Dr. Shinefield: Stated that at Cornell in the late 50's serious newborn infections occurred with 80-81 staph. The technics employed at that time affected neither colonization nor disease. No special attention was given to the umbilical area. In the early 1960's the colonization rate with 80-81 was about 40%, but the organism began to disappear spontaneously. At this point, with hexachlorophene data available, it was decided that hexachlorophene would not be used and the standard technics were employed. The nursery had no infections for the next 2 years.

In San Francisco he has studied 17,000 newborn infants who as a result of the Kaiser plan are well followed. He found 40 to 80% colonization rates and independently of the technics used; 4 per 1,000 babies developed pustules but no serious staph infections. He felt that colonization by itself may not be harmful unless one is dealing with "hot" strains. He believes that if ordinary aseptic technics can change colonization rates from 40 to 80%, their average rates, down to 5 to 10%, and change infection rates from 4 to 1 per 1,000, one should be cautious about additional measures. He believes that a 4/1,000 pustule rate in a nonepidemic period is not alarming and that intensive intervention may give rise to difficulty. He asked Dr. Light about the inverse relation between staph and gram-negative organisms raising the question as to whether it is staph or nonpathogenic micrococci which holds down gram-negative bacteria.

Dr. Light: Replied that studies showed the inverse relationship between coagulase-positive staph and pseudomonas.

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