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Volume 8, Number 12—December 2002


Use of Binary Cumulative Sums and Moving Averages in Nosocomial Infection Cluster Detection1

Samuel M. Brown*Comments to Author , James C. Benneyan†, Daniel A. Theobald‡, Kenneth Sands§, Matthew T. Hahn‡, Gail A. Potter-Bynoe¶, John M. Stelling#**, Thomas F. O'Brien#**, and Donald A. Goldmann¶
Author affiliations: *Massachusetts General Hospital, Boston, Massachusetts, USA; †Northeastern University, Boston, Massachusetts, USA; ‡Vecna Technologies, Inc., Hyattsville, Maryland, USA; §Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA; ¶Children's Hospital, Boston, Massachusetts, USA; #WHO Collaborating Center for Antimicrobial Resistance Surveillance, Boston, Massachusetts, USA; **Brigham and Women's Hospital, Boston, Massachusetts, USA;

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Cluster patients with isolates, dates, and sensitivitiesa

Patient Culture date Body site PFGE type Resistance phenotypeb
O1-1 1/22/99 wd,bl E cli ERY tcy van SAM FEP OXA sxt CZO AMC amk
O1-2 7/10/99 no,ax D CLI ERY TCY van OXA sxt AMK
O1-3 7/10/99 sp D CLI ERY TCY van SAM FEP OXA sxt CZO AMC AMK
O1-4 8/23/99 wd C CLI ERY TCY van SAM FEP OXA sxt CZO AMC AMK
O1-5 9/3/99 wd C CLI ERY TCY van SAM FEP OXA sxt CZO AMC AMK
O1-6 9/6/99 wd C CLI ERY TCY van SAM FEP OXA sxt CZO AMC AMK
O1-7 9/13/99 bl C CLI ERY TCY van OXA sxt AMK
O2-1 1/20/00 bl non-B VAN amc AMP
O2-2 5/12/00 st B VAN amc AMP
O2-3 5/14/00 fl B VAN amc AMP
O2-4 5/18/00 st B VAN amc AMP
O2-5 5/19/00 ti,st B VAN amc AMP TCY chl IPM nit
O2-6 5/24/00 st B VAN amc AMP
O2-7 6/23/00 fl non-B VAN AMC AMP

aMRSA, methicillin-resistant Staphylococcus aureus; PFGE, pulsed-field gel electrophoresis; O1, outbreak 1; O2, outbreak 2; VRE, vancomycin-resistant enteroccocus; bl, blood; sp, sputum; st, stool; wd, wound; ti, tissue; ax, axilla; no, nose; fl, fluid.
bAntibiotic codes in capital letters are resistant results; those in lowercase letters are susceptible: AMC, amoxicillin/clavulanate; AMP, ampicillin; AMK, amikacin; CLI, clindamycin; CZO, cefazolin; ERY, erythromycin; FEP, cefepime; OXA, oxacillin; SAM, ampicillin/sulbactam; SXT, trimethoprim/sulfamethoxazole; TCY, tetracycline; VAN, vancomycin.

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1 Portions of this research were presented at the 39th Annual Meeting of the Infectious Diseases Society of America (IDSA), San Francisco, California, USA, October 25–28, 2001.