Nosocomial outbreaks due to amikacin-resistant tobramycin-sensitive Acinetobacter species: correlation with amikacin usage.
Fifty-seven patients in the Val-de-Grâce hospital were infected or colonized with amikacin-resistant, tobramycin-sensitive Acinetobacter spp. between January 1985 and December 1987. This resistance phenotype was attributed to the recently described 3'-O-aminoglycoside phosphotransferase (APH(3')-VI), on the basis of substrate profile and DNA-DNA hybridization, and was mainly encountered in various biotypes of A. baumannii isolated from patients. It was also encountered in saprophytic A. johnsonii isolates from the hands of 11 healthy workers among the medical staff, which provided evidence for the dissemination of an epidemic gene among different biotypes and species of Acinetobacter. A retrospective epidemiological survey showed a significant correlation between amikacin consumption and case incidence in the wards where cross-infection had occurred.
Buisson
Y
Y
Laboratoire de Biologie Clinique, Hôpital d'Instruction des Armées du Val-de-Grâce, Paris, France.
Tran Van Nhieu
G
G
Ginot
L
L
Bouvet
P
P
Schill
H
H
Driot
L
L
Meyran
M
M
D000151:Acinetobacter Infections / Q000145:classification / Q000188:drug therapy / Q000453:epidemiology*; D000583:Amikacin / Q000494:pharmacology / Q000627:therapeutic use*; D001434:Bacteriophage Typing; D003428:Cross Infection / Q000145:classification / Q000188:drug therapy / Q000453:epidemiology*; D004196:Disease Outbreaks; D004352:Drug Resistance, Microbial / Q000235:genetics; D005602:France / Q000453:epidemiology; D006784:Hospitals, Teaching; D006801:Humans; D008826:Microbial Sensitivity Tests; D012189:Retrospective Studies; D012703:Serotyping; D014031:Tobramycin / Q000627:therapeutic use*
D000583:Amikacin; D014031:Tobramycin