Læknablaðið - 15.02.1980, Qupperneq 21

LÆKNABLADID
9
Það er sameiginleg reynsla á nýburadeilð-
um víða um heim, að blöðrubóla ungbarna
skjóti upp kollinum af og til prátt fyrir
hefðbundnar vinnureglur til að draga úr út-
breiðslu klasasýkla. Fremur ólíklegt er, að
takast megi að útrýma pessum kvilla, en ef til
vill verður minna unt hann, ef nýburar fá að
dveljast að mestu hjá mæðrum sínuni, en sé
ekki hópað saman á nýburastofum, par sem
starfsfólk handfjatlar hvern peirra af öðrum.
Slík samsöfnun er pó óhjákvæmileg á vöku-
deilduni nýbura, en urn pær streymir, auk eigin
starfsfólks og nenta, fjöldi fólks frá öðrum
deildum viðkomandi sjúkrahúss og pví margar
smitleiðir mögulegar.
SUMMARY
Staphylococcal disease in newborns has been repor-
table in lceland since 1962. That year 27 cases were
reported, scattered over 10 districts of the country.
The prevalence gradually increased, reaching a peak
of 83 cases in 1969, of which 73 occurred at 2 small-
town hospitals. At the newborn nurseries of Land-
spítalinn, Reykjavík, there were epidemics of this
disease on and off until 1960, when hexachlorophe-
ne bathing of infants was instituted. After that only
a few cases were recorded annually until 1975, when
7 cases were recorded. During the first half of 1976
27 cases occurred. Due to this epidemic an investi-
gation was made, starting in the fall of 1976. The
rate of nasal carriage of staph. aureus antong the
obstetrical staff was 24 %, but among the staff of
ICU for newborns which opened in Feb. 1976, it was
57 %. The rate of nasal acquisition of staph. aureus
by the babies of ICU and normal newborns was
similar, beginning around the 5th day after birth,
and reached nearly 50 % by day 7 (the usual day of
discharge). Phage typing of 102 staphylococcal
strains collected during this investigation was per-
formed by the Central Lab. for phage typing,
Copenhagen. The prevalent strain from infectious
lesions of the babies was of phage type 3A/3C/±55.
The same phage type was found in nasal swabs from
20 newborns, 2 samples from their surroundings, 2
finger samples from staff and 1 nasal swab from a
staff member who was not one of the permanent
staff of the ICU for newborns.
The epidemic dwindled off in the spring of 1977,
but a new epidemic occurred in the spring of 1978.
Hexachlorophene bathing has never been dis-
continued in the newborn nurseries of Landspítal-
inn, although now practised with caution.
HEIMILDIR
1. Amcrican Academy of Pediatrics, Committee on
Fetus and Newborn: Skin Care of Newborns.
Pediatrics 54:682, 1974.
2. Benenson, A. S. ed: Control of Communicable
Diseases in Man, 11th ed. New York: American
Public Health Association, bls. 233, 1970.
3. Center for Disease Control: Morbidity and
Mortality Weekly Rep. 21 (5): 37, 1972.
4. Cook, J„ Parrish, J. A. and Shooter, R. A.:
Asquisition of staph. aureus by newborn babies
in a hospital maternity department. B. M. J. 11.
jan., 74, 1958.
5. Curdley, A„ Hawk, R. E„ Kimbrough, R. D„
Nathanson, G. and Finberg, L.: Dermal absorp-
tion of hexachlorophene in infants. Lancet, 7.
ágúst, 296, 1971.
6. Difco Supplementary Literature, maí 1972: Coa-
gulase Plasmas.
7. Finland, M.: Epidemic character of staphylococ-
cal infections. Modern Medicine, 38, 22. jan„
1975.
8. Forfar, J. O., Maccabe, A. F.: Masking and
gowning in nurseries for the newborn infant.
Effect on staphylococcal carriage and infection.
B. M. J. 11. jan„ 76, 1958.
9. Hare, R. and Ridley, M.: Further studies on the
transmission of staph. aureus. B. M. J. 11. jan„ 69,
1958.
10. Lowbury, E. J. L„ Ayliffe, G. A. J„ Geddes, A. M„
Williams, J. D.: Control of Hospital Infection
(Kafli: Special Wards and Departments) Chap-
man and Hall 1975.
11. Magnús L. Stefánsson, barnalæknir, Akureyri:
Persónul. uppl.
12. Noblc, W. C.: The dispersal of staphylococci in
hospital wards. J. Clin. Path., 15: 552, 1962.
13. Noble, W. C. and Davies, R. R.: Studies on the
dispersal of staphylococci. J. Clin. Path., 18: 16,
1965.
14. Ólafur Steingrímsson. Erla Sigvaldadóttir, Krist-
ín Jónsdóttir, Arinbjörn Kolbeinsson: Lyfja-
næmi staph. aureus. Læknablaðið 64. árg. 3. tbl.
1978.
15. Parker, M. T.: Phage typing of staphylococcus
aureus í: Methods in Microbiology vol. 78, 2-28,
ed. by Norris, J. R. and Ribbons, D. W. Academic
Press 1972.
16. Ransjö, U.: Isolation Care of Infection-prone
Burn Patients. Scan. J. of Infectious Diseases,
Supplementum 11, 1978.
17. Shuman, R. M„ Leech, R. W. and Ellsworth, A.
C. : Neurotoxicity of hexachlorophene in the
human: A clinicopathological study of 248
children. Pediatrics, 54: 689, 1974.
18. Simon, H. J„ Allwood-Paredes, J„ Trejos, A.:
Neonatal staphylococcal infection. Pediatrics,
35: 254, 1965.
19. Williams, R. E. O.: Healthy carriage of staphylo-
coccus aureus: Its prevalence and importance.
Bactriol. Review, 27: 56-71, 1963.
20. Wolinsky, E„ Lipsitz, P„ Mortimer, E„ Rammel-
kamp, C.: Asquisition of staphylococci by new-
borns. Direct versus indirect transmission. Lan-
cet. 17. sept., 620, 1960.