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Development of gentamicin resistance in gram-negative bacteria in Czechoslovakia and correlation with its usage

M Kettner1, V Krćméry

  • 1Institute of Experimental Pharmacology, Slovak Academy of Sciences, Bratislava, Czechoslovakia.

Drugs Under Experimental and Clinical Research
|January 1, 1988
PubMed

Insights

Gentamicin resistance in Czechoslovakia increased significantly after 1980, particularly in hospital-acquired infections. Most resistant Gram-negative strains produced enzymes rendering them resistant to other aminoglycosides, but amikacin remained effective.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Pharmacology

Background:

  • Gentamicin use became widespread in Czechoslovakia in 1975, with increased availability but restricted use until 1986.
  • A notable rise in gentamicin resistance among key Gram-negative bacteria, including Pseudomonas aeruginosa and Klebsiella, began around 1980.
  • Resistant strains were frequently isolated from hospitalized patients, indicating a significant public health concern despite infection control efforts.

Purpose of the Study:

  • To investigate the prevalence and mechanisms of gentamicin resistance in Gram-negative bacteria in Czechoslovakia.
  • To determine the cross-resistance patterns to other aminoglycosides like netilmicin, tobramycin, and amikacin.
  • To compare resistance patterns with those observed in other European countries.

Main Methods:

  • Analysis of a collection of 69 gentamicin-resistant Gram-negative bacterial strains from seven Czechoslovak regions.
  • Enzyme assays to identify resistance mechanisms, specifically the production of acetyltransferases (AAC) and adenylyltransferases (ANT).
  • Susceptibility testing against gentamicin, netilmicin, tobramycin, and amikacin.

Main Results:

  • 84% of resistant strains produced acetyltransferases (AAC) or adenylyltransferases (ANT).
  • AAC(3) enzymes were most common (55%), followed by ANT(2") (35%).
  • High cross-resistance to tobramycin (87%) and netilmicin (68%) was observed due to plasmid-borne AAC(3)-II, while amikacin retained efficacy against most strains.

Conclusions:

  • The observed resistance mechanisms and cross-resistance patterns in Czechoslovakia align with those reported in Central and Southern Europe.
  • Plasmid-mediated resistance, particularly to AAC(3)-II, is a significant driver of gentamicin resistance and cross-resistance to other aminoglycosides.
  • Amikacin remains a crucial therapeutic option against multiresistant Gram-negative bacteria in the studied region.

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