NURSERY ROUTINES AND STAPHYLOCOCCAL COLONIZATION OF THE NEWBORN

Abstract

Staphylococcal colonization was studied in a newborn nursery for 6½ years. Culture of the nares of each infant at the time of discharge was found to be a simple, effective monitor. The average rate of 4.1% demonstrates that a low rate can he maintained for an extended period of time. Hexachlorophene bathing of infants and handwashing by personnel between the handling of infants appear to be the critical elements of staphylococcal control. Neither the modification of infant bathing to the extent of deferring the initial bath until the attainment of thermal homeostasis, nor of handwashing to the extent of eliminating brushes resulted in increased colonization. It was also possible to eliminate certain traditional elements of nursery routine-the wearing of caps, masks, hair nets, and gowning except when handling an infant outside an incubator-and to allow medical students and parents fret access to the nurseries, all without an increase in colonization. Elaborate nursery precautions are not only expensive but may also discourage physicians from giving optimal care to ill infants; judicious changes in nursery technique may be made, as long as there is careful surveillance of bacterial colonization and infection.