Five cases of high-level aminoglycoside resistant enterococcal septicaemia in Singapore

Five clinical cases of enterococcal septicaemia were studied retrospectively including determination of high-level aminoglycoside resistance (HLAR) to gentamicin, streptomycin and kanamycin. This is the first study of its kind in Singapore. The clinical features and risk factors for this illness were analysed and found to be very similar to enterococcal bacteremia in general. It is important to carry out tests to detect HLAR so that unnecessary aminoglycoside toxicity can be prevented or to decide on the appropriate aminoglycoside to combine with a cell wall-active agent in severe enterococcal sepsis.