Pneumococci in Mouths of Surgical Cases. 



83 



159 (1337) 



Types of pneumococci found in the mouths of surgical cases 



before operation. 



By Miriam Olmstead. 



[From the Bacteriological Laboratory, The Presbyterian Hospital.] 



An investigation of post-operative pneumonia during 1916 

 and 191 7, a report of which has been made by Dr. Whipple, 1 

 involved a routine search for pneumococci in the mouths of cases 

 admitted to the surgical service of The Presbyterian Hospital. 



The method of procedure was as follows: A specimen of 

 sputum or saliva, whatever the patient could expectorate, was 

 received in a sterile jar and sent to the laboratory. The specimen 

 was injected into a mouse and the type of pneumococcus recovered 

 from the mouse was determined by agglutination reactions, testing 

 a pure culture against pneumococcus serum furnished by courtesy 

 of The Rockefeller Institute. When a patient could not expec- 

 torate, the throat was swabbed, a culture made from the swab 

 and pneumococci isolated from the culture. After a few months, 

 only expectorated specimens were used, owing to the small per- 

 centage of cultures yielding pneumococci. From February to 

 June, 1916, two hundred and forty-nine swab cultures were ex- 

 amined, from forty-three of which pneumococcus was recovered, 

 a percentage of only 17.2. The incidence of pneumococcus in 

 four hundred and twenty-nine expectorated specimens during the 

 same period was one hundred and seventy-five, a percentage of 

 40.7. If it had been feasible to inoculate a mouse with the wash- 

 ings from a swab immediately after its leaving the mouth, this 

 method of detecting the presence of pneumococcus in the mouth 

 would have been satisfactory; but in consideration of the tech- 

 nique employed it is highly probable that 17.2 per cent, under- 

 estimates the number of individuals in that group harboring 

 pneumococci. However, in tabulating the results according to 

 type, these individuals have been included. 



Two thousand four hundred and seventy-seven specimens 

 have been examined, two thousand two hundred and twenty-eight 



1 Whipple, A. O., Surg. Cyn. and Obstet., 1918, XXVI, 29. 



