Amikacin, gentamicin and tobramycin resistant Pseudomonas aeruginosa in a leukaemic ward. Epidemiology and genetic studies.
Four patients in a leukaemic ward were infected with multi-resistant Pseudomonas aeruginosa. Similar organisms were found in the environment and it appeared that lapses in aseptic routine contributed to the outbreak. Serological, bacteriophage and pyocin-typing revealed that a fifth patient was infected with a distinct strain, but agarose gel electrophoresis indicated that all patient and environmental strains carried the same plasmid. The plasmid had a molecular weight of 47 (s.d. +/- 2) X 10(6) dal and was transfer deficient. It conferred resistance to carbenicillin, gentamicin, kanamycin, streptomycin, sulphonamide, tetracycline and tobramycin and determined an aminoglycoside adenylyltransferase active against amikacin in-vitro and not in-vivo. Spread of this non-transferable plasmid to a different Ps. aeruginosa strain and dissemination of multi-resistant organisms led to serious infections.
D000328:Adult; D000583:Amikacin / Q000494:pharmacology; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D004352:Drug Resistance, Microbial; D005260:Female; D005839:Gentamicins / Q000494:pharmacology; D006801:Humans; D007938:Leukemia / Q000382:microbiology*; D008297:Male; D008875:Middle Aged; D010957:Plasmids; D011552:Pseudomonas Infections / Q000382:microbiology*; D011550:Pseudomonas aeruginosa / Q000187:drug effects* / Q000235:genetics; D014031:Tobramycin / Q000494:pharmacology; D014552:Urinary Tract Infections / Q000382:microbiology*
D000900:Anti-Bacterial Agents; D005839:Gentamicins; D000583:Amikacin; D014031:Tobramycin