An Outbreak of Nosocomial Salmonella typhimurium Infection Linked to Environmental Reservoir

Between May 16 and July 1,1973, four definite cases and one possible case of clinical salmonellosis occurred in a 175-bed community hospital; there were no deaths. Three of the four patients with definite salmonellosis had had cholecystectomies done by the same general surgeon (A); the fourth was an intensive care unit nurse who cared for one of the ill patients during the diarrheal phase of illness before salmonellosis was diagnosed. Epidemiologic investigation implicated the plastic tubing of an intermittent-suction machine located in the recovery room as the environmental reservoir of the organism, and having a nasogastric tube in place postoperatively was the critical host factor related to illness. The salmonella organisms isolated from the suction machine tubing were identical in serologic reaction, biochemical test results, and bacteriophage susceptibility pattern to those recovered from the four patients with confirmed salmonellosis. Antimicrobial susceptibility patterns were similar but not identical.