Susceptibility of clinical isolates of Staphylococcus aureus to killing by oxacillin.

Sixty clinical isolates of Staphylococcus aureus have been screened for their relative susceptibility to the killing action of oxacillin. Only one of these strains was found to be exceptionally resistant to the bactericidal effect of this and other beta-lactam antibiotics. This ability to survive oxacillin inhibition of cell wall synthesis has been called "tolerance". The characteristics of the tolerant organism, which has been designated the Evans strain, in comparison with other isolates of S. aureus indicate that this form of resistance is not apparent from the minimal inhibitory concentration, is not related to an abnormal growth rate, and can be enhanced by treatment with N-methyl-N'-nitro-N-nitrosoguanidine.