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Fatal Septicemia Due to Staphylococcus aureus 502A: Report of a Case and Review of the Infectious Complications of Bacterial Interference Programs

Fatal Septicemia Due to Staphylococcus aureus 502A: Report of a Case and Review of the Infectious... Abstract During a bacterial interference program in a newborn nursery 38 (5.9%) of 644 deliberately colonized babies developed disease related to the Staphylococcus aureus 502A blocking strain. Thirty infants had pustules, six had conjunctivitis, and one infant developed an abscess. An infant of a diabetic mother developed septicemia and meningitis, probably secondary to passing an umbilical vein catheter through the colonized umbilical stump. Staphylococcus aureus 502A and Escherichia coli were isolated from blood culture before death and from autopsy cultures of blood and peritoneum. A meningeal culture grew S aureus 502A. Gram-positive cocci were identified in liver, lung, heart, and meninges. Only two (0.5%) minor 502A infections were seen in 444 spontaneously colonized infants. The benefits of S aureus 502A programs far outweigh their hazards. Disease due to the 502A strain is more frequent when the inoculum applied to the infant is large than when it is kept below 4,000 bacteria. The fatal case emphasizes that bacteria of extremely low virulence may produce serious disease in compromised hosts and that catheterization through a contaminated umbilical stump may induce bacteremia. References 1. Shinefield HR, Ribble JC, Boris M: Bacterial interference between strains of Staphylococcus aureus, 1960 to 1970 . Amer J Dis Child 121:148-152, 1971. 2. Shinefield HR, Ribble JC, Eichenwald HF, et al: Bacterial interference: Its effect on nursery-acquired infection with Staphylococcus aureus: V. An analysis and interpretation . Amer J Dis Child 105:683-688, 1963. 3. McCracken GH Jr, Shinefield HR: Changes in the pattern of neonatal septicemia and meningitis . Amer J Dis Child 112:33-39, 1966. 4. Yeung CY: Hypoglycemia in neonatal sepsis . J Pediat 77:812-817, 1970.Crossref 5. Nelson JD, Richardson J, Shelton S: The significance of bacteremia with exchange transfusions . J Pediat 66:291-299, 1965.Crossref 6. Light IJ, Sutherland JM, Schott JE: Control of a staphylococcal outbreak in a nursery: Use of bacterial interference . JAMA 193:699-704, 1965.Crossref 7. Light IJ, Walton L, Sutherland JM, et al: Use of bacterial interference to control a staphylococcal nursery outbreak: Deliberate colonization of all infants with the 502A strain of Staphylococcus aureus . Amer J Dis Child 113:291-300, 1967. 8. Blair EB, Tull AH: Multiple infections among newborns resulting from colonization with Staphylococcus aureus 502A . Amer J Clin Path 52:42-49, 1969. 9. Albert S, Baldwin R, Czekajewski S, et al: Bullous impetigo due to group II Staphylococcus aureus: An epidemic in a normal newborn nursery . Amer J Dis Child 120:10-13, 1970. 10. Shinefield HR, Ribble JC, Eichenwald HF, et al: Bacterial interference: Its effect on nursery-acquired infection with Staphylococcus aureus: III. The Georgia epidemic . Amer J Dis Child 105:663-673, 1963. 11. Boris M, Shinefield HR, Ribble JC, et al: Bacterial interference: Its effect on nursery-acquired infection with Staphylococcus aureus: IV. The Louisiana epidemic . Amer J Dis Child 105:674-682, 1963. 12. Drutz DJ, Van Way MH, Schaffner W, et al: Bacterial interference in the therapy of recurrent staphylococcal infections: Multiple abscesses due to the implantation of the 502A strain of Staphylococcus . New Eng J Med 275:1161-1165, 1966.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

Fatal Septicemia Due to Staphylococcus aureus 502A: Report of a Case and Review of the Infectious Complications of Bacterial Interference Programs

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Publisher
American Medical Association
Copyright
Copyright © 1972 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1972.02110070095012
Publisher site
See Article on Publisher Site

Abstract

Abstract During a bacterial interference program in a newborn nursery 38 (5.9%) of 644 deliberately colonized babies developed disease related to the Staphylococcus aureus 502A blocking strain. Thirty infants had pustules, six had conjunctivitis, and one infant developed an abscess. An infant of a diabetic mother developed septicemia and meningitis, probably secondary to passing an umbilical vein catheter through the colonized umbilical stump. Staphylococcus aureus 502A and Escherichia coli were isolated from blood culture before death and from autopsy cultures of blood and peritoneum. A meningeal culture grew S aureus 502A. Gram-positive cocci were identified in liver, lung, heart, and meninges. Only two (0.5%) minor 502A infections were seen in 444 spontaneously colonized infants. The benefits of S aureus 502A programs far outweigh their hazards. Disease due to the 502A strain is more frequent when the inoculum applied to the infant is large than when it is kept below 4,000 bacteria. The fatal case emphasizes that bacteria of extremely low virulence may produce serious disease in compromised hosts and that catheterization through a contaminated umbilical stump may induce bacteremia. References 1. Shinefield HR, Ribble JC, Boris M: Bacterial interference between strains of Staphylococcus aureus, 1960 to 1970 . Amer J Dis Child 121:148-152, 1971. 2. Shinefield HR, Ribble JC, Eichenwald HF, et al: Bacterial interference: Its effect on nursery-acquired infection with Staphylococcus aureus: V. An analysis and interpretation . Amer J Dis Child 105:683-688, 1963. 3. McCracken GH Jr, Shinefield HR: Changes in the pattern of neonatal septicemia and meningitis . Amer J Dis Child 112:33-39, 1966. 4. Yeung CY: Hypoglycemia in neonatal sepsis . J Pediat 77:812-817, 1970.Crossref 5. Nelson JD, Richardson J, Shelton S: The significance of bacteremia with exchange transfusions . J Pediat 66:291-299, 1965.Crossref 6. Light IJ, Sutherland JM, Schott JE: Control of a staphylococcal outbreak in a nursery: Use of bacterial interference . JAMA 193:699-704, 1965.Crossref 7. Light IJ, Walton L, Sutherland JM, et al: Use of bacterial interference to control a staphylococcal nursery outbreak: Deliberate colonization of all infants with the 502A strain of Staphylococcus aureus . Amer J Dis Child 113:291-300, 1967. 8. Blair EB, Tull AH: Multiple infections among newborns resulting from colonization with Staphylococcus aureus 502A . Amer J Clin Path 52:42-49, 1969. 9. Albert S, Baldwin R, Czekajewski S, et al: Bullous impetigo due to group II Staphylococcus aureus: An epidemic in a normal newborn nursery . Amer J Dis Child 120:10-13, 1970. 10. Shinefield HR, Ribble JC, Eichenwald HF, et al: Bacterial interference: Its effect on nursery-acquired infection with Staphylococcus aureus: III. The Georgia epidemic . Amer J Dis Child 105:663-673, 1963. 11. Boris M, Shinefield HR, Ribble JC, et al: Bacterial interference: Its effect on nursery-acquired infection with Staphylococcus aureus: IV. The Louisiana epidemic . Amer J Dis Child 105:674-682, 1963. 12. Drutz DJ, Van Way MH, Schaffner W, et al: Bacterial interference in the therapy of recurrent staphylococcal infections: Multiple abscesses due to the implantation of the 502A strain of Staphylococcus . New Eng J Med 275:1161-1165, 1966.Crossref

Journal

American Journal of Diseases of ChildrenAmerican Medical Association

Published: Jan 1, 1972

References