Comparison of hexachlorophane and chlorhexidine powders in prevention of neonatal infection.

The protective effect of treating the skin of newborn infants with powders containing 1% chlorhexidine or 0.33% hexachlorophane was compared. Each was equally effective in preventing colonisation and infection by Staphylococcus aureus. In contrast, the skin became profusely colonised by coagulase-negative staphylococci, irrespective of the powder used. Venous blood concentrations of chlorhexidine were low or undetectable in the few infants whose blood was analysed.

Pyogenic cocci in infantile eczema throughout one year.

To determine the source of pyococci causing attacks of sepsis in infantile eczema 20 patients with continuing eczema were followed up for one year, regular swabs being taken from the skin, nose, throat, and family contacts. The staphylococci were phage typed and the streptococci serologically typed. Staphylococci of the same phage type in most cases remained in reservoir sites on the skin and coincidently in the nose. Staphylococci causing attacks of clinical sepsis arose from these persistently colonized sites. Staphylococci of the same phage type were also common in family contacts. Streptococci of the same group in most cases did not remain on the skin. Streptococci causing attacks of clinical sepsis arose as new infections from external sources, sometimes from throat infections in the patient or family contacts. Strains of streptococci which are known to be associated with glomerulonephritis were isolated. It has been confirmed that staphylococci resistant to neomycin and sodium fusidate quickly emerge after the topical use of these antibiotics. Streptococci are highly resistant to neomycin and gentamicin, and moderately resistant to sodium fusidate, so the use of these antibiotics in topical steroid preparations will have little effect in preventing further attacks of clinical sepsis in these patients.

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.

Disinfection of cystoscopes by subatmospheric steam and steam and formaldehyde at 80 degrees C.

A new method of disinfection adapted for endoscopic instruments uses low temperature steam at 80 degrees C or steam and formaldehyde at 80 degrees C. The process has considerable advantages over existing methods and more closely approaches the ideal requirements.

Changes in the drug resistance of Staphylococcus aureus in a non-hospital population during a 20-year period.

The antibiotic resistance of Staphylococcus aureus isolated in Bristol from primary skin sepsis and nasal carriers outside hospital was recorded between 1949 and 1969. The proportion of penicillinase-forming strains rose to about 60% but resistance to other antibiotics remained un-common except for a peak about 1957, due to the spread of multiresistant phage-type 80 staphylococci. Reasons are discussed for the failure of other multiresistant staphylococci to increase outside hospital.Recently isolated strains from inside and outside hospital were tested with sulphonamide and trimethoprim. All were sensitive to trimethoprim but 5% of non-hospital strains and 40% of hospital strains were resistant to sulphonamide. It is suggested that sulphonamide-resistant staphylococcal infections should not be treated with sulphonamide-trimethoprim mixtures because of the risk of breeding trimethoprim-resistant strains.