Staphylococcal resistance to aminoglycosides before and after introduction of amikacin in two teaching hospitals.
نویسندگان
چکیده
A prospective study was conducted to determine the prevalence of aminoglycoside-resistant Staphylococcus aureus and coagulase-negative staphylococci before and after the introduction of amikacin as the sole aminoglycoside used in our burn unit, adult intensive care unit, and neonatal intensive care unit. Pharyngeal or endotracheal cultures, as well as superficial surveillance cultures, were collected weekly during the following four study periods: all units for 4 months before amikacin introduction, all units 4 to 8 months after, all units 12 to 13 months after, and the neonatal intensive care unit 30 months after. A total of 2,613 strains of coagulase-negative staphylococci and 316 strains of S. aureus were obtained from 916 patients. During the course of the study, amikacin-resistant coagulase-negative staphylococci increased from 0 to 22%, colonizing 43% of patients, whereas no amikacin-resistant S. aureus was detected. During the preamikacin survey, 68% of the coagulase-negative staphylococci and 12% of the S. aureus strains were resistant to tobramycin and gentamicin. This resistance did not decrease after amikacin was introduced. Initially, 83% of the aminoglycoside-resistant coagulase-negative staphylococci were resistant to both tobramycin and gentamicin. During the last surveillance this value dropped to 40%, and 48% of the strains had become resistant to all three aminoglycosides. Resistance to aminoglycosides, including amikacin, develops quickly in coagulase-negative staphylococci from clinical areas where these antimicrobial agents are widely used. However, aminoglycoside resistance in S. aureus is much less frequent.
منابع مشابه
Clinical Pharmacokinetics of Amikacin in Neonates
Amikacin is a bactericidal aminoglycoside. Aminoglycosides inhibit bacterial protein synthesis. The antibacterial spectrum of amikacin is the broadest of aminoglycosides. Because of its resistance to many of the aminoglycosides-inactivating enzymes, it has a special role in hospitals where gentamicin- and tobramycin-resistant microorganisms are prevalent. Amikacin is active against the majority...
متن کاملHow rational Aminoglycosides are being used in critically ill patients? Results from a teaching hospital in north of Iran
Background: Resistance to antimicrobial agents including aminoglycosides (AGs) is a great concern that is mainly related to inappropriate use. Since there were not adequate data regarding how rationally AGs are being prescribed in our critically ill patients, this study was conducted to determine the main issues in the area of appropriate use of this antibiotic class. Methods: One hundred...
متن کاملEvaluation of aminoglycoside resistance ant(2'')-Ia and ant(4')-IIa genes in Escherichia coli strains isolated from urinary tract infection
Background & aim: About 40% of women and 12% of men experience a urinary tract infection at least once in their lifetime. Aminoglycosides are very effective antimicrobial agents. The emergence and spread of antibiotic resistance in Escherichia coli (E. coli) is becoming a global public health concern. The aim of this study was to determine the presence of ant(2'')-Ia and ant(4')-IIa genes in E....
متن کاملFrequency of resistance to kanamycin, tobramycin, netilmicin, and amikacin in gentamicin-resistant gram-negative bacteria.
In vitro evaluation of 66 epidemiologically distinct, gentamicin-resistant, gram-negative isolates from four hospitals revealed that 92% were kanamycin resistant, 44% were netilmicin resistant, 41% were tobramycin resistant, and 6% were amikacin resistant. Combined resistance to gentamicin, tobramycin, and netilmicin occurred in 30% of the strains. Although the resistance percentage to amikacin...
متن کاملFrequency of 16S rRNA Methylase and Aminoglycoside-Modifying Enzyme Genes among Clinical Isolates of Acinetobacter baumannii in Iran
Background & objective: Multidrug-resistant Acinetobacter baumannii (MDR-AB) is an important nosocomial pathogen which is associated with significant morbidity and mortality, particularly in high-risk populations. Aminoglycoside-modifying enzymes (AMEs) and 16S ribosomal RNA (16S rRNA) methylation are two important mechanisms of resistance to ...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Journal of clinical microbiology
دوره 24 4 شماره
صفحات -
تاریخ انتشار 1986