Notes on the etiology and epidemiology of impetigo contagiosa neonatorum

Abstract

1. Our observations corroborate the opinion of the previous investigators who find that a strain of Staphylococcus aureus of special virulence is the etiologic agent in impetigo contagiosa neonatorum. 2. A pure culture of Staphylococcus aureus isolated from an impetigo lesion failed to produce skin lesions in guinea pigs and rabbits. The same culture caused a nonvesicular inflammatory reaction in the skin of an adult and a typical exfoliating lesion in an infant from whom the organism was originally isolated. A hemolytic streptococcus isolated from the same infant produced only a small atypical lesion. 3. The cultural characteristics of the impetigo staphylococcus are practically the same as those of the ordinary staphylococcus. A questionable minor difference in the rate of carbohydrate fermentation is recorded. 4. The viability of the staphylococcus makes the disease transmissible through both human beings and inanimate objects, and renders disinfection of an infected hospital especially difficult. In the epidemics under observation it is probable that the transmission of the disease occurred chiefly through the nurses and the nursery supplies. 5. The variation in the different epidemics is due probably to a difference in the virulence of the infecting strain. The difference in clinical symptoms between adults and children or in individual infants seems to be due to the resistance of the host. 6. The primary prophylactic measure in a hospital epidemic is the individual handling of the well infants, as early cases are capable of transmitting the infection before a diagnosis is made. 1. Our observations corroborate the opinion of the previous investigators who find that a strain of Staphylococcus aureus of special virulence is the etiologic agent in impetigo contagiosa neonatorum. 2. A pure culture of Staphylococcus aureus isolated from an impetigo lesion failed to produce skin lesions in guinea pigs and rabbits. The same culture caused a nonvesicular inflammatory reaction in the skin of an adult and a typical exfoliating lesion in an infant from whom the organism was originally isolated. A hemolytic streptococcus isolated from the same infant produced only a small atypical lesion. 3. The cultural characteristics of the impetigo staphylococcus are practically the same as those of the ordinary staphylococcus. A questionable minor difference in the rate of carbohydrate fermentation is recorded. 4. The viability of the staphylococcus makes the disease transmissible through both human beings and inanimate objects, and renders disinfection of an infected hospital especially difficult. In the epidemics under observation it is probable that the transmission of the disease occurred chiefly through the nurses and the nursery supplies. 5. The variation in the different epidemics is due probably to a difference in the virulence of the infecting strain. The difference in clinical symptoms between adults and children or in individual infants seems to be due to the resistance of the host. 6. The primary prophylactic measure in a hospital epidemic is the individual handling of the well infants, as early cases are capable of transmitting the infection before a diagnosis is made.