NEWSDAY, Long Island, New York, 9 October 2003.

Mysterious Crop of Staph

Newborns, moms infected after stay at St. Catherine's

By Roni Rabin

October 9, 2003

Two newborns developed antibiotic-resistant staph infections just days after being born at St. Catherine of Siena Medical Center in Smithtown in August, and their mothers also were infected, state Health Department officials have confirmed.

Another baby born at St. Catherine also was diagnosed with Methicillin-resistant staphylococcus aureus, or MRSA, just weeks after his birth May 23, his mother, Kelley Gould of St. James, said. St. Catherine officials said through a spokesman that there was no evidence Gould's infection originated in the hospital.

MRSA doesn't respond to widely used penicillin-related antibiotics. It usually develops in critically ill patients or nursing home residents who have had multiple courses of antibiotics, and is rare in newborns. It can cause serious life-threatening infections, especially if it spreads to vulnerable patients and gets into surgical wounds.

Yesterday, state Health Department inspectors spent a second consecutive day reviewing infection control procedures at St. Catherine's baby nursery, state Health Department spokesman Rob Kenny said.

Meanwhile, questions remained about why the hospital waited 10 days to report the first infections to the state, whether it closed the affected nursery in order to disinfect it, whether its internal investigation ever determined the source of the infections, and what steps were taken after the third and fourth infections were identified. Yesterday, Kenny retracted an earlier statement saying the hospital had identified one of the four infected patients as the source of the infections. He said instead that the hospital's investigation of the source was inconclusive. But he said the hospital acted appropriately to contain the infections, even though the cases were not reported to the state until Aug. 21, 10 days after the first two cases were identified Aug. 11.

"Aggressive steps were taken to contain it and there have been no additional cases since then," Kenny said. Suffolk County officials have refused to comment. A written statement released by Dr. Gus Mantia, medical director of St. Catherine, said the hospital had provided documentation to the state showing that "the hospital moved promptly to close the infected nursery to newborns for approximately 40 hours (Aug. 11 through Aug. 13) during which time we disinfected the facility before reopening."

But state officials said they were not informed the nursery had been temporarily closed. "They never told us they closed the nursery," Kenny said. "They told us they isolated the patients who were exposed to make sure there was no additional spread to other patients."

Michele Werner, also of St. James, whose baby, Brody, was infected four days after his birth on Aug. 7 and who herself tested positive for MRSA, insisted the nursery her son slept in was not closed down. "I only left on the 12th and I was there on the 13th. ... Both Nurseries A and B were packed with babies," she said. "They told me they cleaned them overnight."

When Werner returned home, she was shocked to learn that her friend's baby, born two months earlier at St. Catherine, had also picked up a resistant staph infection. The friend, Kelley Gould, said she found out her baby, Kevin, born May 23, was infected when she took him to the pediatrician two weeks after coming home from the hospital for what she thought was a diaper rash.

Gould and Werner believe the infection wasn't noticed earlier because Gould and her baby were in the hospital for only two days. Werner, who had a Caesarean section, had been kept in the hospital for five days.

But Werner had an even bigger surprise recently when she was shopping at Smith Haven Mall in Lake Grove and struck up a conversation with a third mother, whose baby was about the same age as her son. She soon discovered that the baby, born Aug. 14 in St. Catherine, also developed an antibiotic-resistant staph infection in the hospital.

"That's when I started worrying that they were trying to keep everything quiet and weren't taking care of it," said Werner, who reported her son's infection to the state. "You try to do everything you can to have a healthy baby, and then this happens. ... I would hate for this to happen to another baby."

All of the infected babies were boys who were circumcised at the hospital, though their infections were not in the wounds but on the skin on different parts of their bodies, their mothers said. They were all treated with Clindamycin, a powerful antibiotic, and as a result may face an increased risk of incurring additional antibiotic-resistant infections, the mothers said.

Medical experts said the infections underscore the larger global problem of proliferation of antibiotic resistance, which has been fueled by inappropriate use of antibiotic agents. Resistant staph bacteria also can cause serious infections such as pneumonia and life-threatening blood infections.

Catholic Health Services of Long Island purchased the hospital, then called St. John's Episcopal Hospital, in 2000, when it was on the verge of bankruptcy. In 1998, it was put under state monitoring after state inspections criticized care, including infection control practices.

Copyright © 2003, Newsday, Inc.

(File revised 1 May 2008)