Neonates and Their Toys: Beware?
September 15, 2000
Neonates and Their Toys: Beware?
Abstract & commentary
Synopsis: Toys in a neonatal intensive care unit were commonly colonized by bacteria capable of causing systemic infection.
Source: Davies MW, et al. Pediatrics 2000;106:E18. (http://www.pediatrics.org/cgi/content/full/106/2/e18).
Davies and colleagues in melbourne, aus-tralia cultured all the toys of all the infants in their 20-bed-neonatal intensive care unit (ICU) each week for four weeks. A total of 86 cultures were obtained from 34 toys of 19 infants. Cultures yielded bacteria in 84 (98%) of the 86 samples; no fungi were recovered. Only two cultures yielded coliforms. Streptococci were recovered from 14 specimens; four were S. agalactiae. Staphylococcus aureus was isolated from 16 samples; 13 of these were methicillin-resistant. The remaining 84 isolates were coagulase-negative staphylococci (CNS), Micrococcus species (50), Bacillus species (21), and diphtheroids (12). The characteristics of the toys, including their "fluffiness score," did not influence the culture results.
During the study, five (63%) of the eight infants who were bacteremic had the same species of organism recovered from blood and their toys. However, DNA fingerprinting was not performed to demonstrate possible identity.
Comment by Stan Deresinski, MD, FACP
"Potentially pathogenic" bacteria were recovered from 44% of samples in this study. These included streptococci (including Group B streptococci), coliforms, S. aureus (including methicillin-resistant strains), and CNS. CNS, which were, over time, recovered from every toy in this study, are the most frequent cause of bacteremia in ICUs.
These observations are of interest, but only provide stimulus to further study. No evidence is presented to indicate that the toys were the source of infection in these infants. Even if the toys were colonized with bacteria identical to those causing bacteremia in the neonates, it would still be necessary to overcome the "chicken and egg" problem. Thus, it would be necessary to demonstrate that they were the source of the bacteria, rather than innocent bystanders that had been contaminated with bacteria by the already colonized infants.
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