Skip to main content
Journal of Clinical Microbiology logoLink to Journal of Clinical Microbiology
. 1986 Mar;23(3):604–608. doi: 10.1128/jcm.23.3.604-608.1986

Composition and antimicrobic resistance of skin flora in hospitalized and healthy adults.

E L Larson, K J McGinley, A R Foglia, G H Talbot, J J Leyden
PMCID: PMC268703  PMID: 3958149

Abstract

The aerobic bacterial flora of the skin of the anterior nares, axilla, perineum, and toe web in a group of 37 patients hospitalized for at least 2 weeks was compared with the flora of 30 healthy adults. Colony counts were significantly higher for flora of the perineum and toe web in both groups (P less than 0.05). Patients had significantly higher carriage rates of Proteus, Pseudomonas, and Candida spp. (P less than 0.01). Staphylococcus haemolyticus was isolated more frequently from patients, and S. hominis was isolated more frequently from controls (P less than 0.01). Patient microflora, including gram-positive cocci, gram-negative bacilli, large-colony diphtheroids, and lipophilic diphtheroids, showed a high degree of resistance to multiple antimicrobial agents. The gram-positive coccal flora of patients was significantly more resistant than that of controls for 8 of 10 antimicrobial agents tested. Methicillin resistance occurred in only 2.9% of isolates from controls, but in 44.3% from patients (P less than 0.01). This extensive survey identifies qualitative and quantitative differences in skin flora and confirms that significantly higher levels of antimicrobial resistance are present in all types of organisms from a number of skin sites in hospitalized patients.

Full text

PDF
604

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Archer G. L., Armstrong B. C. Alteration of staphylococcal flora in cardiac surgery patients receiving antibiotic prophylaxis. J Infect Dis. 1983 Apr;147(4):642–649. doi: 10.1093/infdis/147.4.642. [DOI] [PubMed] [Google Scholar]
  2. Archer G. L., Dietrick D. R., Johnston J. L. Molecular epidemiology of transmissible gentamicin resistance among coagulase-negative staphylococci in a cardiac surgery unit. J Infect Dis. 1985 Feb;151(2):243–251. doi: 10.1093/infdis/151.2.243. [DOI] [PubMed] [Google Scholar]
  3. Baumgart S., Hall S. E., Campos J. M., Polin R. A. Sepsis with coagulase-negative staphylococci in critically ill newborns. Am J Dis Child. 1983 May;137(5):461–463. doi: 10.1001/archpedi.1983.02140310043012. [DOI] [PubMed] [Google Scholar]
  4. Bergan T., Lernestedt J. O. Antibiotic resistance in staphylococci from a hospital environment. Chemotherapy. 1983;29(1):28–36. doi: 10.1159/000238170. [DOI] [PubMed] [Google Scholar]
  5. Chow A. W., Taylor P. R., Yoshikawa T. T., Guze L. B. A nosocomial outbreak of infections due to multiply resistant Proteus mirabilis: role of intestinal colonization as a major reservoir. J Infect Dis. 1979 Jun;139(6):621–627. doi: 10.1093/infdis/139.6.621. [DOI] [PubMed] [Google Scholar]
  6. Eng R. H., Wang C., Person A., Kiehn T. E., Armstrong D. Species identification of coagulase-negative staphylococcal isolates from blood cultures. J Clin Microbiol. 1982 Mar;15(3):439–442. doi: 10.1128/jcm.15.3.439-442.1982. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Friedman L. E., Brown A. E., Miller D. R., Armstrong D. Staphylococcus epidermidis septicemia in children with leukemia and lymphoma. Am J Dis Child. 1984 Aug;138(8):715–719. doi: 10.1001/archpedi.1984.02140460007005. [DOI] [PubMed] [Google Scholar]
  8. Gill V. J., Selepak S. T., Williams E. C. Species identification and antibiotic susceptibilities of coagulase-negative staphylococci isolated from clinical specimens. J Clin Microbiol. 1983 Dec;18(6):1314–1319. doi: 10.1128/jcm.18.6.1314-1319.1983. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Gruer L. D., Bartlett R., Ayliffe G. A. Species identification and antibiotic sensitivity of coagulase-negative staphylococci from CAPD peritonitis. J Antimicrob Chemother. 1984 Jun;13(6):577–583. doi: 10.1093/jac/13.6.577. [DOI] [PubMed] [Google Scholar]
  10. Huovinen P., Grönroos P., Herva E., Katila M. L., Klossner M. L., Renkonen O. V., Toivanen P. Aminoglycoside resistance among blood culture isolates. J Clin Microbiol. 1984 Jul;20(1):65–69. doi: 10.1128/jcm.20.1.65-69.1984. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Kirby W. M. Vancomycin therapy of severe staphylococcal infections. J Antimicrob Chemother. 1984 Dec;14 (Suppl 500):73–78. doi: 10.1093/jac/14.suppl_d.73. [DOI] [PubMed] [Google Scholar]
  12. Lacey R. W., Keyworth N., Lincoln C. Staphylococci in the U.K.: a review. J Antimicrob Chemother. 1984 Dec;14 (Suppl 500):19–25. doi: 10.1093/jac/14.suppl_d.19. [DOI] [PubMed] [Google Scholar]
  13. Larson E. L., Strom M. S., Evans C. A. Analysis of three variables in sampling solutions used to assay bacteria of hands: type of solution, use of antiseptic neutralizers, and solution temperature. J Clin Microbiol. 1980 Sep;12(3):355–360. doi: 10.1128/jcm.12.3.355-360.1980. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Liu C. The untamable staphylococci: continuous problems in infectious diseases. Compr Ther. 1984 Jun;10(6):49–54. [PubMed] [Google Scholar]
  15. Lowy F. D., Hammer S. M. Staphylococcus epidermidis infections. Ann Intern Med. 1983 Dec;99(6):834–839. doi: 10.7326/0003-4819-99-6-834. [DOI] [PubMed] [Google Scholar]
  16. Marsik F. J., Brake S. Species identification and susceptibility to 17 antibiotics of coagulase-negative staphylococci isolated from clinical specimens. J Clin Microbiol. 1982 Apr;15(4):640–645. doi: 10.1128/jcm.15.4.640-645.1982. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. McBride M. E., Duncan W. C., Bodey G. P., McBride C. M. Microbial skin flora of selected cancer patients and hospital personnel. J Clin Microbiol. 1976 Jan;3(1):14–20. doi: 10.1128/jcm.3.1.14-20.1976. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. McGinley K. J., Labows J. N., Zeckman J. M., Nordstrom K. M., Webster G. F., Leyden J. J. Pathogenic JK group corynebacteria and their similarity to human cutaneous lipophilic diphtheroids. J Infect Dis. 1985 Oct;152(4):801–806. doi: 10.1093/infdis/152.4.801. [DOI] [PubMed] [Google Scholar]
  19. McGowan J. E., Jr Antimicrobial resistance in hospital organisms and its relation to antibiotic use. Rev Infect Dis. 1983 Nov-Dec;5(6):1033–1048. doi: 10.1093/clinids/5.6.1033. [DOI] [PubMed] [Google Scholar]
  20. Noel G. J., Edelson P. J. Staphylococcus epidermidis bacteremia in neonates: further observations and the occurrence of focal infection. Pediatrics. 1984 Nov;74(5):832–837. [PubMed] [Google Scholar]
  21. Richardson J. F., Marples R. R., de Saxe M. J. Characters of coagulase-negative staphylococci and micrococci from cases of endocarditis. J Hosp Infect. 1984 Jun;5(2):164–171. doi: 10.1016/0195-6701(84)90120-8. [DOI] [PubMed] [Google Scholar]
  22. Tennent J. M., May J. W., Skurray R. A. Multiple antibiotic resistance in Staphylococcus aureus and Staphylococcus epidermidis: plasmids in strains associated with nosocomial infection. Pathology. 1984 Jul;16(3):250–255. doi: 10.3109/00313028409068532. [DOI] [PubMed] [Google Scholar]
  23. Varaldo P. E., Cipriani P., Focá A., Geraci C., Giordano A., Madeddu M. A., Orsi A., Pompei R., Prenna M., Repetto A. Identification, clinical distribution, and susceptibility to methicillin and 18 additional antibiotics of clinical Staphylococcus isolates: nationwide investigation in Italy. J Clin Microbiol. 1984 Jun;19(6):838–843. doi: 10.1128/jcm.19.6.838-843.1984. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Verhoef J., Fleer A. Staphylococcus epidermidis endocarditis and Staphylococcus epidermidis infection in an intensive care unit. Scand J Infect Dis Suppl. 1983;41:56–64. [PubMed] [Google Scholar]
  25. Yu V. L., Zuravleff J. J., Bornholm J., Archer G. In-vitro synergy testing of triple antibiotic combinations against Staphylococcus epidermidis isolates from patients with endocarditis. J Antimicrob Chemother. 1984 Oct;14(4):359–366. doi: 10.1093/jac/14.4.359. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Clinical Microbiology are provided here courtesy of American Society for Microbiology (ASM)

RESOURCES