Prolonged colonization with vancomycin-resistant Enterococcus faecium in long-term care patients and the significance of "clearance".

Little is known about the persistence of colonization with vancomycin-resistant Enterococcus faecium (VRE) in the nononcologic, non-intensive care unit patient. We studied all patients who had VRE isolated on > or =2 occasions of > 1 year apart (Study A) and those who had been "cleared" of VRE colonization after 3 negative stool cultures (Study B). Twelve patients had stored VRE isolates recovered > 1 year apart (Study A), and 58% of paired isolates were genotypically related according to pulsed field gel electrophoresis patterns.

Disseminated Aspergillus ustus infection following cardiac surgery.

Aspergillus ustus is a soil residing fungus that rarely has been implicated in human infections. A 72-year-old man who had undergone surgery for mitral valve replacement and triple coronary artery bypass developed progressive pneumonia with A. ustus.

Simultaneous nosocomial outbreaks caused by multiply resistant Klebsiella pneumoniae types 2 and 30.

Two simultaneous Klebsiella pneumoniae outbreaks resistant to multiple antibiotics are reported. The closely related strains were distinguished by comparing the zone diameters obtained by disk diffusion susceptibility testing but not by interpretations of susceptible, resistant, or intermediate. Similar conclusions were made when minimal inhibitory concentrations were considered.

Laboratory experience with a radiometric method for detecting bacteremia.

Two bacteriologic systems for detecting bacteria in blood were compared; the automated radiometric BACTEC and the conventional method used in our laboratory for many years. BACTEC consisted of two bottles with 30 ml and the conventional method with 50 ml of media for aerobes and anaerobes. The BACTEC bottles were inoculated with 2 to 3 ml and the conventional with 4 to 5 ml of blood at the patient's bedside.