The ubiquitous Staphylococcus aureus causes several kinds of public health and clinical problems. It is the most common causative organism of boils, pimples, and other skin infections. When the staphylococcus grows in cream pies, potato salad, cooked meats, or other foodstuffs that have been prepared unhygienically, it produces a heat-stable, tasteless enterotoxin that causes severe and often explosive vomiting and diarrhea a few hours after ingestion—this is the most common cause of food poisoning outbreaks following communal feasts of many kinds.
Entirely different and more serious consequences can follow from a nidus (place of origin) of staphylococcal infection in hospitals, where the organism is often resistant to all common antibiotics. There have been many fatal outbreaks of "golden staph" infections, sometimes serious enough to lead to temporary closure of affected hospitals. Hospital-acquired (nosocomial) staphylococcal infection, due frequently to antibioticresistant organisms, causes septicemia, endocarditis, osteomyelitis, and pneumonia—any of which can be fatal, especially in debilitated patients.
Another manifestation of staphylococcal infection is toxic shock syndrome. This occurs because super-absorbent vaginal tampons provide an ideal culture medium for the organism, enabling it to produce large quantities of enterotoxin. (Toxic shock syndrome can also be caused by other organisms such as the streptococcus.) Other settings for institutionally acquired staphylococcal infection include nurseries and nursing homes, where vulnerable infants and elderly people can be exposed either to nosocomial or enterotoxic staphylococcal infection.
Prevention of institutionally acquired staphylococcal infection requires rigorous attention to personal hygiene on the part of all attending staff. The nasal mucosa is a common site for carriage of the staphylococcus, which can be detected by swabbing, and can be treated with topically applied antibiotic cream.
JOHN M. LAST