Ultrastructure of staphylococci in respiratory infections treated with nafcillin.

A patient with a pleural effusion containing Staphylococcus aureus was treated with nafcillin. Another patient with bilateral upper lobe infiltrates which grew S. aureus from a catheter inserted through a fiberoptic bronchoscope into the lesion was also treated with nafcillin. Electron microscopy of organisms grown while the patients were receiving nafcillin showed staphylococci which were twice as large as normal and contained multiple cross-walls and normal peripheral cell walls. Such abnormal staphylococci result from exposure to subminimum inhibitory concentrations of beta-lactam antibiotics.