Related Experiment Videos
The epidemiology of Staphylococcus aureus in a newborn nursery from 1970 through 1976
Insights
Discontinuing hexachlorophene (HCP) bathing led to increased Staphylococcus aureus colonization and infection rates in newborns. Improved staff technique and routine umbilical care are recommended for control.
Area of Science:
- Neonatal epidemiology
- Infectious disease surveillance
- Public health microbiology
Background:
- Follow-up study on Staphylococcus aureus (S. aureus) in a newborn nursery, building on 1961-1968 data.
- Previous research highlighted S. aureus epidemiology in neonatal settings.
Purpose of the Study:
- To present results of seven years of epidemiologic surveillance for S. aureus in a newborn nursery (1970-1976).
- To analyze trends in S. aureus colonization and infection rates following changes in bathing practices.
Main Methods:
- Epidemiologic surveillance of S. aureus colonization and infection in a newborn nursery over seven years.
- Culturing of umbilical and anterior nares sites.
- Analysis of S. aureus antibiotic sensitivity patterns and phage types.
Main Results:
- S. aureus colonization rates increased from 1973-1976, primarily linked to the discontinuation of hexachlorophene (HCP) bathing.
- Clinical infection rates also significantly increased when HCP bathing was not used.
- Antibiotic sensitivity patterns remained consistent; five recurrent phage types caused infections.
Conclusions:
- Discontinuation of HCP bathing is a major factor in rising S. aureus rates in nurseries.
- Recommended control measures include improved staff hygiene, continuous surveillance, and routine umbilical care.
- HCP bathing should be a temporary measure for acute staphylococcal disease control.
Abstract:
Results of seven years of epidemiologic surveillance for Staphylococcus aureus in a newborn nursery are presented as a follow-up of a study from this same institution published in 1969. Surveillance of the previous study included years 1961 through 1968. A continued rise in S. aureus colonization rates among newborns occurred from 1973 through 1976 as compared to previous years studied. This was related primarily to the discontinuance of hexachlorophene (HCP) bathing. Other contributing factors were the addition in 1972 of the umbilical (as well as anterior nares) site for culturing, potentially doubling the S. aureus retrieval; the use, beginning in 1972, of an HCP-inhibiting medium for staphylococcal culturing; and probably the presence in previous years of the Hawthorne effect. Clinical infection rates with S. aureus also increased significantly (P less than .001)when HCP bathing was in abeyance. Antibiotic sensitivity patterns of S. aureus isolated from 1970 through 1976 have remained the same. Five phage types were recurrent in causing clinical infections throughout the seven years. A recommended program for control of staphylococcal disease in the newborn nursery includes concentration on improvement of each staff member's individual technique, continuous epidemiologic surveillance, and routine umbilical care with triple dye or bacitracin. Bathing of infants with HCP should be considered a temporary treatment to be terminated as acute disease is controlled.