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Erythromycin resistance in neonatal staphylococcal infection: a long-term survey.

Twenty years ago staphylococcal infection was a major problem among newborn infants in hospitals. Hygienic measures had not proved very effective and the use of antibiotics, although clearly open to question, seemed a possible method of control. Erythromycin, a new antibiotic effective against staphylococci, had just been introduced but reports from the United States suggested that resistance could occur within months of usage. In trials in two hospitals in which erythromycin was not being used elsewhere, erythromycin resistance developed but took years to do so. The longer the period of usage was extended the greater the resistance. Withdrawal of the drug resulted ultimately in the disappearance of resistance. The resistant staphylococci spread throughout the hospital. The staphylococcal infection rate in the units where erythromycin was used did not fall but the mortality rate from staphylococcal infection did.

Cross Infection↗

Staphylococcal infections in patients with atopic dermatitis.

Cutaneous staphylococcal infections appear to be relatively infrequent in atopic dermatitis even though patients have broken skin heavily colonized with staphylococcal organsism. We found superficial staphylococcal pustules on the skin of 22 patients with atopic dermatitis. Such lesions were more commonly found with severe exacerbations of atopic dermatitis. They appeared on unbroken skin independent of hair follicles and were associated with considerable pruritus. Such lesions were rapidly removed by excoriation and frequently were overlooked by patients and physicians. Most lesions appeared when polymorphonuclear leukocyte chemotaxis was depressed. Ineffective chemotaxis combined with high-colonization density and inadequate stratum corneum barrier during exacerbations of atopic dermatitis may lead to mild staphylococcal infections. These infections appear to have no systemic effects but possibly the considerable associated pruritus could worsen the atopic dermatitis. Occasional patients may require intermittent or continuous antibiotic therapy.

Adult↗