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May 1977

Nosocomial Epidemics Seriatim: Multidrug-Resistant Bacteria and R Factors

Arch Intern Med. 1977;137(5):585-587. doi:10.1001/archinte.1977.03630170017007

Nosocomial infections,1-3 changing patterns of and increasing antibiotic resistance among the bacteria that cause those infections,4-6 and the characteristics of factors involved in the transfer of resistance among them7-9 have been subjects of increasing concern in recent years. In addition, there has also been a provocative challenge to physicians about the manner in which they prescribe antibiotics as possibly contributing to those problems.10 These problems and concerns are well illustrated in the report of sequential outbreaks of hospital-acquired infections with resistant Serratia and Klebsiella that appears in this issue of the Archives (see p 581).

OUTBREAK OF INFECTIONS  The first infections with gentamicin sulfate-resistant Serratia marcescens were identified at the Veterans Administration Hospital in Nashville late in 1973. After this epidemic reached its peak and the number of cases began to decline, another wave of infections occurred in the same hospital; this time they were caused

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