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Staphylococcus aureus Colonization and Infection After Discharge from a Term Newborn Nursery

Published online by Cambridge University Press:  02 January 2015

Elaine E.L. Wang*
Affiliation:
McMaster University Medical Centre, Hamilton, Ontario, Canada
Diane Elder
Affiliation:
McMaster University Medical Centre, Hamilton, Ontario, Canada
Norma Mishkel
Affiliation:
McMaster University Medical Centre, Hamilton, Ontario, Canada
*
Division of Infectious Disease, Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, CanadaM5G 1X8

Abstract

During a 6-month period, term infants underwent nasal and umbilical swabbing within 96 hours of delivery and again at 1 to 18 (mean 3.8) weeks after discharge. Swabs were inoculated onto horse blood agar and all S aureus isolates were phage typed. Two hundred three infants were enrolled and follow-up was obtained for 181 (89%). Thirty-two of 181 (17.6%) were initially colonized, of whom 12 (37.5%) were colonized on follow-up. Thirty-two of 181 became colonized subsequent to hospital discharge. No single phage type predominated. Twenty-five patients were diagnosed to have clinical illness—omphalitis (11), conjunctivitis (10), and pustulosis (5). Six of these were colonized with 5 aureus initially, although organisms of the same phage type were not recovered from cultures obtained at the time of clinical illness. There was no significant difference in the rate of infections in colonized (19%) versus noncolonized (12%) infants. In five patients where S aureus was recovered at the time of symptoms, all organisms were acquired subsequent to discharge. We conclude that nursery colonization with S aureus did not lead to clinical illness, and clinical illnesse s previously ascribed to S aureus frequently occur in the absence of these bacteria.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1987

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References

1.Gooch, JJ, Britt, EM: Staphylococcus aureus colonization and infection in newborn nursery patients. Am J Dis Child 1978; 132:893896.Google Scholar
2.Haley, RW, Bregman, DA: The role of understanding and overcrowding in recurrent outbreaks of staphylococcal infection in a neonatal special-care unit. J Infect Dis 1982; 145:875885.CrossRefGoogle Scholar
3.Lagercrantz, R, Nystrom, B, Wretlind, B: Staphylococci and infection in maternity wards. IV. Studies in a partial rooming-in system. Acta Paediatr Scand 1973; 62:621624.Google Scholar
4.Hargiss, C, Larson, E: The epidemiology of Staphylococcus aureus in a newborn nursery from 1970 through 1976. Pediatrics 1978; 62:348353.Google Scholar
5.Gillespie, WA, Simpson, IC, Tozer, RC: Staphylococcal infection in a maternity hospital: Epidemiology and control. Lancet 1958; 2:19751980.Google Scholar
6.Albert, S, Baldwin, R, Czekajewski, S, et al: Bullous impetigo due to group II Staphylococcus aureus. An epidemic in a normal newborn nursery. Am J Dis Child 1970; 120:1013.Google Scholar
7.Najem, GR, Riley, HD, Ordway, NK: Clinical and microbiologic surveillance of neonatal staphylococcal disease. Relationship to hexachlorophene whole-body bathing. Am J Dis Child 1975; 129:297302.Google Scholar
8.Campbell, AGM, Pitkewicz, JS: The incidence of infection in nurseries since the discontinuation of hexachlorophene bathing. Pediatrics 1972; 52(Suppl):360367.Google Scholar
9.Gluck, L, Wood, HF: Effect of an antiseptic skin care regimen in reducing staphylococcal colonization in newborn infants. N Engl J Med 1961; 265:11771181.Google Scholar
10.Katzman, GH: Effect of triple dye in a staphylococcal outbreak. Pediatr 1975; 86:313314.Google Scholar
11.Stratford, BC: The investigation and treatment of superficial staphylococcal infections. Med J Aust 1963; 1:308312.Google Scholar
12.Wolinsky, E, Lipsitz, PJ, Mortimer, EA, et al: Acquisition of staphylococci by newborns: Direct versus indirect transmission. Lancet 1960; 2:620622.Google Scholar
13.Mortimer, EA, Wolinsky, E, Gonzaga, AJ, et al: Role of airborne transmission in staphylococcal infection. Br Med J 1966; 1:319322.Google Scholar
14.Smith, DH: Epidemics of infectious diseases in newborn nurseries. Clin Obstet Gynecol 1979; 22:409423.Google Scholar
15.Czarlinsky, DK, Hall, RT, Barnes, WG, et al: Staphylococcus colonization in a newborn nursery, 1971-1976. Am J Epidemiol 1979; 109:218225.Google Scholar
16.Infection Control in the Hospital, ed 4. Chicago, American Hospital Association, 1979; pp 122-124,153154.Google Scholar
17.Burr, ML, Howells, CHL, Rees, PWJ: Antibiotic resistant staphylococci acquired during the first year of life. J Hyg 1978; 81:125130.Google Scholar
18.Blair, JE, Williams, REO: Phage typing of staphylococci. Bull WHO 1961; 24:771784.Google Scholar