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October 15, 1960


JAMA. 1960;174(7):913. doi:10.1001/jama.1960.03030070091024

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To the Editor:—  In the paper by Dr. Nunnelly (J. A. M. A.173:1020 [July 2] 1960) are a number of points that require clarification:

  1. Of the 106 "respiratory and associated conditions," presumably screened to eliminate viral infections but at the same time representing a random sample," there are (Table 1) 106 associated organisms. One must assume one organism for each patient. Does this proportion of Klebsiella pneumoniae, Pseudomonas aeruginosa, and Escherichia coli, 58 out of 106 respiratory bacteria (Table 1), represent a peculiar geographic phenomenon?

  2. In Case 2 one encounters something unusual, a beta-hemolytic streptococcus that is penicillin resistant. Does this apply to one or more of the other 25 streptococci of Table 1? This is mentioned because of the difficulty we have in our efforts at rheumatic fever prophylaxis in convincing house officers of the necessity to treat hemolytic streptococcal infections with penicillin for at

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