Streptomycin-dependent variants of Bact. coli isolated from patients during treatment with streptomycin.

Since the publication in 1947 of Miller and Bohnhoff's report on streptomycin-dependent meningococci, streptomycin-dependent variants of many other bacterial species have been isolated and studied in vitro (Paine and Finland, 1948; Kushnick, Randles, Gray, and Birkeland, 1947; Yegian, Budd, and Vanderlinde, 1949). Miller and Bohnhoff also showed streptomycin-dependence in vivo when mice infected with streptomycin-dependent meningococci survived unless they were treated with streptomycin. Reports on the development of streptomycindependent variants observed clinically seem to have been relatively scanty. Miller and Bohnhoff found streptomycin-dependent bacteria in the throats of patients who had been treated with streptomycin, but these microorganisms did not play any role in the pathogenesis of the patients' illnesses. Dufourt, Brun, Viallier, and Kalb (1951) found streptomycin-dependent tubercle bacilli in patients receiving streptomycin treatment and claimed that continued administration of streptomycin in certain cases aggravated the infection. Eight cases of infection of the urinary tract treated with streptomycin are reported. During the treatment bacterial flora emerged which were only able to multiply on media containing streptomycin, i.e., the cultures were completely streptomycin dependent. After the withdrawal of streptomycin the streptomycin-dependent bacteria disappeared. In one patient renewed administration of streptomycin resulted in aggravation of the infection. This case will be described in detail together with a brief account of the seven other cases.