A prospective study of staphylococcal infection and its prevention among infants and mothers after childbirth in hospital and at home

An evaluation of antiseptics used for hand disinfection in wards

The antibacterial effectiveness of hand antiseptics commonly used in wards was studied by laboratory and in-use tests and their acceptability assessed by means of a questionnaire passed to hospital staff. To determine the immediate and long-term antibacterial effects of the preparations the in-use tests were performed by groups of students. The greatest immediate reduction in bacterial counts on hands was obtained by products containing chlorhexidine. The long-term antibacterial effect was recorded with emulsions containing 3% hexachlorophane, 2% Irgasan CF3R or 4% chlorhexidine when used constantly on several consecutive days. Considerable discrepancies were recorded in the antibacterial effectiveness of some preparations when comparing laboratory and in-use test results. Therefore it is suggested that antiseptics should be tested by in-use tests which more closely resemble practical conditions before their use, or further trial, in hospital.

Absorption of hexachlorophane from dusting powder on newborn infant's skin

In a maternity hospital in which the umbilicus and trunk of healthy newborn infants were treated with 0.33% hexachlorophane dusting powder, the hexachlorophane content of blood was measured in mothers before delivery, in infants' umbilical samples at birth, and at 8 days of age in capillary blood samples. One mother and her baby had rather high blood concentrations of hexachlorophane, probably derived from a toilet preparation used before admission to hospital. Hexachlorophane was absent or barely detectable in the other mothers' blood and in the infants' umbilical blood. The hexachlorophane concentrations in the blood of 8-day-old infants ranged from nil to 0.166 mug./ml. (mean 0.066 mug./ml.). These were much less than the concentrations reported to be toxic in animals.In a previous trial now reported here, a dusting powder containing chlorhexidine instead of hexachlorophane was found to delay the separation of the umbilical cord.

From Phisohex to Hibiscrub

In a field trial of three disinfectant-detergent preparations for the surgical scrub Hibiscrub (a 4% chlorhexidine detergent solution) maintained a significantly greater residual antibacterial action on the skin of the gloved hands of an operating team than was obtained with Disadine (povidone-iodine detergent preparation) (P<0.001). In comparison with Phisohex (3% hexachlorophane in detergent cream), the established surgical scrub of the operating team for many years, Hibiscrub maintained marginally more significant residual disinfection (P 0.05). Of the three preparations the members of the team found Hibiscrub to be more acceptable for use than either Disadine or Phisohex.

Control at hospital level of infections by methicillin-resistant staphylococci in children

Rapid spread of methicillin-resistant staphylococci (MeRS) in a children's hospital is described. Within 4 months of the first isolation MeRS had been isolated from infections in all clinical units. MeRS were also regularly isolated at the out-patient department. Protective isolation of one of the clinical units had no effect on the infection rate by MeRS. The use of antiseptics (Hexachlorophene and chlorhexidine) and gentamicin nose cream in children and staff members in three out of five clinical units resulted in a significant reduction of the prevalence of nose colonization by MeRS in children. In staff members a non-significant reduction of the prevalence of colonization and a significant reduction of the acquisition of MeRS was found. After a few months the infection rate decreased to zero in the units where the measures were introduced. It remained unchanged in the other units. Phage typing of two sets of strains collected at an interval of 6 months showed that the infections were mainly caused by two endemic strains of MeRS. The majority of the infections caused by MeRS was of minor importance. In 16% of the infections a strain was isolated repeatedly and for more than 1 week. After the introduction of antiseptics a relative increase of infections by Gram-negative bacteria was observed. The significance of this phenomenon is discussed.