Surveillance of aminoglycoside resistance: European data

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Abstract

The susceptibility patterns of gram-negative aerobic organisms to aminoglycosides differ widely from one European health care center to another and depend upon local antibiotic prescribing policies. Reports of the susceptibility of Pseudomonas aeruginosa to gentamicin and tobramycin have ranged from as low as 49.8 percent and 77.7 percent, respectively, in Greece, to as high as 96.6 percent and 99.2 percent, respectively, in the United Kingdom. The susceptibility of P. aeruginosa to gentamicin, tobramycin, and amikacin decreased in our hospital from 73.1 percent, 94.8 percent, and 95.6 percent, respectively, in 1982, to 43.1 percent, 70.6 percent, and 74.3 percent, respectively, in 1984. A prospective surveillance study of the susceptibility of gram-negative aerobic bacilli to four aminoglycosides (gentamicin, tobramycin, amikacin, and netilmicin) was performed over a period of 17 months. Gentamicin and tobramycin were freely used, while the use of amikacin was restricted throughout the hospital during a four-month baseline period (May through August 1984). Gentamicin and tobramycin accounted for 94 percent of the aminoglycoside use. During the following 13 months (September 1984 through September 1985), amikacin was used as the first-line aminoglycoside and accounted for more than 97 percent of the aminoglycoside usage. A total of 1,866 organisms were analyzed during the baseline period; 5,429 were analyzed during the amikacin-usage period. The overall susceptibility to gentamicin, tobramycin, amikacin, and netilmicin increased from 86.9 percent, 90.4 percent, 94.2 percent, and 88.3 percent, respectively, to 92.3 percent, 94.0 percent, 97.3 percent, and 92.3 percent, respectively. P. aeruginosa isolates had the most striking changes, with the susceptibility to gentamicin, tobramycin, amikacin, and netilmicin increasing from 43.1 percent, 70.6 percent, 74.3 percent, and 50.6 percent, respectively, during the baseline period, to 64.5 percent, 81.6 percent, 90.8 percent, and 65.1 percent, respectively, during the amikacin-usage period. The use of amikacin as a first-line aminoglycoside, while use of the other aminoglycosides was restricted, seemed to have a favorable influence on the susceptibility pattern of gram-negative aerobic isolates in our hospital.

References (27)

  • DN Gerding et al.

    Aminoglycoside resistance in gramnegative bacilli during increased amikacin use: comparison of experience in 14 United States hospitals with experience in the Minneapolis Veterans Administration Medical Center

    Am J Med

    (1985)
  • RP Mouton

    Choice of an aminoglycoside

    J Antimicrob Chemother

    (1980)
  • P Gardner et al.

    Nosocomial management of resistant gram-negative bacilli

    J Infect Dis

    (1980)
  • H Giamarellou et al.

    Emergence of aminoglycoside multiresistant Pseudomonas aeruginosa in 1982–1983: mechanisms of resistance and epidemiology in a general hospital

    Chemiotherapia

    (1984)
  • CJ Soussy et al.

    Evolution et état actuel de la résistance aux aminosides: résultat de deux etudes multicentriques

  • FH Kayser et al.

    Empfindlichkeit von bacterien gegenuber chemotherapeutika (Zurich 1980)

    Schweiz Med Wochenschr

    (1982)
  • AJ De Neeling et al.

    Resistance to aminoglycosides and beta-lactam antibiotics in Pseudomonas aeruginosa in the Netherlands

  • B Wiedeman et al.

    Multicenter study of the sensitivity of Pseudomonas aeruginosa to antimicrobial agents

    Eur J Clin Microbiol

    (1985)
  • RJ Williams et al.

    National survey of antibiotic resistance in Pseudomonas aeruginosa

    J Antimicrob Chemother

    (1984)
  • K Dornbusch et al.

    Aminoglycoside resistance in blood and urine isolates consecutively collected in 28 European laboratories

  • National Committee for Clinical Laboratory Standards

    Performance standards for antimicrobial disk susceptibility tests

  • National Committee for Clinical Laboratory Standards

    Methods for dilution antimicrobial susceptibility tests for bacteria that grow aerobically

  • IA Holder

    Gentamicin resistant Pseudomonas aeruginosa in a burn unit

    J Antimicrob Chemother

    (1986)
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    This work was supported by a grant from Bristol-Myers.

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