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Gentamicin- and clindamycin-resistant Staphylococcus aureus

J D Semel, G M Trenholme, S Levin

    The American Journal of the Medical Sciences
    |July 1, 1980
    PubMed
    Summary
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    Gentamicin- and clindamycin-resistant Staphylococcus aureus (GCRS) emerged between 1975-1978, showing a significant increase in 1977. GCRS infections were linked to higher mortality rates and hospital-acquired infections.

    Area of Science:

    • Medical Microbiology
    • Infectious Diseases
    • Antimicrobial Resistance

    Background:

    • Staphylococcus aureus bacteremia is a serious infection.
    • Gentamicin and clindamycin are commonly used antibiotics for severe infections.

    Observation:

    • From 1975-1978, 9% of S. aureus bacteremia isolates were resistant to gentamicin and clindamycin.
    • Resistant isolates (GCRS) increased significantly in 1977, accounting for 23% of S. aureus isolates.
    • GCRS infections were more common in hospital-acquired cases, particularly in intensive care units.

    Findings:

    • Prior or concurrent use of gentamicin and/or clindamycin was associated with GCRS isolation.
    • Infection with GCRS had a 73% mortality rate, compared to 28% for sensitive strains (GCSS).

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  • GCRS remained susceptible to oxacillin, cephalothin, tetracycline, vancomycin, and amikacin, but resistant to kanamycin and tobramycin.

    • Implications:

    • The rise of GCRS poses a significant clinical challenge.
    • Plasmid-mediated resistance suggests potential for further spread.
    • Clinicians must be aware of emerging resistance patterns to guide effective antibiotic therapy, especially when using gentamicin-clindamycin combinations.