Smith R J, Alder V G, Warin R P
Br Med J. 1975 Jul 26;3(5977):199-201. doi: 10.1136/bmj.3.5977.199.
To determine the source of pyococci causing attacks of sepsis in infantile eczema 20 patients with continuing eczema were followed up for one year, regular swabs being taken from the skin, nose, throat, and family contacts. The staphylococci were phage typed and the streptococci serologically typed. Staphylococci of the same phage type in most cases remained in reservoir sites on the skin and coincidently in the nose. Staphylococci causing attacks of clinical sepsis arose from these persistently colonized sites. Staphylococci of the same phage type were also common in family contacts. Streptococci of the same group in most cases did not remain on the skin. Streptococci causing attacks of clinical sepsis arose as new infections from external sources, sometimes from throat infections in the patient or family contacts. Strains of streptococci which are known to be associated with glomerulonephritis were isolated. It has been confirmed that staphylococci resistant to neomycin and sodium fusidate quickly emerge after the topical use of these antibiotics. Streptococci are highly resistant to neomycin and gentamicin, and moderately resistant to sodium fusidate, so the use of these antibiotics in topical steroid preparations will have little effect in preventing further attacks of clinical sepsis in these patients.
为了确定引起婴儿湿疹败血症发作的化脓性球菌的来源，对20例持续性湿疹患儿进行了为期一年的随访，定期从皮肤、鼻子、喉咙以及家庭接触者处采集拭子。对葡萄球菌进行噬菌体分型，对链球菌进行血清学分型。大多数情况下，相同噬菌体类型的葡萄球菌存在于皮肤的储存部位，同时也存在于鼻子中。引起临床败血症发作的葡萄球菌源自这些持续定植的部位。相同噬菌体类型的葡萄球菌在家庭接触者中也很常见。大多数情况下，同一组的链球菌不会留在皮肤上。引起临床败血症发作的链球菌是来自外部来源的新感染，有时来自患者或家庭接触者的喉咙感染。分离出了已知与肾小球肾炎有关的链球菌菌株。已经证实，局部使用新霉素和夫西地酸钠后，对这两种抗生素耐药的葡萄球菌会迅速出现。链球菌对新霉素和庆大霉素高度耐药，对夫西地酸钠中度耐药，因此在局部类固醇制剂中使用这些抗生素对预防这些患者的临床败血症进一步发作几乎没有效果。
