This preliminary data are on the subject of neonatal meningitis caused by gram-negative organisms. During 1970 and 1971, Dr. George Mc Cracken of Dallas designed a study to investigate therapy of gram-negative meningitis. Thirteen centers if the United States and Canada were chosen on the basis of their experience with the disease over the preceding few years. Together they had seen some 50 infants yearly with meningitis from their cummulative population base of 100,000-150,000 births yearly. Participants of the study include centers in Dallas, Birmingham, Memphis, Atlanta, New Orleans, Baltimore, Cleveland, Cincinnati, San Francisco, Los Angeles, Salt Lake City, Montreal, and Boston.

The study began on September 1, 1971 with some of the 13 centers officially enrolling as late as December. Initially the number of patients enrolled in the study met expectations. In 1972 enrollees fell off so severely that changes in study design were suggested at the last meeting of investigators in May. The total number of infants entered in the study from September through May is 15. In examining the experience before December 8, 1971 compared to the experience after December 8th the number of newborn infants with meningitis fell from .09 per day to .05 per day. This highly significant change is in the face of a greater mean population base in the second period. The change is associated, at least in time, with the decrease in use of hexachlorophene bathing in nurseries (.32/1000 to .18/1000).

For my second topic, I'd like to review some of the alternatives available to the clinician faced with a nursery outbreak of Staphylococcal disease.

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