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. 1977 Feb;11(2):179–184. doi: 10.1128/aac.11.2.179

Emergence of Gentamicin-Resistant Klebsiella in a General Hospital

R P Rennie *, I B R Duncan 1
PMCID: PMC351949  PMID: 848921

Abstract

Gentamicin had been in use in a general hospital for over 7 years before any gentamicin-resistant Klebsiella were observed. In 1974 and 1975, nine different gentamicin-resistant serobiotypes of Klebsiella were isolated from 35 patients. The first strain to appear had R-factor-mediated gentamicin resistance, and it infected 19 patients during a period of almost 2 years, spreading largely by case-to-case infection in patients with urinary catheters. It appeared to lose the capacity to transfer its gentamicin resistance after it had infected five of the patients. We had previously isolated on the same ward a gentamicin-susceptible Klebsiella of identical type, and it was found to be capable of acquiring an R-factor for gentamicin resistance. All of the other types of gentamicin-resistant Klebsiella infected few patients and did not persist in the hospital; four of them had R-factor-mediated resistance to gentamicin and all four, as did the original strain, cotransferred kanamycin, neomycin, and tobramycin resistance. Every gentamicin-resistant Klebsiella was susceptible to amikacin and netilmicin.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Anderson J. D. The effect of R-factor carriage on the survival of Escherichia coli in the human intestine. J Med Microbiol. 1974 Feb;7(1):85–90. doi: 10.1099/00222615-7-1-85. [DOI] [PubMed] [Google Scholar]
  2. Bryan L. E., Shahrabadi M. S., van den Elzen H. M. Gentamicin resistance in Pseudomonas aeruginosa: R-factor-mediated resistance. Antimicrob Agents Chemother. 1974 Aug;6(2):191–199. doi: 10.1128/aac.6.2.191. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Casewell M. W. Experiences in the use of commercial antisera for the capsular typing of klebsiella species. J Clin Pathol. 1972 Aug;25(8):734–737. doi: 10.1136/jcp.25.8.734. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Datta N. Infection caused by Proteus mirabilis strains with transferrable gentamicin-resistance factors. Lancet. 1975 Jun 21;1(7921):1355–1357. doi: 10.1016/s0140-6736(75)92262-x. [DOI] [PubMed] [Google Scholar]
  5. Davies J. Bacterial resistance to aminoglycoside antibiotics. J Infect Dis. 1971 Dec;124 (Suppl):S7–10. doi: 10.1093/infdis/124.supplement_1.s7. [DOI] [PubMed] [Google Scholar]
  6. Davis T. J., Matsen J. M. Prevalence and characteristics of Klebsiella species: relation to association with a hospital environment. J Infect Dis. 1974 Oct;130(4):402–405. doi: 10.1093/infdis/130.4.402. [DOI] [PubMed] [Google Scholar]
  7. Martin C. M., Ikari N. S., Zimmerman J., Waitz J. A. A virulent nosocomial Klebsiella with a transferable R factor for gentamicin: emergence and suppression. J Infect Dis. 1971 Dec;124 (Suppl):S24–S29. doi: 10.1093/infdis/124.supplement_1.s24. [DOI] [PubMed] [Google Scholar]
  8. Medeiros A. A., O'Brien T. F. Association of cephalosporinase activity, cephalothin resistance, and episome-mediated drug resistance in Klebsiella strains. Antimicrob Agents Chemother (Bethesda) 1966;6:321–327. [PubMed] [Google Scholar]
  9. Noriega E. R., Leibowitz R. E., Richmond A. S., Rubinstein E., Schaefler S., Simberkoff M. S., Rahal J. J., Jr Nosocomial infection caused by gentamicin-resistant, streptomycin-sensitive Klebsiella. J Infect Dis. 1975 May;131 (Suppl):S45–S50. doi: 10.1093/infdis/131.supplement.s45. [DOI] [PubMed] [Google Scholar]
  10. PERRET C. J. Iodometric assay of penicillinase. Nature. 1954 Nov 27;174(4439):1012–1013. doi: 10.1038/1741012a0. [DOI] [PubMed] [Google Scholar]
  11. Pollack M., Charache P., Nieman R. E., Jett M. P., Reimhardt J. A., Hardy P. H., Jr Factors influencing colonisation and antibiotic-resistance patterns of gram-negative bacteria in hospital patients. Lancet. 1972 Sep 30;2(7779):668–671. doi: 10.1016/s0140-6736(72)92084-3. [DOI] [PubMed] [Google Scholar]
  12. Price D. J., Sleigh J. D. Control of infection due to Klebsiella aerogenes in a neurosurgical unit by withdrawal of all antibiotics. Lancet. 1970 Dec 12;2(7685):1213–1215. doi: 10.1016/s0140-6736(70)92179-3. [DOI] [PubMed] [Google Scholar]
  13. Rennie R. P., Duncan I. B. Combined biochemical and serological typing of clinical isolates of Klebsiella. Appl Microbiol. 1974 Oct;28(4):534–539. doi: 10.1128/am.28.4.534-539.1974. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Richmond A. S., Simberkoff M. S., Rahal J. J., Jr, Schaefler S. R factors in gentamicin-resistant organisms causing hospital infection. Lancet. 1975 Dec 13;2(7946):1176–1178. doi: 10.1016/s0140-6736(75)92660-4. [DOI] [PubMed] [Google Scholar]
  15. Rose H. D., Schreier J. The effect of hospitalization and antibiotic therapy on the gram-negative fecal flora. Am J Med Sci. 1968 Apr;255:228–236. doi: 10.1097/00000441-196804000-00003. [DOI] [PubMed] [Google Scholar]
  16. Selden R., Lee S., Wang W. L., Bennett J. V., Eickhoff T. C. Nosocomial klebsiella infections: intestinal colonization as a reservoir. Ann Intern Med. 1971 May;74(5):657–664. doi: 10.7326/0003-4819-74-5-657. [DOI] [PubMed] [Google Scholar]

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