During the 1950s, Staphylococcus aureus became a major source of hospital infections and death, particularly in neonates. This situation was further complicated by the fact that Staphylococcus quickly gained resistance to most antibiotics. Controlling these infections was a pressing concern for hospital workers, especially bacteriologists who tackled it through the use of a new epidemiologic tool: phage typing. This article argues that during the mid- to late 1950s a series of staphylococcal hospital and nursery epidemics united phage typers, brought international recognition to the usefulness of their technique, and, in the process, contributed to the establishment of the new field of infection control. Through the use of this new tool, phage typers established themselves as experts in infection control and, in some places, became essential members of newly formed infection-control committees. The nursery epidemics represent a particularly important test for phage typing and infection control, for this staphylococcal strain (80/81) was especially virulent and spread rapidly beyond the hospital to the wider community. The epidemiologic information provided by phage typers was vital for devising practical advice on how to control this deadly strain of Staphylococcus and also for transforming the role of the hospital bacteriologist from mere technician into infection-control expert.
During a five-day period, four neonates in a neonatal nursery developed Campylobacter entercolitis. Investigations suggested that cross-infection or common-source infection were unlikely and that the neonates acquired their infection during delivery from their respective mothers, three of whom were also found to harbour Campylobacter jejuni in their stools. This suggestion was confirmed with use of the Lior serotyping system in a blind fashion. Each neonate was infected with a different serotype, and each of the three culture-positive mothers had the same serotype as her neonate. Examination of multiple colonies from the stools of five individuals showed that each was likely to have been infected by only one serotype. The presenting clinical features in the four neonates provides further evidence that neonatal Campylobacter entercolitis typically manifests as a benign, self-limited, nonfebrile, diarrheal illness with bloody stools.
A survey of 23 perinatal units in New Brunswick hospitals was conducted by means of a mailed questionnaire to determine the type of care provided to newborns. The results showed various degrees of conformity with published guidelines for the care of newborns. Deficiencies were noted in several areas of care: failing to give or improperly giving vitamin K1 prophylaxis (in 7 of the units), flushing the eyes after silver nitrate prophylaxis (in 10), using hexachlorophene to bathe newborns (in 11) and delaying the first feeding up to 12 hours (in 3). It is essential to provide appropriate support to newborns as they adjust to a new environment and to ensure that alternative practices are in keeping with current scientific knowledge.
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