Clinical and Microbiologic Surveillance of Neonatal Staphylococcal Disease

Najem, G. Reza; Riley, Harris D.; Ordway, Nelson K.; Yoshioka, Hajime

doi:10.1001/archpedi.1975.02120400013003

Cited by 7 publications

(2 citation statements)

References 18 publications

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“…1,28 In other circumstances, cessation of hexachlorophene bathing was associated with a subsequent outbreak or at least significant increases in colonization. 10,23,29,30 The importance of professional staff carriage of the epidemic strain has been emphasized on a number of occasions. 8,25,[31][32][33][34][35][36][37] In studies of old, the finding of commonality has most often depended on phage typing of outbreak and staff carrier isolates.…”

Section: Risk Factors For Acquisitionmentioning

confidence: 99%

“…As is usual in uncontrolled studies, it is possible that the introduction of handwash agents is also associated with several other changes in practice that too may have some effect. Hexachlorophene bathing of the newborn proves to be an effective method to reduce skin colonization, 29,30,33,35,45,46,75 but concerns about hexachlorophene toxicity have prevented many from xviii. Antibiotic prophylaxis continuing such a practice.…”

Section: Measures For Controlmentioning

confidence: 99%

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Staphylococcus aureusOutbreaks Among Newborns: New Frontiers in an Old Dilemma

2003

Am J Perinatol

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The acquisition of Staphylococcus aureus by the newborn in the early neonatal period is common. Most such acquisitions are not followed by infection, although the potential for serious infection increases in the intensive care unit setting. Attack rates for infection are quite variable, but outbreaks have occurred on many occasions. Although some bacterial virulence factors, such as exfoliative toxins, are associated with outbreaks, most epidemic strains do not have well-defined virulence factors that can be incriminated. There are many possible control measures, but the implementation of these are balanced by the existing circumstances and perceived cost. As methicillin-resistant S. aureus (MRSA) becomes endemic in hospital settings, these bacteria are becoming much more common in nursery outbreaks. Over time, antibiotic selection and enhanced disease causation will lead to the evolution of hypervirulent MRSA clones. The latter will become an increasing problem unless effectively controlled.

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Section: Risk Factors For Acquisitionmentioning

confidence: 99%

Section: Measures For Controlmentioning

confidence: 99%

Staphylococcus aureusOutbreaks Among Newborns: New Frontiers in an Old Dilemma

2003

Am J Perinatol

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Staphylococcus aureus Colonization and Infection in Newborn Nursery Patients

Gooch¹,

Britt²

1978

Arch Pediatr Adolesc Med

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\s=b\The correlation between Staphylococcus aureus colonization and infection among newborns was studied during a four-year period. Of the 9,423 newborns cultured, 24% were colonized at the time of discharge and in 2% of these an infection developed, whereas only 0.2% of the noncolonized newborns experienced a staphylococcal infection. The weekly colonization rates ranged from 0% to 62%, and outbreaks of infections (two or more concurrent) occurred periodically when the colonization rates ranged from 11% to 57%. Colonization rates per se did not serve as an indicator of an actual or potential outbreak of infection. Instead, the occurrence of two or more concurrent cases of staphylococcal infection or presumptive evidence of an outbreak seems to be a more reliable indicator than colonization monitoring.(Am J Dis Child 132: [893][894][895][896] 1978) The newborn who becomes colo¬ nized with Staphylococcus aureus after birth is more likely to have a staphylococcal infection develop than one who is uncolonized.1"7 Because of this, effective control of staphylococ¬ cal colonization in the newborn has become an integral component of infection control in the hospital nur¬ sery. During the past several years, considerable effort has been devoted to the development of techniques for controlling staphylococcal colonization among newborns."1' One such proce¬ dure is that of staphylococcal coloniza¬ tion surveillance. Staphylococcal col¬ onization surveillance was initiated in an effort to recognize any sudden increase in the staphylococcal coloni¬ zation rate and to permit prompt remedial action before a severe epi¬ demic could develop. The effective¬ ness of this infection surveillance procedure was studied over a fouryear time period by analyzing S aureus colonization rates and their influence on the development of nursery-acquired infections among newborns. METHODS Nursery RoutinesDuring the four-year study period, admissions to the nursery averaged 2,300 newborns per year; the average stay was four days. The nursery was situated on the top floor of a 558-bed community-teaching hospital adjacent to the delivery suites and the obstetrical ward. Traffic into the nursery was restricted. The nursery was organized into a cohort system of two small nurseries each admitting 20 consecutive newborns directly from the delivery room. Premature infants or those who were high risk or ill at birth were admitted to the "premie" nursery rather than the general nursery. The newborns remained in their respective cohorts until discharged. At¬ tempts were made to have nursing person¬ nel limit their work to one of the cohort groups during a given shift, but because of the large number of newborns and limited staff, the nurses often worked in both areas.All nursery personnel followed routine nursery technique. This included a threeto five-minute hand scrubbing with 3% hexachlorophene on entering the nursery and a hand washing with the same prepa¬ ration before and after each infant contact.Nurses working full-time in the nursery wore scru...

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