嬰兒室金黃色葡萄球茵皮膚感染的控制

Control of Staphylococcal Skin Infections in a Nursery

黃富源(Fu-Yuan Huang) ； 陳中明(Chung-Ming Chen) ； 邱世昌(Shr-Chang Chyou) ； 姚秀康(Shiow-Kang Yau)

《Acta Paediatrica Sinica》 32卷3期 (1991/06) Pp. 165-170

https://doi.org/10.7097/APS.199106.0165

摘要

金黃色葡萄球菌的皮膚感染是引起嬰兒室中院內感染最常見的一個問題，本文回顧馬偕醫院嬰兒室在最近五年半間金黃色葡萄球菌引起皮膚感染的病例流行與控制經驗。從1985年1月發生皮膚感染的流行（共29例）後，開始常規使用3% hexacholorophene (HCP)給新生兒洗澡，很快地病例數就減少到3月份的3例。接著4月改以嬰兒香皂取代HCP後，病例數又劇增到5月份的30例，故6月起再繼續使用HCP，皮膚感染病例才得以控制。1987年3月和1988年6月同樣的葡萄球菌皮膚感染流行情形又重演，一停止使用HCP，皮膚感染率很快地增加，但自從於1988年10月27日再度停用HCP，並且以triple dye取代95%酒精塗抹臍帶及其周圍一吋的皮膚後，直到1990年6月都沒有金黃色葡萄球菌皮膚感染的流行發生。從我們的經驗及過去報告得知當嬰兒房中有金黃色葡萄球菌引起皮膚感染流行時，使用3% HCP給新生兒洗浴可以有效降低病例控制感染，另外如以triple dye處理臍帶，亦可取代HCP之洗浴以達感染流行控制之目的。

並列摘要

Outbreaks of skin infections due to Staphylococcus aureus continue to be a major problem in newborn nurseries. In this report, we described how the staphylococcal skin infections were controlled in the nursery during the last 5½ years. An outbreak of staphylococcal skin infection (totally 29 cases) developed in January 1985, and declined dramatically to 3 cases in March of the same year when 3% hexachlorophene (HCP) bathing was used (period 1-January 1985 to March 1985). The infections increased to 30 cases in May when HCP bathing was discontinued arid was replaced by baby soap baths (period 2-April 1985 to May 1985). Once again, HCP bathing (period 3-June 1985 to January 1987) was reinstituted and infection rate was reduced. After discontinuation of HCP (period 4-February 1987 to March 1987), another outbreak of staphylococcal skin infection reappeared. It was controlled again with HCP bathing (period 5-April 1987 to April 1988). Daily baby soap baths were continued during period 6 (May 1988 to October 1988), and skin infections increased again. Finally in period 7 (November 1988 to June 1990), daily baby soaps were reinstituted and a triple dye was applied daily to the cord and to the surrounding skin (1 inch diameter) until discharge. During this period, staphylococcal skin infections was reduced to 1-4 cases and no more outbreaks occurred.
Our data confirmed that 3% HCP bathing of newborns reduced the infection rate of Staphylococcus aureus during an endemic period, and supported that triple dye may be an alternative to HCP for preventing staphylococcal skin infection in a newborn nursery.

並列關鍵字

Staphylococcus aureus skin infection ； hexacholorphene ； triple dye