The epidemiology of Staphylococcus aureus in a newborn nursery from 1970 through 1976.

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.