OBSERVATIONS ON THE SPECIFIC TREATMENT (TYPE A ANTISERUM) OF STAPHYLOCOCCAL SEPTICEMIA; SECOND REPORT

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Abstract
104 patients with staphylococcal septicemia and 4 with severe infection without septicemia were treated with specific Type A antibacterial serum prepared in rabbits. All the staphylococci isolated in this study fermented mannite and contained Type A carbohydrate. None of the strains were particularly virulent for white mice. About half of the strains were tested in rabbits, and a lesser number in guinea pigs; their virulence for these animals also was considered low. In addition to the antiserum, treatment included surgical drainage and supportive care. Of the patients treated, 48 survived and 54 died; in the latter group there were 5 patients who, although dying of other causes, recovered from the staphylococcal septicemia. Type A antiserum exerted its greatest effect in osteomyelitis present with septicemia; 26 patients were treated, and 23 recovered; 3 died as explained above; an additional patient with bacteremia recovered. The least promising results were observed in cardiac infection and sinus thrombosis; there were 18 patients in the former group and 3 in the latter, all of whom died. Of the 54 patients dying, 15 succumbed within 72 hrs. after starting serum; this and other conditions tabulated in the text suggest that all the failures may not have been entirely due to impotency on the part of the antiserum. The data indicate at this time a 2-fold increase in the usual survival rate, but actual evaluation of the serum will have to await future work from different sources.

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