Hospital Infection Control

Acquisition of C. difficile may occur by person-to-person spread in outbreak situations in institutions, such as nursing homes and hospitals and thus a history of antibiotic use is not an essential prerequisite. Mortality in the elderly may be high and isolation is essential. Pneumonia due to M. bovis is TB (though most is due to M. tuberculosis). Vancomycin resistant enterococcal infections are more important than drug-sensitive infections, particularly as enterococcus is generally a pathogen of low virulence. Outbreaks of multidrug resistant Klebsiella can sweep through ITUs very quickly and to devastating effect. MRSA, which is resistant to glycopeptides such as vancomycin, is a potentially untreatable organism and intermediate-resistant isolates have already been recognized in the UK.