BACTEREMIA DUE TO COAGULASE-POSITIVE STAPHYLOCOCCUS AUREUS

Abstract

One hundred cases seen between 1951 and 1958 at the Milwaukee County General hospital are presented. One-half of these cases developed while the patients were in the hospital for other reasons. The most common portal of entry was operative procedure (22%), followed by the respiratory tract (21%) and the skin (21%). The majority of patients were white males between the ages of 40 and 80. Sixty-four of the patients died. The clinical picture, laboratory findings, and differences between survivors and fatalities are presented. Antibiotics to which the causative strains were sensitive (in vitro) (M. I. C, < 6 ug/ml) were 55% effective, whereas no responses occurred when antibiotics were used to which strains were resistant in vitro. Vancomycin, neomycin, kanamycin and ristocetin inhibit all strains of staphylococci, so one of these drugs should be used when the sensitivity test results are not available. Erythromycin, the tetracyclines and penicillin are as effective as the newer drugs against strains that show in vitro sensitivity to them. The mortality of staphylococcal bacteremia has not improved strikingly since antibiotics have come into use, although more older patients and diabetics survive. The most promising ways to reduce mortality are by preventing infection through reducing the dosages of staphylococci received by hospitalized patients, by increasing the dosages and specificity of antibiotic therapy, and by finding means to augment the natural resistance of individuals who contract the disease.