedures for surgery (excluding obstetrics and nonsurgical procedures) were selected and the following variables analyzed: type of hospital, patient characteristics, procedure, anesthetic technique, time used, postoperative care, and type of emergency (deferrable or not).

[Distribution of anesthesia practice, types of anesthesia, and human resources in Catalonia, Spain, in 2003].

Background And Objective: The aim of this arm of the ANESCAT 2003 study was to describe the temporal distribution and types of anesthesia used in Catalonia, Spain, in 2003, along with the associated human resources used.

Patients And Method: Data were used from a survey of 23,136 anesthetic procedures collected on 14 randomly selected days in 2003 and an individual questionnaire was completed by 765 anesthesiologists working in Catalonia.

Results: Anesthesia practice was divided into that associated with surgery (78.

Pathophysiology of pneumonia.

The development of pneumonia requires that a pathogen reach the alveoli and that the host defenses are overwhelmed by microorganism virulence or by the inoculum size. The endogenous sources of microorganisms are nasal carriers, sinusitis, oropharynx, gastric, or tracheal colonization, and hematogenous spread. Other external sources of contamination, such as intensive care unit workers, aerosols, or fibrobronchoscopy, must be considered as accidental.

Hospital-acquired pneumonia: etiologic considerations.

The development of pneumonia requires the pathogen to reach the alveoli and the host defenses to be overwhelmed, either by microorganism virulence or by inoculums size. The endogenous sources of microorganisms are nasal carriers, sinusitis, mouth, oropharynx, gastric, or tracheal colonization, and hematogenous spread. The exogenous sources of microorganisms are biofilm of the tracheal tube, ventilator circuits, nebulizers, and humidifiers.