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Importance of the environment and the faecal flora of infants, nursing staff and parents as sources of Gram-negative bacteria colonizing newborns in three neonatal wards

Bedeutung der Stationsumgebung und der Darmflora der Neugeborenen, des Pflegepersonals und der Eltern für die Kolonisation Neugeborener mit gramnegativen Bakterien. Untersuchung auf drei Neugeborenenstationen

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Summary

Gram-negative bacteria are an important cause of invasive infection among neonates. In this study a novel fingerprinting method was used for the first time to assess the importance of various potential reservoirs of the major gram-negative enterobacteria that colonized 46 consecutive infants in three neonatal special care units during a three to four week period. Such bacteria were isolated from the oropharynx, umbilical cord and faeces in 24%, 33% and 100% of the infants, respectively.Klebsiella/Enterobacter spp. dominated overEscherichia coli and spreading (shared) over sporadic strains. Sixty-one percent of the neonates were colonized with at least one and up to six different strains shown to exist in the ward, mainly in other infants. Environmental reservoirs and the faecal flora of mothers and staff were of minor importance. Vertical transmission occurred in 12% of vaginally delivered infants and in 0% of those delivered by caesarean section.

Zusammenfassung

Gramnegative Bakterien sind wichtige Erreger invasiver Infektionen bei Neugeborenen. In der vorliegenden Studie wurde erstmals eine moderne Fingerprint-Methode eingesetzt, um die Bedeutung verschiedener möglicher Reservoirs für die Besiedelung durch Enterobakterien zu bestimmen. In drei Neugeborenen-Spezialstationen wurden während vier Wochen Untersuchungen bei 46 nacheinander aufgenommenen Neugeborenen durchgeführt. Aus dem Oropharynx, der Nabelschnur und den Faeces der Kinder wurden in 24%, 33% und 100% Enterobakterien isoliert.Klebsiella/Enterobacter spp. waren häufiger nachzuweisen alsEscherichia coli. Stämme, die sich ausgebreitet hatten, waren häufiger als sporadische Stämme. 61% der Neugeborenen waren mit bis zu sechs Stämmen besiedelt, die sich in der Stationsumgebung, vor allem aber auch bei den anderen Neugeborenen nachweisen ließen. Die Umgebung und die Stuhlflora der Mütter und des Pflegepersonals waren von geringerer Bedeutung. Eine vertikale Übertragung erfolgte bei 12% der vaginal entbundenen Neugeborenen und bei keinem der durch Sectio entbundenen Kinder.

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Authors and Affiliations

  1. Dept. of Bacteriology, National Bacteriological Laboratory, S-105 21, Stockholm

    Birgitta Fryklund R. N., Birgitta Berglund & L. G. Burman M. D., Ph. D.

  2. Dept. of Paediatrics, St. Göran's Children's Hospital, S-112 81, Stockholm, Sweden

    K. Tullus M. D., Ph. D.

Authors
  1. Birgitta Fryklund R. N.
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  2. Birgitta Berglund
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  3. L. G. Burman M. D., Ph. D.
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  4. K. Tullus M. D., Ph. D.
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Fryklund, B., Berglund, B., Burman, L.G. et al. Importance of the environment and the faecal flora of infants, nursing staff and parents as sources of Gram-negative bacteria colonizing newborns in three neonatal wards. Infection 20, 253–257 (1992). https://doi.org/10.1007/BF01710789

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