Tracking the Staph

Now that dangerous and potentially deadly infections with drug-defying strains of bacteria have become a major public-health menace, especially among patients already in hospitals for other reasons (TIME, March 24, Nov. 17), physicians will go to any lengths to trace the source of the trouble. Last week Dr. Harris D. Riley Jr. told a New Orleans meeting of the American Federation for Clinical Research how elementary gumshoe work had led disease detectives from Oklahoma City to a small-town hospital that was a hotbed of infection.

Two sisters, 10 and 12, had been bothered for months with skin abscesses that would not heal despite treatment with the most powerful antibiotics. They were taken to Children's Memorial Hospital in Oklahoma City. There Dr. Riley and colleagues identified the cause of the girls' illness as a strain of Staphylococcus aureus (the commonest germ in wounds and boils) that resists the killing powers of penicillin and many other drugs. Fortunately, the strain was sensitive to the antibiotic vancomycin, and the girls were soon on the mend. But where had they picked up the infection?

Playmates, the obvious suspects, were exonerated. Checking the parents, the doctors found that the girls' mother was a nurse in a small hospital 100 miles away. And this hospital had had an epidemic of resistant staph just before the girls got their abscesses. Tricky test-tube work showed that the mother was carrying the same resistant staph in her nasal passages. She was a "healthy carrier." More work showed that 43 of 59 patients and staff members also carried staph, mostly in mild form. The mother is now getting a combination of antibiotics in hopes of making her a healthy noncarrier.

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