STAPHYLOCOCCAL INFECTIONS

Staphylococcus pyogenes is the main pathogen of this species and it is responsible for a variety of suppurative condition in man such as boils, carbuncles, perinephric abscess, osteomyelitis, pneumonia, necrotizing entero-colitis and septicaemia with pyaemic abscesses. The organism may also contaminate food and produce a heat-labile toxin which, if ingested, causes acute vomiting and diarrhoea. 
The infection is derived from a human source. Commonly this is the nose, perineum or fingers of a carrier. Not infrequently the patient is a carrier and autoinfection occurs. The widespread use of antibiotics and sulphonamides has led to the emergence of strains of staphylococci which are resistant to many antibacterial infections acquired in hospital. It is the duty of every nurse, doctor, medical student and hospital worker to take all possible precautions against the spread of infection. 
Necrotising entero-colitis is usually the result of the unrestricted growth of drug-resistant staphylococci in the gut following the virtual elimination of the other intestinal flora during oral chemotherapy. The illiness is sometimes so severe as to resemble cholera in the severity of the diarrhea and the ensuing dehydration and collapse. 
Patients with staphylococcal infections should be nursed with full barrier precautions against the spread of infection. The choice of antibiotic depends to some extent on whether the infection has been acquired inside or outside hospital. In the later case the organism will probably be sensitive to benzylpenicillin and the tetracyclines. If the therapeutic response is not satisfactory within 48 hours, then sensitivity tests from the outset If patient is seriously ill treatment should be commenced with cloxacillin. If staphylococcus proves to be sensitive to benzylpenicillin this antibiotic can then be substituted, a change which will be no less effective and which will substantially reduce the expense of treatment. If the patient is hypersensitive to the penicillins, either erythromycin, lincomycin, fucidin or cephaloridine may be used, depending on the sensitivity of the organism and the severity of the illiness.

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