SYNOPSIS Members of a newly recognized group of hospital staphylococci, which are believed to have arisen from 83A staphylococci by lysogenization, differ from them in several cultural characters. Some but not all of these characters appear to be determined by the carriage of phage.In 1960, a new group of Staphylococcus aureus strains not lysed by any of the basic set of typing bacteriophages made their appearance in British hospitals. These organisms gave inhibition reactions with some of the group III phages applied at 1,000 times the routine test dilution. This suggested that they were related to each other, and possibly also to staphylococci that were lysed only by phage 83A, which gave similar inhibition reactions and had first been recognized about two years earlier as causes of endemic infection in British hospitals. Jevons and Parker (1964) produced evidence that the new untypable staphylococci had arisen from the 83A organism by lysogenization with a phage which blocked the reaction with phage 83A. The blocking phages obtained from several distinct strains of the new organisms were, however, all different in host range, and included members of several serological groups. Strains from different places also differed in their susceptibility to lysis by a set of experimental phages. It was concluded that the new organisms had arisen by a number of separate lysogenizations, and probably not all from the same 83A strain. They did not constitute a 'type', but rather a group or complex of related strains.In 1963, several authors reported that the new untypable staphylococci had unusual cultural characters. Willis and Turner (1963) in Leeds found that many Staph. aureus strains that were resistant both to penicillin and to tetracycline formed a lemon-yellow pigment on glycerol monoacetate agar. According to Jacobs, Willis, Ludlam, and , most of these lemon-yellow organisms were untypable, but gave inhibition reactions with group III phages at routine test dilution x 1,000. In this they resembled the new untypable organisms prevalent in Glasgow Received for publication January 1966 and Liverpool (Temple and Blackburn, 1963;Turner, 1963;Willis, Jacobs, and Goodburn, 1963). Further investigations showed that lemon-yellow, tetracycline-resistant cultures differed from most others in that they were usually not 'proteolytic', i.e., did not cause darkening of heated blood agar (99 %), but were often f-lysin positive (33 %) and staphylokinase (fibrinolysin) negative (68 %); the incidence of these characters in other Staph. aureus cultures was, for absence of protease 21 %, for ,B-lysin production 3 %, and for absence of staphylokinase 24 %. It was later shown that the new untypable staphylococci seldom hydrolysed Tween 80 (Smith, Willis, and O'Connor, 1965). Robertson (1963) found that most of them were resistant to neomycin (see also Lowbury, Babb, Brown, and Collins, 1964). It seemed, therefore, that the new organisms were characteristically lemon-yellow, non-'proteolytic', ,B-lysin positive, staphylokinase-negat...
Common-source OutbreaksCommon-source outbreaks of sepsis due to Gram-negative organisms arise because of the persistence or multiplication of the organisms in items of equipment or in solutions used in hospitals. This paper reviews forty-three such outbreaks, selected from the published reports of the last twenty years to illustrate the many different
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