PEDIATRICS Vol. 51 No. 4 April 1973, pp. 608-615
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NURSERY EPIDEMIC CAUSED BY A NONTYPABLE GRAY COLONY VARIANT OF STAPHYLOCOCCUS AUREUS

Rajam S. Ramamurthy M.D.1, Rosita S. Pildes M.D.1, and Sherwood L. Gorbach M.D.1

1 Departments of Pediatrics, Cook County Hospital, The Chicago Medical School, The Abraham Lincoln School of Medicine of the University of Illinois College of Medicine and Hektoen Institute

A nursery epidemic caused by coagulase-positive Staphylococcus aureus and involving 32 infants is reported. The epidemic occurred between March 16, 1971, and May 3, 1971, in spite of hexachlorophene bathing. No breaks in technique could be identified. The causative pathogen was sensitive to hexachlorophene in a 1:10,000 dilution and its morphological characteristics were unique. The colonies, on human blood agar, were intensely hemolytic and had a grayish white color. These characteristics proved useful markers for identification of the carriers.

The epidemic was brought under control by several measures. Reinforcement of nursery techniques was ineffective. Nasal antibiotics decreased the number of cases but the persistent carriers required prolonged treatment. Cohort system was effective, but complete eradication of the pathogenic organism occurred, only after the carriers were removed from the nursery.

The emergence of a virulent strain of S. aureus was considered an important factor in this epidemic. The maintenance of a low colonization rate may, by itself, be inadequate in the prevention of epidemics caused by a virulent strain.

Submitted on October 16, 1972
Accepted on December 19, 1972