AEROBES ISOLATED IN FECAL MICROFLORA OF INFANTS IN THE INTENSIVE-CARENURSERY - RELATIONSHIP TO HUMAN-MILK USE AND SYSTEMIC SEPSIS

Background: Staphylococcus epidermidis is a leading cause of nosocomia l sepsis in the intensive care nursery. The relationship between rates of gastrointestinal colonization and the incidence of systemic sepsis with S. epidermidis in hospitalized neonates is under investigation. Methods: In this study, we enrolled 46 infants consecutively admitted to the intensive care nursery (mean +/- standard deviation, birth weig ht 1300 +/- 337 gm, gestational age 29.4 +/- 2.2 weeks). At the time o f enrollment, infants had been fed enterally for at least 1 week (28 w ere fed formula and 18 received their own mothers' frozen milk). Stool samples were collected when infants were 2 to 3 weeks of age (16.3 +/ - 7.4 days). Results: Aerobic stool flora were present in 65% of all p atients. Human milk use was associated with a significant increase in the presence of aerobic stool flora (78% vs 46%, p = 0.035), as well a s more frequent isolation of S. epidermidis. The incidence of S. epide rmidis sepsis was 33% in those infants whose stool specimens grew S. e pidermidis and 3.5% in those whose stool specimens did not (p < 0.01). Conclusions: These findings suggest the gastrointestinal tract as a p ossible site of entry for S. epidermidis in the hospitalized preterm i nfant. In addition, frozen human milk may be a vehicle for gastrointes tinal S. epidermidis colonization.