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SummaryLarge discrepancies in the available data on skin microbiology stimulated investigations of the number, interactions, and location of commensals and the true efficiency of disinfection by using skin biopsy, culture of frozen sections, and other methods.Most current procedures were less than 0 5% as sensitive as the biopsy method described. This gave mean bacterial counts ranging from 4,400/cm2 on the breast to 400,000/cm2 in the axillae. An iodine preparation removed 95% of accessible organisms, but about 20% of bacteria were protected by follicles, crevices, and lipids. Commensals in over 20% of people produced antibiotics against a wide range of pathogens. Conversely, "satellitism" was demonstrable in 12% of people.

The date of onset of 360 acute renal transplant rejection episodes from 1969 to 1973 have been compared with the prevalence of various common viral infections and infections due to Mycoplasma pneumoniae. A positive correlation was found for influenza B infections (r = 0.43, p < 0.01) up to 5 months before transplantation and for adenovirus infections (r = 0.32, p < 0.05) at 1 month before kidney grafting.

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Antibiotic-producing bacteria were present on the healthy intact skin of 77 of 340 people but predominated in only 38-9% of these. In contrast, antibiotic-producers which occurred in the lesions of 51 out of 263 dermatological patients predominated in 78-4%. The presence of inhibitory commensals in skin lesions was associated with a significantly low incidence of secondary infection both on admission and during hospital stay; there was, however, a small excess of Gram-negative infections on admission in skin lesions containing antibiotic producers. Among ninety surgical patients, also, the presence of inhibitory skin bacteria was associated with a relatively low rate of wound colonization by pathogenic bacteria. The ecological implications and practical applications of the findings are discussed.