Staphylococcus aureusColonization and Infection After Discharge from a Term Newborn Nursery

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.

Role of antimicrobial applications to the umbilical cord in neonates to prevent bacterial colonization and infection: a review of the evidence

“…Elsewhere, comparing S. aureus-colonized and noncolonized neonates, there was a 75% increased risk of infection among colonized compared with noncolonized infants, but this result was also not statistically significant (OR 1.75; 95% CI 0.51, 5.22). 26 In other studies in which omphalitis or other skin infections in neonates have been secondary outcomes, statistical power to detect differences in infection rates has been inadequate. 9, 17, 22…”