SOME BACTERIOLOGICAL DATA ON DERMATOLOGICAL PATIENTS .1. ANTIBIOGRAMS AND PHAGE TYPES OF STAPHYLOCOCCI

[摘要] Some representative bacteriological data are presented on strains of S. aureus isolated from dermatological patients treated during 1955-1960. These data differ from those of most laboratory reports in that correlation of clinical and epidemiological information permitted deletion of data on replicate strains from the same patient. The minimum inhibitory concentration of 8 antibiotics in broth was determined for 70 different strains from 54 patients. Results with the disc technique agreed. For susceptible organisms, the order of effectiveness of the antibiotics on a weight basis was penicillin, novo-biocin, tetracycline, oxytetracycline, erythromycin, neomycin, chloram-phenicol, and bacitracin. Nevertheless, neomycin completely inhibited more strains than any other antibiotic tested in this 5 year period. Of 2545 different strains from 2016 patients, about 60% were resistant to penicillin, with about 30% resistant to penicillin only. Approximately 20% were resistant to tetracycline; more than half of these were resistant to streptomycin as well. No increase in percentage of antibiotic resistant strains isolated annually was observed. For a sample year (1959-1960), 849 strains from 576 patients were classified according to antibiogram, phage type, and source, including diagnoses of the patients and sites from which the strains were isolated. Strains from patients with furunculosis differed in their percentage distributions of both antibiograms and phage types from those strains from patients with other diagnoses. For each diagnosis the percentage distributions of antibiograms and phage types of nasal strains resembled those from lesions. Furunculosis strains were characterized by (1) a higher percentage of phage type 80/81 and types within Group I, (2) a higher percentage of antibiograms denoting resistance, and (3) a lower percentage, about half as many, not lysed by any phage. Strains from diagnoses other than furunculosis were characterized by (1) a higher percentage of phage types within Group III, (2) a higher percentage of antibiograms denoting susceptibility to all or most of the 5 antibiotics tested, and (3) a higher percentage, twice as many, not lysed by any phage. Of 234 out-patients having S. aureus in either the nares or lesions, only about two thirds had it in both sites and about half had strains with the same antibiogram and phage type in both nares and lesion. In other words, of those with S. aureus in both nares and lesions, about four fifths had identical strains in both sites. This relationship was irrespective of diagnosis. Cultures were taken from another group of dermatological patients on their admission to the hospital and repeated subsequently until discharge. About 10% (16 of 154) acquired strains with antibiograms or phage types differing from those isolated on admission. Only 2 patients developed clinical infections, viz. furunculosis, subsequent to hospitalization.