III. Bacterial Contamination of the Umbilicus

Abstract

In December 1957, two cases of omphalitis occurred in one of the nurseries. Hemolytic streptococcus and S. aureus were isolated from the umbilicus in each case. These findings prompted us to take umbilical swabs from all the babies in the two nurseries on the same ward. Table XIX shows that on this occasion 83% of the 23 cords sampled were contaminated with Hemolytic streptococcus and 78% with S. aureus. When it was noted that such a high percentage of cords were contaminated with pyogenic streptococci and staphylococci, it was decided to treat all babies by painting the cords once daily with aqueous benzalkonium, Zephiran®, (1:1000). After this procedure had been in use for 5 weeks, surveys showed that 67% of 57 infants' cords still carried Hemolytic streptococcus and 68% carried S. aureus (Table XIX). As the Zephiran® treatment had not reduced the number of either streptococci or staphylococci appreciably, triple-dye was applied daily to the cord stumps (Jellard, J.:Brit. M. J., 1:925, 1957). With this method, although streptococci and staphylococci were not immediately eliminated, the results after 6 weeks showed a low rate of contamination (Table XIX). Although not shown in the Table, on the occasion of our last survey, when 31 cords were sampled, no streptococci were recovered. The presence of such a high degree of streptococcal cord contamination was disturbing. An explanation for this was sought by attempting to locate streptococcal throat-carries amongst the nursery personnel. However, pyogenic streptococci were not recovered from their throats. No case of streptococcal puerperal sepsis had been reported from the maternity wards of the hospital for more than a year.