Hillier Kathryn
Unit for History and Philosophy of Science, University of Sydney, NSW, Australia.
Bull Hist Med. 2006 Winter;80(4):733-61. doi: 10.1353/bhm.2006.0130.
During the 1950s, Staphylococcus aureus became a major source of hospital infections and death, particularly in neonates. This situation was further complicated by the fact that Staphylococcus quickly gained resistance to most antibiotics. Controlling these infections was a pressing concern for hospital workers, especially bacteriologists who tackled it through the use of a new epidemiologic tool: phage typing. This article argues that during the mid- to late 1950s a series of staphylococcal hospital and nursery epidemics united phage typers, brought international recognition to the usefulness of their technique, and, in the process, contributed to the establishment of the new field of infection control. Through the use of this new tool, phage typers established themselves as experts in infection control and, in some places, became essential members of newly formed infection-control committees. The nursery epidemics represent a particularly important test for phage typing and infection control, for this staphylococcal strain (80/81) was especially virulent and spread rapidly beyond the hospital to the wider community. The epidemiologic information provided by phage typers was vital for devising practical advice on how to control this deadly strain of Staphylococcus and also for transforming the role of the hospital bacteriologist from mere technician into infection-control expert.
在20世纪50年代,金黄色葡萄球菌成为医院感染和死亡的主要来源,尤其是在新生儿中。葡萄球菌迅速对大多数抗生素产生耐药性这一事实,使情况更加复杂。控制这些感染是医院工作人员,尤其是细菌学家的紧迫关切,他们通过使用一种新的流行病学工具:噬菌体分型来应对这一问题。本文认为,在20世纪50年代中期至后期,一系列葡萄球菌医院和托儿所疫情使噬菌体分型专家团结起来,使他们的技术的实用性得到国际认可,并在此过程中为感染控制新领域的建立做出了贡献。通过使用这种新工具,噬菌体分型专家确立了自己作为感染控制专家的地位,在一些地方,成为新成立的感染控制委员会的重要成员。托儿所疫情对噬菌体分型和感染控制来说是一个特别重要的考验,因为这种葡萄球菌菌株(80/81)具有特别强的毒性,并且迅速从医院传播到更广泛的社区。噬菌体分型专家提供的流行病学信息对于制定如何控制这种致命葡萄球菌菌株的实用建议至关重要,也对于将医院细菌学家的角色从单纯的技术人员转变为感染控制专家至关重要。