Predominance of two newly described capsular polysaccharide types among clinical isolates of Staphylococcus aureus.

A capsular polysaccharide typing schema for Staphylococcus aureus, based upon the preparation of rabbit typing sera with eight prototype strains, has been reported ( Karakawa and Vann , 1982). These antisera were used to classify the capsular polysaccharides of 246 S. aureus isolates from patients in a survey of hospitals in several countries and 49 consecutive blood isolates obtained over a 17-month period in a clinical study at the Boston Veterans' Administration Medical Center. Two capsular types, 5 and 8, accounted for about 70% of these isolates; most of the remaining strains could not be typed with the available antisera. The clinical study of bacteremia identified capsular types 5 and 8 among both community-acquired and nosocomial isolates and showed that strains bearing these two types caused the patterns of disease reported for staphylococcal bacteremia. There was an association between the phage type and the capsular type of these bacteremic strains. The capsular types of the "classic" encapsulated strains of S. aureus, M (type 1) and Smith (type 2), were not observed among blood isolates in this study. The observation that most clinical isolates of S. aureus belong to two recently defined capsular types provides a new focus for investigations into the virulence of this common nosocomial pathogen and suggests the potential for protective acquired immunity against staphylococcal bacteremia.