Longitudinal analysis of endemic gentamicin- and tobramycin-resistant gram-negative bacilli in a community hospital.
The epidemiology of endemic gentamicin- and tobramycin-resistant gram-negative bacilli at a community hospital was analyzed over a one-year period three years following an original analysis at the same hospital. The frequency and distribution of resistant organisms remained stable over the time spanning the two studies. Only 2.8% of all gram-negative bacilli were resistant to gentamicin or tobramycin, and the majority of resistant isolates were non-Enterobacteriaceae. The respiratory and urinary tracts remained the body sites most prone to harbor resistant organisms. Risk analysis using a matched comparison group again revealed prior treatment with an aminoglycoside to be the only significant factor pre-disposing to acquisition of resistant gram-negative bacilli. This analysis indicates that community hospitals may not be important reservoirs of endemic aminoglycoside-resistant gram-negative bacilli, and reconfirms the observation that each hospital must define its own pattern of aminoglycoside resistance and unique risk factors.
D000150:Acinetobacter / Q000187:drug effects / Q000302:isolation & purification*; D001424:Bacterial Infections / Q000382:microbiology*; D002353:Carrier State / Q000382:microbiology*; D003428:Cross Infection / Q000382:microbiology*; D004352:Drug Resistance, Microbial; D004755:Enterobacteriaceae / Q000187:drug effects / Q000302:isolation & purification*; D005839:Gentamicins / Q000627:therapeutic use; D006764:Hospitals, Community; D006801:Humans; D008137:Longitudinal Studies; D009518:New York; D011549:Pseudomonas / Q000187:drug effects / Q000302:isolation & purification*; D014031:Tobramycin / Q000627:therapeutic use
D005839:Gentamicins; D014031:Tobramycin