Salmonellosis of the Newborn with Transmission by Delivery Room Resuscitators

Abstract

Two Salmonella outbreaks among newborn infants are presented, the etiologic agents being S. montevideo and S. bareilly. respectively. In both outbreaks, a high clinical attack rate among exposed infants (52% and 82%, respectively) indicated widespread dissemination of the etiologic agent. Recovery of the causative organism in each outbreak from the water-trap fluid of the delivery-room resuscitator suggested contamination of delivery room atmosphere by air exhausted from this apparatus. In both outbreaks interval between birth and onset of illness was short, being 3 days or less in 87% of cases in one outbreak and 72% in the 2d. Bacteriologic study of resuscitating apparatus in a sample of hospitals revealed frequent contamination of catheters, face masks, and water-trap fluid by a large variety of organisms, suggesting need of greater care on the part of delivery room supervisors and hospital administrators. A study of household contacts showed spread of infection to 7 persons in outbreak A (44% of contacts studied) and 22 persons (32% of contacts studied) in outbreak B. In spite of high clinical attack rates among exposed newborn infants in the 2 outbreaks, secondary infection among household contacts was associated primarily with inapparent or subclinical infection. Marked susceptibility to organisms of the Salmonella group may be inferred among newborn infants as opposed to older children and adults.