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The aim of this study was to determine the frequency and persistence of Staphylococcus aureus carriage in the throat in relation to anterior naris carriage. By use of a sensitive enrichment broth, S. aureus was cultured from the two sites from 259 patients upon admission to an orthopedic ward and from 87 staff members of the same ward. The throat was the most common carriage site in both groups. Forty percent of the patients and 54% of the staff were positive for S. aureus in the throat, compared to 31% and 36%, respectively, in the anterior nares. To determine the persistence of carriage, 67 individuals were repeatedly sampled from the anterior nares and the throat over 2 years (5 to 10 sampling occasions; mean, 7.8). The majority, 58% (39/67), were defined as persistent carriers of S. aureus, considering culture results from both sites. Of the 39 persistent carriers, 15 individuals were culture positive from only the throat on more than half of the sampling occasions (these are called preferential throat carriers) while only 5% (two individuals) were preferential anterior naris carriers by use of the same definition. Typing of the collected S. aureus isolates by pulsed-field gel electrophoresis revealed that the same strain of S. aureus was present, over time, in the throat of an individual at least to the same extent as in the anterior nares. Throat carriage was at least as persistent as carriage in the anterior nares.

Microcalorimetry was used to study the kinetics of the actions of various tetracyclines on a strain of Escherichia coli. Differences in the capacity to suppress the metabolism of this bacterium were observed. When the antibiotic was present from the start of the experiment, a heat production of 2.0 muW/ml was registered after 12.5 h using minocycline; the corresponding figures for doxycycline, oxytetracycline, and tetracycline were 7.3, 6.6, and 4.5 h, respectively. In these experiments, equal concentrations, i.e., half the minimum inhibitory concentration (MIC), of each drug were used. The MIC for all the tetracyclines tested, determined by the broth dilution technique, was 0.8 mug/ml. In other experiments, the antibiotic (concentration, 1.6 mug/ml = 2x MIC) was introduced into the growth vessel during the logarithmic growth phase of the organism. The extent and duration of the inhibitory effect on the metabolism, as judged from the decrease in heat production, varied with the different tetracyclines. Immediately after introduction, minocycline, doxycycline, oxytetracycline, and tetracycline decreased the heat production in decreasing order of potency. With tetracycline, the heat production rose after about 1 h, and with minocycline it rose after about 9 h. The heat production remained at a low level for at least 19 h when using doxycycline and oxytetracycline. The results indicate that microcalorimetry offers a means for studies of the kinetics of the antibacterial actions of antibiotics and provides information that cannot be obtained by conventional bacteriological techniques. This information may be of use, in conjunction with pharmacokinetic data, in establishing optimum doses and dose intervals in antibiotic therapy.