Nosocomial Escherichia coli O157 infection

Nosocomial transmission of Shiga toxin-producing Escherichia coli O157 to t wo patients and three nurses is described. The index case presented with re ctal bleeding rather than diarrhoea, and additional infection control measu res were therefore only instituted after detection of the organism. Of the nurses, two were asymptomatic and detected on a screening programme of all staff in contact with the affected patients. Two patients died, one from Cl ostridium perfringens bacteraemia. The use by staff of full protective gown s for handling patients from their first onset of diarrhoea is recommended, rather than plastic aprons. Interest from the media was intense, despite t he small number of patients and staff affected, and early preparations for media enquiries should be made in such episodes. (C) 2000 The Hospital Infe ction Society.