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ABNORMAL COLONIZATION AND INFECTION IN NEONATES Kotherine Sprunr

The incidence of infection and its relationship to bacterial colonization of the pharynx of infants in a neonatal ICU has been investigated. Pharyngeal bacterial flora were frequently monitored on a semi-quanfitive basis in 62 infants with RDS and 70 concurrent broadly matched controls. All infections occurred in infants with high abnormal colonization and were due to the type of bacterium producing the high colonization. Early high abnormal colonization occurred more frequently in RDS infants (42%) than in controls (27%); this high incidence was independent of antibiotic treatment. 5 of 9 abnormally colonized RDS infants without therapy had sepsis compared to only 1 of 5 control infants (urinary tract infection). Staphylococcus epidermidis and Gram negative enteric bacilli were the most frequent causes of high colonization; most infections were due to the enteric bacilli. Infection rates were similar in the two groups receiving antibiotics (RDS 4/41, controls 3/50) but differed when no antibiotics were given (RDS 6/21, controls 1/20). We recommend that all ICU infants, particularly those with RDS, be followed closely with frequent throat cultures to determine those with added risk of infection. Abnormally colonized infants should be treated on minimal indication as directed by the antibiotic sensitivity of the colonizing organism.