Antibiotic-Resistant Staphylococci Characteristics of the epidemic and measures for its control

Abstract

Problems of antibiotic-resistant staphylococcal infections have been reviewed with particular reference to the epidemiology and management.
A close correlation was found between consumption of antibiotics and occurrence of staphylococcal resistance. The epidemic strain, notably of 80/81 phage type, appeared to possess enhanced virulence in many outbreaks, as pointed out by various investigators.
The role of healthy carriers, especially of nasal carriers, in propagating staphylococcal diseases has been discussed along with considerations on the mechanism ofnasal carriage of resistant strains. Perineal and fecal carriers were also mentioned as important sources of dissemination.
It is felt by the author that the control of “hospital” staphylococcal infections is inseparablly related to the rational use of chemotherapeutic drugs. Antibiotic treatment of resistant staphylococcal infections was described in connection with informations concerning the two types of antibiotics, bactericidal and bacteriostatic, classified according to their antistaphylococcal activities in vitro. Tetracyclines, chloramphenicol, erythromycin, novobiocin, oleandomycin, leucomycin and ristocetin are considered as bacteriostatic agents against staphylococci. Each of these drugs as well as bactericidal antibiotics including penicillin, streptomycin, bacitracin, neomycin, kanamycin and vancomycin was given a brief account of its route of administration, dosage and untoward side effects.
The difficulties in handling severe cases of staphylococcal infection demonstrable with discrepancies between laboratory data and clinical response have never been fully explained. An experimental study by Prof. Yow and the writer was not conclusive as to the possibility that a large bacterial population might minimize the action of certain antibiotics.