Development of lincomycin resistance by staphylococci.
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Biomedical subjects
Publications and source records attributed to I B Duncan.
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A survey was made of the phage-types of staphylococci responsible for cross-infection in a large veterans' hospital between 1961 and 1964. An earlier survey had shown that in 1959 most of the infections were caused by staphylocci of the "80/81/82" group. In 1961 a new group of staphylococci were first recognized and provisionally designated as "Atypical Group III" strains; these were non-typable by the usual typing phages but showed inhibition patterns with some of the Group III phages. The "Atypical Group III" staphylococci all showed one or other of four patterns of multiple antibiotic resistance. By 1963 these resistant "Atypical Group III" staphylococci had become more frequent than "80/81/82" strains as causative agents of cross-infection, although both groups have continued to cause infections in the hospital. "Atypical Group III" strains mainly infected surgical wounds and skin ulcers, whereas "80/81/82" strains commonly produced primary skin sepsis, such as boils.
The usefulness of the new antibiotic, lincomycin, was assessed on both bacteriological and clinical grounds. Of 3200 strains of staphylococci isolated from clinical material, only 40 were resistant to lincomycin. These 40 were all of the same phage type and in fact almost all represented different isolations of the same staphylococcus which had spread to cross-infect various patients. Sixteen of 22 patients with staphylococcal infections, nine of 14 with pneumonia, 15 of 17 with acute exacerbations of bronchitis and two patients with other bacterial infections recovered completely with lincomycin therapy. The only side effect was diarrhea in four of the 42 patients given the drug by mouth. The place of lincomycin in therapeutics seems to be principally in the treatment of chronic osteomyelitis and, in patients allergic to the penicillins, in the treatment of staphylococcal, respiratory and other infections for which penicillin is usually employed.