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Staphylococcal necrotic infection decreases activity of mitochondrial monoamine oxidase from rabbit liver. The animals treated with tetracycline exhibited a further inhibition of staphylotoxin-repressed MAO activity. Administration of penicillin as well as of vitamins B2 and B12 resulted in the same level of the enzyme activity as in non-treated animals. Treatment of animals with tetracycline in combination with vitamins B2 and B12 ensured a restoration of MAO activity, repressed by antibiotics, to the level of non-treated animals. Combined administration of penicillin and methycillin with vitamins B2, as well as methycycline and morphocycline with vitamin B12 resulted in a higher enzyme activity compared with respective values in non-treated animals. The best stimulatory action was exerted by a combination of penicillin with vitamin B2 and methycillin with vitamin B12. In these cases, MAO activity was higher in rabbits receiving antibiotics only and was restored to the level of enzyme activity in intact animals. Combined administration of penicillin with vitamin B12 and morphocycline with vitamin B2 exerted no action on MAO activity inhibited by staphylococcal exotoxin.
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Staphylococcal folliculitis are a common disability in early adult life. Some patients suffer only one attack, while others continue to develop recurrences over months. In such a case, nasal carriage of staphylococcus aureus should be sought in the patients and family members. The lesions may often respond to topical antiseptics. Systemic antibiotics should only be started when furuncles are complicated. Topical antibiotics, applied to the anterior nares of patients and household carriers, seems to control recurrent infection more effectively than systemic antibiotics alone. Even so, few patients will experience recurrent lesions despite good initial response to treatment.
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An aerosol-induced staphylococcal infection of previously non-infected guinea pigs is described. Investigations concerning the dynamics of this infection indicate that: 1. An infection ("carrier state") could be established predictably in every animal exposed to the aerosol inoculum. 2. Infection was limited to the upper respiratory tract and occurred without apparent systemic dissemination. 3. Cross-infection between infected and non-infected animals did not occur. 4. The initially established infection persisted in detectable form for 6 days or less in the majority of exposed animals. 5. Tetracycline administration prior to and following aerosol infection with tetracycline-resistant strains significantly prolonged the duration of the carrier state. 6. When tetracycline-resistant strains were employed, the infection could be recalled predictably by means of tetracycline administration. 7. Infection initiated with a tetracycline-susceptible strain could not be recalled by tetracycline administration. 8. The mechanism(s) of action of tetracycline in recalling the attenuated infection is (are) unknown. It (they) may not be wholly attributable to ecological changes alone, at least as these are usually considered. The indigenous microflora diminished and changed as a result of tetracycline administration, and no growth-enhancing effect of the antimicrobial of the infection strains was detectable in vitro. 9. The experimental model described lends itself well to the study of attenuated staphylococcal infection in guinea pigs, and to more general studies of staphylococcal epidemiology and pathogenesis.
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Serious staphylococcal infections remain a significant clinical problem despite advances in antibacterial therapy. Resistance to penicillin is common and methicillin-resistant staphylococci have become troublesome nosocomial pathogens in many institutions. Penicillinase-resistant penicillins (e.g. flucloxacillin, cloxacillin and oxacillin) are the preferred drugs for all methicillin-susceptible staphylococcal infections, although first generation cephalosporins, beta-lactam/beta-lactamase inhibitor combinations, clindamycin, and occasionally erythromycin and cotrimoxazole (trimethoprim/sulfamethoxazole) are alternatives. Serious infections due to methicillin-resistant staphylococci should be treated with parenteral vancomycin. Teicoplanin, where available, is a suitable alternative. Rifampicin, fusidic acid and some fluoroquinolones may be useful oral alternatives, although resistance develops rapidly if they are used as single agents. Cotrimoxazole and minocycline have also proven useful when strains are susceptible. Staphylococcal toxic shock syndrome often requires aggressive resuscitation and anti-staphylococcal therapy for generally 10 to 14 days. Staphylococcus aureus bacteraemia remains a life-threatening condition which, in all but one-third of cases, is associated with an underlying septic focus such as endocarditis, osteomyelitis or occult abscess. Differentiating between complicated and uncomplicated bacteraemia is critical to define the appropriate treatment regimen. Serious staphylococcal sepsis such as endocarditis and acute osteomyelitis generally requires prolonged (4 to 6 weeks) antibiotic treatment. Coagulase-negative staphylococci are the commonest cause of prosthetic device infection, and generally require prolonged therapy with an agent to which they have proven to be sensitive, e.g. a penicillinase-resistant penicillin or vancomycin. Removal of infected foreign or prosthetic material, and drainage of deep collections remain a critical aspect of all therapy.
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