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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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