Staphylococcal infection in an intensive-care unit, and its relation to infection in the remainder of the hospital.

A survey of the staphylococcal infections occurring in a general hospital over a period of four and a half years showed that multiple-resistant strains of phage type 77 were endemic in the medical and surgical wards. Strains of this phage type were uncommon among patients attending the casualty department, and those found were usually either fully sensitive to antibiotics or resistant to benzylpenicillin only. Regular monitoring of patients admitted to the intensive-care unit showed that 58% of staphylococcal infections in such patients were present at the time of admission to the unit. Although the wards thus constituted a significant reservoir of infection for the intensive-care unit, there was no evidence to suggest that the return of patients from the unit to the wards was responsible for the transfer of infection in the opposite direction. The possibility of reducing the numbers of multiple-resistant staphylococci in the general wards, by the screening of all new admissions for the presence of tetracycline-resistant strains, appears to be impracticable in this area.