抄録
The disturbances of the usual bacterial ecology induced by the administration of antibiotics have already been described. While the usual microbial population maintains a delicate balance between the various types, antibiotic therapy favours the multiplication of certain members of the bacterial population. Therapy directed toward infections with antibiotics may allow or promote the insensitive or resistant organisms to these medicaments to flourish. Such changes in microbial population are occasionally associated with a superinfection. In addition to Proteus, Pseudomonas and Candida, certain species of. staphylococci are also capable of promoting a new infection. This incidence had been first pointed out by Kramer in 1948 who had reported on a fatal staphylococcal enteritis developing during streptomycin therapy. This problem has recently received new prominence in medical literature because of the many reports published at U.S.A. and various countries in Europe. However, there has been no report on the infection in this country up to date.
It happened that a girl, aged 7, was admitted with a clinical diagnosis of dysentery, when we paid an attention to the incidence of this infection. During the administration of tetracycline, she suddenly developed pyrexia with frequent diarrhoea, vomitings, and violent abdominal pain. Her syndrome was gastroenteritic, not a dysenteric one that was shown at the early stage after admission, and she died just 36 hours after the acute onset of symptoms. All cultures made from the throat, faeces and vomiting substance obtained before her death produced a pure growth of coagulase-positive haemolytic staphylococcus. The diagnosis of staphylococcal gastro-enteritis was ascertained from the laboratorial result. Examining on the materials of the cases presented by these syndromes, we were confident of the existence of some cases caused by staphylococcal infection promoted by antibiotic administration. Thereafter, other 24 cases of staphylococcal enteritis were found in this hospital during the period of 4 months, from April to July of 1954.
The purpose of this paper is to report on some findings obtained from these patients as follows: 1) the relation between antibiotic therapy and staphylococcal gastro-enteritis, 2) the clinical picture of staphylococcal gastro-enteritis, 3) its treatment, and 4) resistance of staphylococcus to several antibiotics.
