During a bacterial interference program in a newborn nursery 38 (5.9%) of 644 deliberately colonized babies developed disease related to the Staphylococcus aureus 502A blocking strain. Thirty infants had pustules, six had conjunctivitis, and one infant developed an abscess. An infant of a diabetic mother developed septicemia and meningitis, probably secondary to passing an umbilical vein catheter through the colonized umbilical stump. Staphylococcus aureus 502A and Escherichia coli were isolated from blood culture before death and from autopsy cultures of blood and peritoneum. A meningeal culture grew S aureus 502A. Gram-positive cocci were identified in liver, lung, heart, and meninges. Only two (0.5%) minor 502A infections were seen in 444 spontaneously colonized infants. The benefits of S aureus 502A programs far outweigh their hazards. Disease due to the 502A strain is more frequent when the inoculum applied to the infant is large than when it is kept below 4,000 bacteria. The fatal case emphasizes that bacteria of extremely low virulence may produce serious disease in compromised hosts and that catheterization through a contaminated umbilical stump may induce bacteremia.
Houck PW, Nelson JD, Kay JL. Fatal Septicemia Due to Staphylococcus aureus 502A: Report of a Case and Review of the Infectious Complications of Bacterial Interference Programs. Am J Dis Child. 1972;123(1):45–48. doi:10.1001/archpedi.1972.02110070095012
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