NEONATAL STAPHYLOCOCCAL INFECTION

Abstract

The dynamics, consequences, and prevention of neonatal staphylococcal colonization were studied in San Salvador, El Salvador. The results indicate that: All untreated infants who resided in the hospital for more than 48 hours became colonized. Umbilical preceded nasal colonization in this group. An antiseptic skin care program effectively prevented colonization among treated infants in the hospital. Colonization in this group did occur in the first 3 months of life, but never to the extent found among the controls. Nasal preceded umbilical colonization in the treated group. Staphylococcal disease occurred four times as frequently in the control group as in the treated group and four times as often in males as in females. Initial staphylococcal colonization in mothers and family members of the two study groups and the non-staphylococcal disease experiences of both populations were essentially identical. Therefore, the differences in colonization rates and staphylococcal disease among the infants were probably due to the infant care program. Studies on the epidemiology of neonatal staphylococcal infection and disease in San Salvador were carried out from birth through the first 3 months of life. The phage-types and antibiograms of hospital- and community-derived strains differed widely from each other. The excess morbidity encountered in untreated infants was traceable almost entirely to hospitalacquired infections. The first strain acquired by an infant was not necessarily the disease-producing strain, and multiple sequential colonizations occurred among the infants and their mothers. All hospital-acquired strains persisted and declined at approximately the same rate throughout the study.