Comments from Website
author: Of all of the articles, this one is the most compelling for
the argument that silver has potentially superior antimicrobial
properties. Note that this research is done by the CDC,
themselves!
Comments from Physicians at
this article's end: None
Outbreak of erythromycin-resistant
staphylococcal conjunctivitis in a newborn nursery.
Pediatr Infect Dis J 9: 268-73
(1990)[90245496]
Division of Field Services, Centers for Disease Control,
Atlanta, Georgia.
Abstract
We investigated an outbreak of erythromycin-resistant
Staphylococcus aureus conjunctivitis in a hospital newborn
nursery that used erythromycin eye ointment to prevent
ophthalmia neonatorum. Cases occurred in 2 clusters; 20 (14%)
of 146 infants in the nursery developed conjunctivitis from
July through October, 1987; and 5 (7%) of 69 infants in the
nursery developed conjunctivitis during April and May, 1988.
A case-control study of the first cluster demonstrated that
culture-confirmed cases were more likely than controls to
have received prophylactic erythromycin eye ointment or their
initial bath from one nurse (odds ratio, 9.0; P = 0.01) or to
have been delivered by one physician (odds ratio, 12.7; P =
0.03). The nurse was the only staff person to have a
nasopharyngeal culture which yielded erythromycin-resistant
S. aureus. Control measures,
instituted in October, 1987, included using silver nitrate
drops instead of erythromycin eye ointment for prophylaxis;
however, in January, 1988, the hospital resumed use of
erythromycin eye ointment. No additional cases were
identified until mid-April, 1988, when the second cluster of
cases occurred. At that time the hospital reinstituted the
use of silver nitrate and no additional cases were
identified. This investigation illustrates
the potential for conjunctival infection with an
antimicrobial-resistant pathogen when antimicrobials are used
to prevent ophthalmia neonatorum.
Authors:
K. Hedberg, T. L. Ristinen, J. T. Soler, K. E. White, C. W.
Hedberg, M. T. Osterholm & K. L. MacDonald
MeSH Terms:
Administration, Topical, Case-Control Studies, Cluster
Analysis; Conjunctivitis, Bacterial/epidemiology; Conjunctivitis,
Bacterial/microbiology; Conjunctivitis, Bacterial/prevention
& control; Conjunctivitis, Bacterial/transmission; Cross
Infection/epidemiology, Cross Infection/microbiology, Cross
Infection/prevention & control, Cross Infection/transmission,
Disease Outbreaks*/prevention & control; Drug Resistance,
Microbial; Erythromycin/administration & dosage,
Erythromycin/pharmacology, Female; Hospitals, Community; Human,
Infant, Newborn, Male, Microbial Sensitivity Tests,
Minnesota/epidemiology; Nurseries, Hospital; Risk Factors,
Staphylococcal Infections/epidemiology, Staphylococcal
Infections/microbiology, Staphylococcal Infections/prevention
& control, Staphylococcal Infections/transmission,
Staphylococcus aureus/isolation & purification,
Staphylococcus aureus/physiology
Substances:
Erythromycin