Summary
The aminoglycosides play a central role in the treatment of infectious diseases caused by gramnegative bacteria. During the period of January to June 1984, 45 clinical specimens collected in our neonatal intensive care unit grewEnterobacter cloacae; 41 of them were gentamicin resistant. One neonate developed septicemia. The routine antibiotic protocol was then changed from gentamicin-ampicillin to amikacin-ampicillin for a period of six months. During this period the resistance to gentamicin declined to a minimum. Only eight of 122 specimens proved to harbor gram-negative organisms resistant to gentamicin. The gentamicin-resistantE. cloacae vanished. No isolate was resistant to amikacin. The gentamicin-ampicillin regimen was then reintroduced.
Zusammenfassung
Aminoglykoside spielen in der Therapie von Infektionen durch gramnegative Bakterien eine zentrale Rolle. Im Zeitraum von Januar bis Juni 1984 wurden aus 45 von Patienten unserer Neugeborenen-Intensivstation entnommenen ProbenEnterobacter cloacae isoliert, davon waren 41 gentamicinresistent. Ein Neugeborenes erkrankte an einer Sepsis. Daraufhin wurde die Routine-Antibiotikatherapie von Gentamicin-Ampicillin für sechs Monate auf Amikacin-Ampicillin umgestellt. In diesem Zeitraum ging die Resistenz gegen Gentamicin auf ein Minimum zurück. Nur aus acht von 122 Proben ließen sich gentamicinresistente gramnegative Mikroorganismen isolieren. Die gentamicinresistentenE. cloacae-Stämme verschwanden. Keines der Isolate war resistent gegen Amikacin. Die Antibiotikatherapie wurde wieder auf Gentamicin-Ampicillin umgestellt.
Similar content being viewed by others
Literature
Hemming, V. G., Overal, J. C., Britt, M. R. Nosocomial infections in a newborn intensive care unit. New. Engl. J. Med. 294 (1976) 1310–1313.
Goldman, D. A., Leclair, J., Macone, A. Bacterial colonization of neonates admitted to an intensive care unit environment. J. Pediatr. 93 (1978) 288–293.
Wielmusky, E., Drucker, M., Cohen, T., Reisuer, S. H. Replacement of gentamicin by amikacin as a means of decreasing gentamicin resistance of gram-negative rods in a neonatal intensive care unit. Is. J. Med. Sci. 19 (1983) 1006–1008.
Bauer, A. W., Kirby, W. M. M., Sherris, J. C. Antibiotic susceptibility testing by a standardized single disc method. Am. J. Clin. Pathol. 45 (1966) 493–496.
Montgomerie, J. Z. Epidemiology ofKlebsiella and hospital-associated infection. Rev. Infect. Dis. 1 (1979) 736–753.
Saravolatz, L. D., Arking, L., Polhold, D., Fisher, E. S., Borer, R. An outbreak of gentamicin-resistantKlebsiella pneumoniae. Inf. Control. 5 (1984) 79–84.
Ristuccia, A. M., Cunha, B. A. The aminoglycosides. Med. Clin. North. Amer. 66 (1982) 303–312.
Betts, R. F., Valenti, W. M., Chapman, S. W., Chonmaitree, T., Mowrer, G., Pincus, P., Messner, M., Robertson, R. Five-year surveillance of aminoglycoside usage in a university hospital. Ann. Intern. Med. 100 (1984) 219–222.
Levine, F. J., Maslow, M. J., Leibowitz, R. E., Pollock, A. A., Hanna, B. B., Schaefler, S., Simberkoff, M. S., Rahal, S. J. Amikacin-resistant gram-negative bacilli. J. Infect. Dis. 151 (1985) 295–300.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Raz, R., Sharir, R., Shmilowitz, L. et al. The elimination of gentamicin-resistant gram-negative bacteria in a newborn intensive care unit. Infection 15, 32–34 (1987). https://doi.org/10.1007/BF01646115
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/BF01646115