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Related Experiment Videos

Gentamicin- and silver-resistant pseudomonas in a burns unit.

K Bridges, A Kidson, E J Lowbury

    British Medical Journal
    |February 17, 1979
    PubMed
    Summary

    Gentamicin-resistant Pseudomonas aeruginosa outbreaks in burns units are challenging. Patient segregation, not antibiotic changes, effectively controlled a 1977-8 gentamicin-resistant Pseudomonas aeruginosa outbreak.

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    Area of Science:

    • Medical Microbiology
    • Infectious Diseases
    • Hospital Epidemiology

    Background:

    • Gentamicin-resistant Pseudomonas aeruginosa (Ps aeruginosa) emerged as a significant issue in a hospital burns unit during 1977-8.
    • High prevalence (over 90%) of gentamicin resistance was observed in Ps aeruginosa strains during the outbreak's peak.

    Purpose of the Study:

    • To investigate the characteristics and control of a gentamicin-resistant Ps aeruginosa outbreak in a burns unit.
    • To determine the transferability and stability of gentamicin resistance and identify effective control measures.

    Main Methods:

    • Serotyping of Ps aeruginosa strains to identify common characteristics.
    • In vitro and in vivo studies to assess gentamicin resistance transfer.
    • Monitoring of antibiotic resistance patterns, including silver nitrate and carbenicillin resistance.
    • Evaluation of different infection control strategies, including antibiotic treatment changes and patient segregation.

    Main Results:

    • All gentamicin-resistant Ps aeruginosa strains belonged to a single serotype (O:11, H:2,5).
    • Silver nitrate resistance was observed in some strains but was unstable upon subculture.
    • In vitro transfer of gentamicin resistance was demonstrated, but no evidence of in vivo transfer was found between Ps aeruginosa strains or with enterobacteria.
    • No doubly resistant (gentamicin-carbenicillin) strains were identified.
    • Stopping gentamicin treatment did not reduce the outbreak; patient segregation into separate wards was effective.

    Conclusions:

    • The outbreak was caused by a specific, highly prevalent strain of gentamicin-resistant Ps aeruginosa.
    • Antibiotic resistance transfer mechanisms require further investigation, but in vivo transfer was not evident in this study.
    • Patient segregation proved to be the most effective control strategy for this outbreak, highlighting the importance of non-pharmacological interventions in managing hospital-acquired infections.

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