Studies of the Epidemiology of Staphylococcal Infection

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Abstract
The hospital-acquired staphylococcal postoperative infection rate over a 16 month period during 1961-62 at the Johns Hopkins Hospital was 1.6%, but there were noteworthy variations for specific operations. The highest infection rates were seen after operations upon the gastrointestinal tract. Gastrectomy, cholecystectomy, lysis of abdominal adhesions, drainage of abdominal abscess, esophageal operations, colon resections, and abdominal-perineal resections had rates in excess of 5%. Various factors such as age, sex, medication, degree of debilitation, other diseases, etc. are discussed in relation to staphylo-cocoal infection. Prophylactic antibiotics were not related to changes in the infection rate, but infections following their administration were usually caused by organisms that were antibiotic-resistant. A marked increase in the frequency of infections due to staphylococci that were nontypable using routine bacteriophage concentrations was observed. Many of these organisms were lysed when concentrated type 54 bacteriophage was used, and these strains had the unique property of being resistant to neomycin and kanamycin. Their prevalence was related to the increased use of neomycin in this hospital. It was suggested that measures for the prevention of epidemics in hospitals may differ importantly from those required to prevent sporadic infections in highly susceptible individuals; and that such sporadic infections are commonly due to organisms acquired by the patient in the hospital preoperatively and introduced into the wound at the time of operation when host defenses are maximally depressed.