Epidemics of Nosocomial Urinary Tract Infection Caused by Multiply Resistant Gram-Negative Bacilli: Epidemiology and Control

Abstract

Seven large epidemics of urinary tract infection, the causative organisms of which had extremely high levels of drug resistance, are discussed. Hospitalized patients were the primary reservoir. Gastrointestinal carriage was prominent in the outbreaks caused by Klebsiella pneumoniae. The major reservoir for Serratia marcescens and Proteus rettgeri appeared to be the genitourinary tracts of catheterized patients. The epidemic organisms were transmitted on the hands of personnel. Measures for prevention of infection included diminishing the revervoir, interrupting contact spread and modifying risk factors.