Staphylococcus aureusin the infant upper respiratory tract: I. Observations on hospital-born babies

Abstract

Pernasal and throat swabs taken on 106 newborn babies showed that 99% harboured coagulase-positiveStaph. aureusby the time they left the hospital nursery. When the strains isolated from thirty-four of them were phage typed and tested for penicillin sensitivity, it was found that thirty-three (97%) carried at least one penicillin-resistant strain. Phage typing of their subsequent cultures, taken as they became older, demonstrated that they retained these strains for very long periods. Of the twenty-one still under observation at 6 months of age, eleven (53%) were carrying one or more of their original hospital strains, and an additional three (14%) still were consistently yielding an untypable strain believed to be identical to that acquired in hospital. Similarly, of those remaining under observation for the last 6 months of their first year, at least 50% continued to carry their hospital strains.These babies frequently retained the hospital strains in their throats longer than in their noses. Although their nasal cultures often became negative after the first few months of life, the original hospital strains continued to be recovered from the throats. This would indicate that the throat culture is more accurate than the nasal culture in determining staphylococcal carriers among this age group. Antibiotic-resistant staphylococci in the infant throat may have considerable epidemiological significance, since babies tend to widely distribute their saliva.The observations suggest that the staphylococci acquired at birth become a normal component of the upper respiratory flora, and may thus prevent new strains of staphylococci from becoming established later. This may explain why newborn babies retain the antibiotic-resistant staphylococci of the hospital much longer than do adult patients. Antibiotic-resistant strains among the general non-hospital population will be increased steadily by babies born in hospitals.

Antibiotic resistant staphylococci acquired during the first year of life

“…aureus on these two occasions was associated more frequently than could be explained by chance even though the organisms were usually of different phage types. This confirms the observations of 129 9 HYG 8Ic Hurst (1957) that 'babies who do not become carriers within the first 2 months of life are unlikely to do so later'. It also suggests that the carrier state is not necessarily dependant upon the type of Staph.…”

“…aureus in their noses, and the majority of these bacteria were resistant to penicillin (Barber et al 1953;Hurst, 1957;Williams, 1961). It was suggested that 'antibiotic-resistant strains among the general non-hospital population will be increased steadily by babies born in hospital' (Hurst, 1957). In 1962 Miller, Galbraith & Green endeavoured to relate the carriage of resistant staphylococci to the recent history of the subjects concerned and concluded that admission to hospital was the major factor.…”

Transmission of Infectious Diseases Through Breast Milk and Breastfeeding

“…193 By the fifth day of life, 40% to 90% of the infants in the nursery will be colonized with S. aureus. Localized infection can be impetigo, pustulosis in neonates, cellulitis, or wound infection, and invasive or suppurative disease includes sepsis, pneumonia, osteomyelitis, arthritis, and endocarditis.…”

Nasal staphylococci in children – a follow-up study

“…The results obtained at 5 years were compared with those from the same children when they were swabbed the first time and also at one year, since it has been suggested (Hurst, 1957) that 'babies who do not become carriers within the first two months of life are unlikely to do so later'. In fact there was little relationship between the results of the swabs taken during the first year of life and those at five years.…”