Observations on the Bacteriology and Epidemiology of Nursery Infections

Abstract

THE STUDY of the control of skin infections of the newborn infants was started in the winter of 1948-49, when the incidence of pyoderma neonatorum in the nurseries of the Vancouver General Hospital reached a rate of 121 cases per 1000 live-births. At that time the nursery techniques were improved and there was a change from "dry" skin care to the application of 1% ammoniated mercury ointment. This did not prove to have a lasting beneficial effect. From January 1, 1948 until April 30, 1952, the incidence of pyoderma varied in a most unpredicted manner. From May 1, 1952 until December 31, 1956, various methods of skin care were used experimentally to determine the effect of these on the pyoderma rate in the nurseries. During these observations, a study was made of various other aspects of the epidemiology of pyoderma neonatorum: 1. Studies of staphylococcal contamination of the environment. a) Nasal carrier rate of infants, mothers, nurses and other personnel. b) Nursery air. c) The intact skin of normal infants versus infants with pyoderma. d) Mothers' hands and bedding. e) Nurses' hands and gowns. f) Babies' tubs and bedding. 2. Identification by phage-typing and antibiotic resistance of the organisms isolated. a) From pustules. b) From nasal carriers. 3. Observation of the cytology of exudate from pustules (bacterial and nonbacterial). THE NURSERIES In the Women's Pavilion of the Vancouver General Hospital are six regular nurseries providing from 21.0 to 31.0 square feet per bassinet. The number of bassinets per nursery ranges from 12 to 22. The daily census shows that the per cent of occupancy ranges from 61 to 81.