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ELECTRONIC ARTICLE: Mark W. Davies, Samuel Mehr, and Suzanne T. Garland Bacterial Colonization of Toys in Neonatal Intensive Care Cots Pediatrics 2000; 106: e18 [Abstract] [Full text] [PDF]

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Bacterial colonization of toys in NICUs

HD Dellagrammaticas   (22 August 2000)

Bacterial colonization of toys

Colin Morley   (29 August 2000)

Bacterial colonization of toys in NICUs 22 August 2000
HD Dellagrammaticas, Associate Professor in Neonatal Paediatrics NICU,2nd Department of Paediatrics University of Athens Send letter to journal: Re: Bacterial colonization of toys in NICUs hdellagr{at}ath.forthnet.gr HD Dellagrammaticas	Editor, We read with interst the study by Davies et al (1) on bacterial colonization of toys in intensive care cots. We think however that some important information is missing namely on the 'care' the toys were receiving. Were they ever washed, were they wrapped etc. Our approach regarding toys in cots/incubators is that plastic ones are cleaned at least daily using an appropriate disinfectant and subsequently dried and fluffy ones (of any degree as classified by davies at al) are wrapped in cling film which is changed daily (frequently more than that. We have been taking sawbs from these toys (although admittedly not routinely) and altough we have grown the occasional staph. epidermidis we have not been able to associate them with either colonization nor infection of the corresponding infants. As these findings are not the product of a specifically designed prospective study, they should be viewed with caution. We appreciate that wrapping fluffy toys with cling film we interfere with their fluffiness but we think that this is a small price to pay. We entirely agree with the authors on the'necessity' of toys in NICUs and that there should be harder evidence before their removal is contemlated Dr. HD Dellagrammaticas MD, FRCPCH Dr. Nicoletta Iacovidou MD References 1 Davies MW, Mehr S, Garland ST, Morley CJ. Bacterial colonization of toys in neonatal intensive care cots. Pediatrics 106:No2 August 2000
Bacterial colonization of toys 29 August 2000
Colin Morley, Professor of Neonatal Medicine Royal Women's Hospital, Melbourne Send letter to journal: Re: Bacterial colonization of toys Colin{at}morleys.net Colin Morley	We thank Dr Dellagramaticas for his interest in our paper. The answers to his questions are: The toys were placed in the incubators without any special treatment. They were never washed or disinfected and were not wrapped up. They stayed with the child until discharge. We are interested that his NICU cleans and disinfects the toys and then wraps them in cling film daily and, not surprisingly, this seems to be associated with a low rate of bacterial contamination. As with many aspects of routine care, we do not know what is the best way to handle toys in incubators. Some suggest that all toys should be banned, others that the bacteria they carry are picked up from the infants and they are not the source of infection. I am afraid the only scientific way to resolve this dilemma is more studies. To continuously match the infants’ bacteria to their toys would be expensive, time consuming, tedious and still might not provide a definitive answer. We are now undertaking a simple randomised controlled trial of putting toys in incubators or on the shelf outside. The outcome is the incidence of proven infection. If anyone would like to join our study to enhance recruitment so that we all know the answer as soon as possible please contact me. Colin Morley