Adult epiglottitis: 6 years experience in a university teaching hospital in Hong Kong

AbstractObjectives:To review the incidence and trends of MRSA during a 12-year (1989-2000) period at a university teaching hospital and the relationship between strain distribution by antibiogram and molecular typing.Design:Retrospective review of laboratory-based surveillance records on MRSA isolation and characterization of strains by antimicrobial susceptibility and PFGE. A patient episode was counted at the time when MRSA was first isolated.Setting:A 1,350-bed university teaching hospital in Hong Kong.Patients:Those with clinical isolates of MRSA.Results:During 1989 to 2000, the hospital recorded 1,203,175 deaths and discharges (D&D) and encountered 5,707 patient episodes of new MRSA isolation. The overall incidence of patient episodes of MRSA was 0.47/100 D&D. In 1989, the incidence was 0.81/100 D&D and fell to a low of 0.33/100 D&D in 1995, but then rose to 0.50/100 D&D in 2000. Antibiogram and DNA typing identified 5 major types. PFGE type A constituted 68% (211/312) of isolates and was present throughout the 12-year period. PFGE type B constituted 13% (40/312) of isolates and was only present from 1995 to 2000. These isolates form a distinct clone and had unique antibiotic resistance profiles.Conclusions:The study showed the establishment of a dominant MRSA clone (PFGE type A group) in the intensive care, medical, and surgical units and the appearance of a new MRSA strain in 1995 (PFGE type B), which partly explained the rise in incidence of MRSA cases and a disproportionate rise in MRSA bacteremia from 1995 to 2000.

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Out-of-Hospital Cardiac Arrest in a Teaching Hospital in Hong Kong: Descriptive Study Using the Utstein Style

Hong Kong Journal of Emergency Medicine ◽

10.1177/102490790501200304 ◽

2005 ◽

Vol 12 (3) ◽

pp. 148-155 ◽

Cited By ~ 3

Author(s):

AKC Wai ◽

P Cameron ◽

CK Cheung ◽

P Mak ◽

TH Rainer

Keyword(s):

Cardiac Arrest ◽

Hong Kong ◽

Hospital Discharge ◽

Teaching Hospital ◽

Discharge Rate ◽

Demographic Data ◽

University Teaching ◽

Time Interval ◽

Utstein Style ◽

Hospital Cardiac Arrest

Objective To describe, using the Utstein template, the characteristics of patients presenting with out-of-hospital cardiac arrest to a university teaching hospital in the New Territories of Hong Kong, and to evaluate survival. Design Prospective study. Setting The emergency department of a teaching hospital in the New Territories, Hong Kong. Participants Patients older than 12 years with non-traumatic out-of-hospital cardiac arrest who were transported to the hospital between 1 July 2002 and 31 December 2002. Main outcome measures Demographic data, characteristics of cardiac arrest and response time intervals of the emergency medical service presented according to the Utstein style, and also survival to hospital discharge rate. Results A total of 124 patients were included (49.2% male; mean age 71.9 years). The majority of cardiac arrests occurred in patients' home. The overall bystander cardiopulmonary resuscitation (CPR) rate was 15.3% (19/124). The most common electrocardiographic rhythm at scene was asystole, whilst pulseless ventricular tachycardia (VT)/ventricular fibrillation (VF) was found in 18.0%. The overall survival was 0.8% (1/124), and survival to hospital discharge was significantly higher for patients with VF or pulseless VT than those patients with other rhythms of cardiac arrest (11.1% versus 0%). The median witnessed/recognised collapse to defibrillation time was 14 minutes. The median prehospital time interval from collapse/recognition to arrival at hospital was 33 minutes. Conclusion The prognosis of out-of-hospital cardiac arrest in Hong Kong was poor. Major improvements in every component of the chain of survival are necessary.

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