Sources and susceptibilities of staphylococci isolated from children. A seven-year survey.

A seven-year surveillance was done of the antibiotic susceptibility of Staphylococcus aureus isolated from patients seen in The Children's Hospital, Birmingham, Ala. There were no outbreaks of hospital-acquired staphylococcal infection during this time. Of 5,479 strains, 2,685 were from hospitalized children; 2,794 of 5,479 were from outpatients. The incidence of penicillin resistance increased from 76% to more than 85% between 1973 and 1979, with no significant difference noted between inpatient and outpatient strains. Penicillin resistance was similar, regardless of the clinical source (site of isolation) of staphylococci. Skin lesions, soft tissue, wounds, and abscess perennially accounted for the greatest proportion of isolates. Thus, skin lesions represent an important reservoir for penicillin-resistant staphylococci. Nearly all strains were susceptible to the other antibiotics tested; multiple resistance was rare. Susceptibility to clindamycin, erythromycin, cephalothin, sodium, and nafcillin sodium remained stable through the years. These agents provide effective therapeutic regimens for patients with staphylococcal infection, including those with penicillin allergy.