Staphylococcal infections

THE STAPHYLOCOCCUS problem has been placed high on the agenda of the Public Health Service for this year. Last year it was Asian flu vaccine. The year before it was poliomyelitis vaccine. This year it is the problem of hospital-acquired staphylococcus infection. It is pleasing to me to see the position pediatricians have taken as one of the first national organizations to realize the importance of this situation. The Academy was one of the first bodies to urge the formation of hospital infection committees. Pediatricians by training, experience, tradition and in many other ways are eminently qualified to lead in this regard. We have seen the establishment of many of these hospital infection committees. Some of these committees find themselves in the position of consultants, and they sometimes hardly know what to do. So, my remarks this morning will be directed to you as though half of you were serving on infection committees in your hospitals and the other half were chiefs of services of newborn nurseries. I shall confine my remarks to the newborn nursery. One word regarding hospital infection committees—the formation of such a committee, even of an active committee, does not abrogate the responsibilities of a chief of service nor the individual physician. One cannot delegate to others the responsibility of protecting your patients from hospital-acquired disease. You cannot as chief of a nursery expect the committee to protect you from the staphylococcus problem. I should like simply to state a few principles, and then tell you a little bit about where you can obtain some help as members of infection committees (summarized in the table). The first principle is that as far as the newborn nursery goes, most of the staphylococcal lesions appear after the baby goes home, and you may not know about them. This indicates that one must look hard for trouble. One can't wait until it comes to him. The primary function of the infection committee is surveillance, and knowing when you have trouble and when you don't. The best way I know of to assess this situation is to establish some kind of survey after babies go home.