Staphylococcal sepsis in a burns unit

An outbreak of staphylococcal sepsis in a burns unit occurred between January 1976 and May 1978. Many patients and members of staff had boils, and a number of patients also developed septicaemia. Most of the boils in the early period of the trial and a large proportion of boils in patients during the later period yielded Staphylococcus aureus resistant to penicillin, tetracycline and erythromycin only (PTE), and were shown to be of phage type 95 in the early period while strains were phage typed. From blood cultures, most strains in the early period were of resistance pattern PTE and phage type 95, but in the later period other resistance patterns were predominant. Strains from burns were usually multiresistant (PTEKNML) and of the phage pattern 29/77, which had been endemic in the Unit, but during the early period of the outbreak there was an increased proportion of strains in burns with the resistance pattern PTE and of phage type 95. Staphylococcal sepsis has for many years been very infrequent in the burns unit. This outbreak seems to have been initiated by a strain of phage type 95 and resistance pattern PTE, but during the course of the outbreak the endemic strain of type 29/77 and some other staphylococci seem to have developed enhanced ability to cause clinical infections, conceivably by transduction from the epidemic strain of phage type 95.