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Enteropathogenic escherichia coli in a special care nursery port moresby papua new guinea


Enteropathogenic escherichia coli in a special care nursery port moresby papua new guinea



Papua New Guinea Medical Journal 31(4): 283-286



An outbreak of diarrhoea associated with enteropathogenic E. coli (EPEC) occurred in the Special Care Nursery of Port Moresby General Hospital and lasted nearly 5 months. 16 babies had EPEC in their stools, of whom 14 were sympatomatic. A further 3 babies had typical symptoms but their stools were not cultured before death. The usual presentation was profuse watery diarrhoea, with rapid onset of hypovolaemic shock. Most affected babies required intravenous rehydration. Lactose intolerance was found in one-third; 5 of 17 (29%) symptomatic babies died, and a further 3 absconded. Initial control measures, including cohort nursing, improvement of handwashing techniques and oral neomycin, had no effect on the spread of the infection. The institution of gown and glove barrier nursing and iodine-based handwashing solutions was associated with cessation of spread of infection. It is recommended that gown and glove barrier nursing should be instituted at an early stage in diarrhoeal outbreaks in speical care nurseries, regardless of the logistic problems involved.

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