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Aminoglycoside resistance among blood culture isolates

Insights

High rates of tobramycin and gentamicin resistance in Staphylococcus epidermidis were observed in one Finnish hospital, potentially linked to increased aminoglycoside use. This study highlights the impact of antibiotic consumption on antimicrobial resistance patterns.

Area of Science:

  • Clinical Microbiology
  • Infectious Diseases
  • Pharmacology

Background:

  • Aminoglycoside antibiotics are crucial for treating serious bacterial infections.
  • Monitoring antimicrobial resistance patterns is essential for effective treatment strategies.
  • Staphylococcus epidermidis is a common cause of hospital-acquired infections.

Purpose of the Study:

  • To determine the prevalence of resistance to gentamicin, tobramycin, amikacin, and netilmicin in blood culture isolates.
  • To investigate regional variations in aminoglycoside resistance, particularly in Staphylococcus epidermidis.
  • To explore the potential correlation between aminoglycoside consumption and resistance development.

Main Methods:

  • Collected 633 blood culture isolates from seven major Finnish hospitals between 1981 and 1982.
  • Determined antimicrobial susceptibility using the Sensititre microtiter procedure.
  • Analyzed aminoglycoside consumption data from Turku University Central Hospital.

Main Results:

  • Overall resistance to the tested aminoglycosides ranged from 1.3% to 6.5%.
  • Turku University Central Hospital showed significantly higher rates of tobramycin (57%) and gentamicin (29%) resistance in Staphylococcus epidermidis compared to other hospitals (16% and 18%, respectively).
  • Increased consumption of tobramycin (330%) and amikacin (290%) and decreased gentamicin use were noted in Turku prior to the resistance findings.
  • Tobramycin resistance was mediated by specific aminoglycoside-modifying enzymes: APH(2")-AAC(6") and ANT(4").

Conclusions:

  • A localized increase in aminoglycoside use may drive the emergence of resistant Staphylococcus epidermidis strains.
  • Continuous surveillance of antibiotic resistance and consumption is vital to guide antimicrobial stewardship.
  • Understanding resistance mechanisms is key to developing strategies against emerging antimicrobial resistance.

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