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Endemic Resistance to Amikacin Among Hospital Isolates of Gram-Negative Bacilli: Implications for Therapy

Published online by Cambridge University Press:  02 January 2015

Gary P. Wormser ,
Joseph Tatz  and
Joseph Donath
Gary P. Wormser*
Affiliation:
Sections of Infectious Diseases and Laboratory Medicine of the Veterans Administration Medical Center, Bronx, New York Division of Infectious Diseases and the Department of Medicine of the New York Medical College, Valhalla, New York
Joseph Tatz
Affiliation:
Sections of Infectious Diseases and Laboratory Medicine of the Veterans Administration Medical Center, Bronx, New York Division of Infectious Diseases and the Department of Medicine of the New York Medical College, Valhalla, New York
Joseph Donath
Affiliation:
Sections of Infectious Diseases and Laboratory Medicine of the Veterans Administration Medical Center, Bronx, New York Division of Infectious Diseases and the Department of Medicine of the New York Medical College, Valhalla, New York
*
New York Medical College, Room 03, Macy Pavilion, Valhalla, NY 10595
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Abstract

We reviewed the records of the microbiology laboratory of the Veterans Administration Medical Center, Bronx, New York in order to determine the prevalence, epidemiology and complete antibiotic susceptibility profile of amikacin-resistant aerobic and facultative gram-negative bacilli isolated from clinical specimens submitted for culture between January 1,1980 and May 1,1981. Of more than 5000 gram-negative rods isolated during this 16-month period, 2.8% were determined to be resistant to amikacin by the disc diffusion method. Eighty-eight of the amikacin-resistant organisms were unique isolates derived from cultures on 74 patients located throughout the hospital. Urine (51%) and sputum (27%) were the predominant sources of specimens yielding resistant strains. These organisms represented seven different genera of Enterobacteriaceae (58%) or Pseudomonas aeruginosa (31%) and other glucose non-fermenting species (11%). Resistance to amikacin was usually associated with resistance to gentamicin, tobramycin and most of the other antimicrobials tested. Twenty percent of isolates were susceptible to only a single antimicrobial, and another 5% were resistant to every agent routinely tested. Although geographic clustering of a small number of amikacin-resistant organisms occurred twice (a strain of Proteus mirabilis on the spinal cord injury service and a strain of P. aeruginosa on one medical ward), the vast majority of isolations were consistent with a pattern of endemic resistance.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 4 , Issue 2 , April 1983 , pp. 93 - 99
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1983

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References

1.Rennie, RP, Duncan, IBR, Emergence of gentamicin-resisiant Klebsiella in a general hospital. Antimicrob Agents Chemother 1977;11:179–184.CrossRefGoogle ScholarPubMed
2.Weinstein, RA, Nathan, C, Gruensfelder, R, et al: Endemic aminoglycoside resistance in gram-negative bacilli: Epidemiology and mechanisms. J Infect Dis 1980;141:338–345.CrossRefGoogle ScholarPubMed
3.Speller, DCE, Hospital infection by multi-resistant gram-negative bacilli. J Antimicrob Chemother 1980;6:168–170.CrossRefGoogle ScholarPubMed
4.Davies, J, Bacterial resistance to aminoglycoside antibiotics. J Infect Dis 1971;124(Suppl):7–10.CrossRefGoogle ScholarPubMed
5.Pien, FD, Ho, PWL, Antimicrobial spectrum, pharmacology, adverse effects, and therapeutic use of amikacin sulfate. Am J Hosp Pharm 1981;38:981–989.Google ScholarPubMed
6.Block, CS, Fabian, B, Robinson, RG, Gentamicin-resistant gramnegative bacilli in hospital patients. Part II. In vitro aspects including susceptibility to tobramycin and amikacin. S Afr Med J 1978;53:396–399.Google Scholar
7.John, FJ Jr, Rubens, CE, Farrar, WE JrCharacteristics of gentamicin resistance in nosocomial infections. Am J Med Sci 1980;279:25–30.CrossRefGoogle ScholarPubMed
8.Duncan, IBR, Cheung, EY, Haidane, EV, et al: Resistance to aminoglycoside antibiotics of gram-negative bacilli isolated in Canadian hospitals. Can Med Assoc J 1981;124:1165–1167.Google ScholarPubMed
9.Lynch, JM, Hodges, GR, Clark, GM, Dworzack, DL, Gram-negative bacteremias. Analysis of factors for clinical assessment of gentamicin resistance. Arch Intern Med 1981;141:582–586.CrossRefGoogle ScholarPubMed
10.Price, KE, Kresei, PA, Farchione, LA, et al: Epidemiological studies of aminoglycoside resistance in the USA. J Antimicrob Chemother 1981;8(Suppl A):89–105.CrossRefGoogle Scholar
11.Tally, FP, Gorbach, SL, Review of 152 patients with bacteremias treated with amikacin. Am J Med 1977;62:940–944.CrossRefGoogle ScholarPubMed
12.Hahn, DM, Schimpff, SC, Young, VM, et al: Amikacin and cephalothin: Empiric regimen for granulocytopenic cancer patients. Antimicrob Agents Chemother 1977;12:618–624.CrossRefGoogle ScholarPubMed
13.Meyer, RD, Patterns and mechanisms of emergence of resistance to amikacin. J Infect Dis 1977;136:449–452.CrossRefGoogle ScholarPubMed
14.Wormser, GP, Donath, J, Kennish, A, et al: Fatal pneumonia. Emergence of an amikacin sulfate-resistant strain of Escherichia coli. NY State J Med 1981;81:1088–1089.Google ScholarPubMed
15.Cook, LN, Davis, RS, Stover, BH, Outbreak of amikacin-resistant Enterobacteriaceae in an intensive tare nursery. Pediatrics 1980;65:264–268.CrossRefGoogle Scholar
16.Bauer, WW, Kirby, WMM, Sherris, JC, et al: Antibiotic susceptibility testing by a standardized single disc method. Am J Clin Pathol 1966;45:493–496.CrossRefGoogle Scholar
17.Performance standards for antimicrobial disc susceptibility tests, in Approved Standards, ed 2. Villanova, Pennsylvania, National Laboratory Standards, 1979;16–17.Google Scholar
18.Washington, JA II, Yu, PKW, Gavan, TL, et al: Interpretation of the disc diffusion susceptibility test for amikacin: Report of a collaborative study. Antimicrob Agents Chemother 1979;15:400–407.CrossRefGoogle Scholar
19.Perryman, FA, Flournoy, DJ, Prevalence of gentamicin and amikacin-resistant bacteria in sink drains. J Clin Microbiol 1980;12:79–83.CrossRefGoogle ScholarPubMed
20.DiPersio, JR, Krafczyk, TL, In vitro activity of netilmicin, gentamicin, tobramycin and amikacin against glucose fermenting and non-fermenting bacteria. Chemother 1980;26:323–333.CrossRefGoogle Scholar
21.Janda, JM, Bottone, EJ, Pseudomonas aeruginosa enzyme profiling: Predictor of potential invasiveness and use as an epidemiological tool. J Clin Microbiol 1981;14:55–60.CrossRefGoogle ScholarPubMed
22.Moellering, RC Jr, Wennemen, C, Kunz, LJ, et al: Resistance to gentamicin, tobramycin and amikacin among clinical isolates of bacteria. Am J Med 1977;62:873–881.CrossRefGoogle ScholarPubMed
23.Jauregui, L, Cushing, RD, Lerner, AM, Gentamicin/amikacin-resistant gram-negative bacilli at Detroit General Hospital, 1975-1976. Am J Med 1977;62:882–888.CrossRefGoogle ScholarPubMed
24.Kauffman, CA, Ramondo, NC, Williams, SG, et al: Surveillance of gentamicin-resistant gram-negative bacilli in a general hospital. Antimicrob Agents Chemother 1978;13:918–923.CrossRefGoogle ScholarPubMed
25.Drasar, FA, Farrell, W, Maskell, J, et al: Tobramycin, amikacin, sissomicin, and gentamicin resistant gram-negative rods. Br Med J 1976;2:1284–1287.CrossRefGoogle ScholarPubMed
26.Mouton, RP, Choice of an aminoglycoside. J Antimicrob Chemother 1980;6:166–167.CrossRefGoogle ScholarPubMed
27.Finland, M, Changing ecology of bacterial infection as related to antibacterotherapy. J Infect Dis 1970;122:419–431.CrossRefGoogle Scholar
28.Price, KE, Casson, K, DeRegis, RG, et al: Amikacin: Antimicrobial properties and resistance mechanisms affecting its activity. Presented at the US Amikacin Symposium, Los Angeles, November 9 to 10, 1976.Google Scholar
29.Sande, MA, Mandeli, GL, Miscellaneous antibacterial agents; antifungal and antiviral agents, in Oilman, AG, Goodman, LS, Gilman, A (eds): The Pharmacological Basis of Therapeutics, ed 6. New York, MacMillan Publishing Co Inc, P 1230.Google Scholar
30.Stephens, M, Potten, M, Bint, AJ, The sensitivity of gentamicin-resistant gram-negative bacilli to cefotaxime, other cephalosporins and aminoglycosides. Infection 1979;7:109–112.CrossRefGoogle ScholarPubMed
31.Reimer, LG, Mirrett, S, Relier, LB, Comparison of in vitro activity of moxalactam (LY127935) with cefazolin, amikacin, tobramycin, carbenicillin, piperacillin and ticarcillin against 420 blood culture isolates. Antimicrob Agents Chemother 1980;17:412–416.CrossRefGoogle ScholarPubMed
32.Thomas, FE Jr, Leonard, JM, Alford, RH, Sulfamethoxazole-trimelhoprim-polymixin therapy of serious multiply drug-resistant Serratia infections. Antimicrob Agents Chemother 1976;9:201–207.CrossRefGoogle ScholarPubMed