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Gentamicin Treatment Associated with Later Nosocomial Gentamicin-Resistant Serratia marcescens Infections

Published online by Cambridge University Press:  02 January 2015

Donald R. Graham ,
Herbert W. Clegg II ,
Roger L. Anderson ,
Gladys A. Chelgren ,
Steven R. Mostow  and
Richard E. Dixon
Donald R. Graham*
Affiliation:
Hospital Infections Branch, Bacterial Diseases Division, Bureau of Epidemiology, Center for Disease Control, Public Health Service, U.S. Department of Health and Human Services, Atlanta, Georgia
Herbert W. Clegg II
Affiliation:
Hospital Infections Branch, Bacterial Diseases Division, Bureau of Epidemiology, Center for Disease Control, Public Health Service, U.S. Department of Health and Human Services, Atlanta, Georgia
Roger L. Anderson
Affiliation:
Hospital Infections Branch, Bacterial Diseases Division, Bureau of Epidemiology, Center for Disease Control, Public Health Service, U.S. Department of Health and Human Services, Atlanta, Georgia
Gladys A. Chelgren
Affiliation:
Veterans Administration Medical Center, University of Colorado Health Sciences Center, Denver, Colorado
Steven R. Mostow
Affiliation:
Veterans Administration Medical Center, University of Colorado Health Sciences Center, Denver, Colorado
Richard E. Dixon
Affiliation:
Hospital Infections Branch, Bacterial Diseases Division, Bureau of Epidemiology, Center for Disease Control, Public Health Service, U.S. Department of Health and Human Services, Atlanta, Georgia
*
Springfield Clinic, 1025 S. 7th St., Springfield, It 62703
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Abstract

During a hospital epidemic of infections with gentamicin-resistant Serratia marcescens (GRS), we studied the relation between receiving antibiotics and acquiring GRS. In a five-month period, 22 patients acquired GRS, whereas 18 patients acquired gentamicin-sensitive Serratia (GSS). When compared with patients with nosocomial GSS infection, patients with nosocomial GRS had been in the hospital (p = 0.04) and the intensive care unit (p = 0.003) longer before infection and more had received gentamicin (p = 0.001) or ampicillin (p = 0.02) before infection. To control for the influence of underlying disease, we matched all 12 ICU patients with GRS infection and 12 patients without GRS infection for underlying illness and duration of intensive care. Use of any antibiotic (p = 0.04), or a combination of gentamicin plus ampicillin or cephalosporin (p = 0.047) was more common among patients with GRS infection. The hospital had not significantly increased the use of aminoglycosides from the previous year. We conclude that for the individual patient antimicrobial therapy, especially with gentamicin or ampicillin, creates a risk for later infection by GRS that is independent of the severity of the underlying illness.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 2 , Issue 1 , February 1981 , pp. 31 - 37
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2001

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