title: High-level resistance to aminoglycosides: comparison of community and nosocomial fecal isolates of enterococci.
abstract: Fecal carriage of enterococci highly resistant to streptomycin, gentamicin, and kanamycin was examined in 64 healthy volunteers with no exposure to hospitals and in 53 hospitalized individuals. High-level resistance to streptomycin and gentamicin was found in fecal specimens from 3% and 0, respectively, of the healthy volunteers and in fecal specimens from 41% and 15%, respectively, of the hospitalized individuals. We found that high-level resistance to kanamycin was also more common among hospitalized individuals than among healthy volunteers (36% vs. 17%). The frequent occurrence of high-level resistance to kanamycin in fecal isolates confirms that amikacin is a poor choice when attempting to achieve synergistic therapy for enterococcal infections, in particular for those infections that are nosocomially acquired.
authors.affiliation: Departments of Internal Medicine and of Microbiology and Molecular Genetics, University of Texas Medical School, Houston, USA.
authors.forename: T M
authors.initials: TM
authors.lastname: Coque
authors.forename: R C
authors.initials: RC
authors.lastname: Arduino
authors.forename: B E
authors.initials: BE
authors.lastname: Murray
mesh_terms: D001483:Base Sequence; D004352:Drug Resistance, Microbial; D016983:Enterococcus / Q000187:drug effects*; D005243:Feces / Q000382:microbiology*; D005839:Gentamicins / Q000494:pharmacology*; D006761:Hospitals; D006801:Humans; D007613:Kanamycin Resistance; D008969:Molecular Sequence Data; D013307:Streptomycin / Q000494:pharmacology*
chemical_list: D005839:Gentamicins; D013307:Streptomycin