title: Mechanism of aminoglycoside resistance among beta-lactam-resistant Escherichia coli in the United States.
abstract: We examined aminoglycoside (AG) resistance in ampicillin-resistant Escherichia coli obtained from nine hospitals participating in the National Nosocomial Infections Study. The isolates were tested to 25 antimicrobials using broth microdilution methods. If the organism was intermediate or resistant to gentamicin, tobramycin, netilmicin, or amikacin, we determined the class of aminoglycoside-modifying enzyme (AME) using the phosphocellulose paper binding assay. Of 423 E. coli, 21 (5%) were intermediate or resistant to one or more of the AGs. All but two of these E. coli isolates had at least one AME. Twelve isolates had phosphotransferase (APH) enzymes; seven had adenyltransferase (ANT) enzymes (all ANT[2"]); and four had acetyltransferase (AAC) enzymes. The seven ANT[2"]-producing isolates were more likely to be acquired in the community than in the hospital (4/7 ANT[2"]-producing E. coli versus one of 14 of the other AG-resistant E. coli, p = 0.03, Fisher's exact test). These findings suggest that for E. coli resistant to both ampicillin and an AG, APH enzymes are the predominant AME class. Additionally, isolates with certain AMEs may be acquired both in the community and in the hospital.
authors.affiliation: Hospital Infections Program, Center for Disease Control, Atlanta, GA 30333.
authors.forename: R P
authors.initials: RP
authors.lastname: Gaynes
authors.forename: R
authors.initials: R
authors.lastname: Cooksey
authors.forename: C
authors.initials: C
authors.lastname: Thornsberry
authors.forename: J M
authors.initials: JM
authors.lastname: Swenson
authors.forename: J M
authors.initials: JM
authors.lastname: Hughes
mesh_terms: D000617:Aminoglycosides; D000667:Ampicillin / Q000494:pharmacology*; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D003428:Cross Infection / Q000382:microbiology*; D004352:Drug Resistance, Microbial; D004926:Escherichia coli / Q000187:drug effects* / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000382:microbiology*; D006801:Humans; D008826:Microbial Sensitivity Tests; D014481:United States
chemical_list: D000617:Aminoglycosides; D000900:Anti-Bacterial Agents; D000667:Ampicillin