Epidemiology and Treatment of Chronic Staphylococcal Infections in the Household

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Abstract
Information on the actual incidence of staphylococcal infection in the general population is meager, available data suggesting that 1 to 9% are affected, with about one-fourth of this group suffering a chronic or recurrent process. "Staphylococcal families" have been described where a particular phage type, either hospital-acquired or of unknown origin, may persist for up to 6 years. Evidence is presented suggesting that the epidemiology of chronic infections involves 2 pathways: cross-infection and auto-infection. There thus appears to be a significant correlation in phage type of strains recovered from lesions and those from carrier sites: nose, perineum and skin. Control measures must therefore take account of these sites, as well as of the particular susceptibility of the lesion site and the host. The use of nasal antibacterial agents, skin and perineal antisepsis, systemic antibiotics, various immunogenic materials-vaccines, toxoids or combinations of the two- and gamma globulin, is reviewed. In view of the spontaneous remissions necessitating long-term follow-up of chronically infected patients treated by any one particular method, it is concluded that better controlled data are needed, and several approaches to research in this field are presented.