Abstract
The clinical evidence pointing to an infective origin of rheumatoid arthritis has led numerous investigators to seek a bacterial agent to which etiological significance could be ascribed. A wide variety of such agents has been reported, but lack of uniformity in the results obtained has confused rather than clarified the issue. Cecil, Nicholls and Stainsby, 1 by the use of a special technique, claim to have demonstrated the presence of streptococci in the blood-stream in 61.5% of a series of 78 cases examined. Because of the unusual nature of this report and the importance of such a finding the present investigation was undertaken.
The greatest care was exercised to follow their technique. The type of patient selected in all cases presented the characteristic clinical syndrome of rheumatoid arthritis. Cases of osteo-(hypertrophic, degenerative) arthritis were not included.
One hundred and five separate blood cultures were done on 80 patients. In the majority of instances the specimens of blood obtained at each vene puncture were divided into 2 portions so that in all 204 samples of blood were cultured. Eighteen selected patients were cultured on 2 occasions, 3 on 3 occasions and one on 6 occasions.
As a control 31 samples of blood were obtained from 16 normal individuals and subjected to similar methods of culture. Sixteen tubes of sterile, autoclaved agar were subjected to the same manipulations and cultured by the same technique.
The results may be summarized as follows: (1) In spite of the greatest care to conduct all manipulations under sterile precautions the technique was so involved as to call into serious question the significance of all bacterial growth encountered.
Get full access to this article
View all access options for this article.