The complete record of throat cultures on these cases is presented in Table LXVIII.
Group I includes 37 cases positive for hemolytic streptococci on admission.
(a) Twenty-two of these remained positive throughout the period of observation. Four patients became negative after one or two weeks and later showed positive findings, leaving the hospital as positives. These are classified as “irregular.” The results of culture were as follows: Cultured once only, 7; positive after one week, 7; positive after two weeks, 6; positive after three weeks, 2; irregular, 4.
| Table LXVIII | ||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Results of Throat Cultures in 242 Hospital Patients Identified as “Carriers” of Hemolytic Streptococci; Cultures Taken at Weekly Intervals | ||||||||||||||
| GROUP | 1st Culture | 2nd Culture | 3rd Culture | 4th Culture | 5th Culture | 6th Culture | 7th Culture | 8th Culture | 9th Culture | 10th Culture | 11th Culture | 12th Culture | No. of Contact “Carriers.” | No. with Acute Hem. Strep. Complications |
| I | 37 | Cases | ||||||||||||
| + | 7 | |||||||||||||
| + | + | 7 | ||||||||||||
| + | + | + | 6 | |||||||||||
| + | + | + | + | 2 | ||||||||||
| + | − | 8 | ||||||||||||
| + | − | − | 1 | |||||||||||
| + | − | − | − | − | 1 | |||||||||
| + | + | − | 1 | |||||||||||
| + | − | + | 2 | |||||||||||
| + | − | − | − | − | + | + | + | 1 | ||||||
| + | + | − | − | + | + | + | 1 | |||||||
| II | 67 | Cases | ||||||||||||
| − | + | 26 | 3 | |||||||||||
| − | + | + | 12 | 5 | ||||||||||
| − | + | + | + | 2 | 2 | |||||||||
| − | + | − | 9 | 1 | ||||||||||
| − | + | − | − | 0 | 1 | |||||||||
| − | + | + | − | 2 | 1 | |||||||||
| − | + | + | + | + | − | − | + | − | 1 | |||||
| − | + | − | + | 2 | ||||||||||
| III | 74 | Cases | ||||||||||||
| − | − | + | 38 | 5 | ||||||||||
| − | − | + | + | 5 | 3 | |||||||||
| − | − | + | + | + | 4 | 1 | ||||||||
| − | − | + | + | + | + | 0 | 2 | |||||||
| − | − | + | − | − | − | 0 | 1 | |||||||
| − | − | + | − | 4 | ||||||||||
| − | − | + | + | − | − | − | − | 1 | ||||||
| − | − | + | + | − | 0 | 2 | ||||||||
| − | − | + | + | − | − | − | 1 | |||||||
| − | − | + | + | + | + | − | 0 | 1 | ||||||
| − | − | + | − | + | 1 | |||||||||
| − | − | + | − | + | + | 2 | ||||||||
| − | − | + | − | + | + | + | 1 | |||||||
| − | − | + | − | − | + | + | 1 | |||||||
| − | − | + | + | + | − | − | + | 1 | ||||||
| IV | 34 | Cases | ||||||||||||
| − | − | − | + | 12 | 4 | |||||||||
| − | − | − | + | + | 5 | |||||||||
| − | − | − | + | + | + | 4 | ||||||||
| − | − | − | + | − | 3 | 1 | ||||||||
| − | − | − | + | − | − | 1 | ||||||||
| − | − | − | + | + | − | 1 | ||||||||
| − | − | − | + | + | + | − | 1 | |||||||
| − | − | − | + | − | − | + | + | 1 | ||||||
| − | − | − | + | + | − | − | − | − | − | 0 | 1 | |||
| V | 16 | Cases | ||||||||||||
| − | − | − | − | + | 1 | 1 | ||||||||
| − | − | − | − | + | + | 1 | 1 | |||||||
| − | − | − | − | + | − | 3 | 1 | |||||||
| − | − | − | − | + | − | − | − | 0 | 2 | |||||
| − | − | − | − | + | − | − | − | − | − | 1 | ||||
| − | − | − | − | + | + | − | 1 | |||||||
| − | − | − | − | + | − | + | 2 | |||||||
| − | − | − | − | + | + | − | + | 1 | ||||||
| − | − | − | − | + | + | − | − | − | + | 1 | ||||
| VI | 7 | Cases | ||||||||||||
| − | − | − | − | − | + | 1 | ||||||||
| − | − | − | − | − | + | + | 2 | |||||||
| − | − | − | − | − | + | − | 3 | |||||||
| − | − | − | − | − | + | − | − | 1 | ||||||
| VII | 4 | Cases | ||||||||||||
| − | − | − | − | − | − | + | 2 | |||||||
| − | − | − | − | − | − | + | + | 1 | ||||||
| − | − | − | − | − | − | + | − | − | − | − | − | 1 | ||
| VIII | 3 | Cases | ||||||||||||
| − | − | − | − | − | − | − | + | 2 | ||||||
| − | − | − | − | − | − | − | + | + | + | 1 | ||||
(b) Eleven of the patients entering as positives became negative, 10 after one week and 1 after two weeks.
This group of cases furnishes no data concerning the duration of the “carrier” state, since all cases were positive when first observed. In 30 per cent of instances, hemolytic streptococci disappeared within the first two weeks of observation.
Groups II to VIII include 205 patients who became positive at some time during their stay in the hospital. The arrangement in groups depends upon the length of time the patients remained in the hospital before acquiring S. hemolyticus. Ninety-five of these patients had no further cultures after the initial positive culture. Fourteen appear as “irregular,” as defined above. These two classes of cases are omitted in the following summary of these groups. The initial positive culture is arbitrarily considered the day of infection and subsequent cultures mark off weekly intervals.
(a) Thirty-nine patients had acute infections due to hemolytic streptococci. Thirteen of these patients passed from observation after their initial positive culture. The cases with repeated cultures after initial positive may be summarized as in Table LXIX.
| Table LXIX | |||
|---|---|---|---|
| NO. PATIENTS CULTURED | NO. BECOMING NEGATIVE | PER CENT BECOMING NEGATIVE | |
| Recultured after one week | 26 | 7 | 26.9 |
| Recultured after two weeks | 14 | 8 | 57.1 |
| Recultured after three weeks | 7 | 4 | 57.1 |
| Recultured after four weeks | 2 | 2 | 100.0 |
The records within this small group of cases indicate that hemolytic streptococci tend to disappear with the passing of the acute infection.