Gentamicin-resistant gram-negative bacilli in hospital patients. Part I. Preliminary epidemiological assessment

Gentamicin-resistant Gram-negative bacilli (GRNB) have been isolated from specimens received from 23 hospitals in and around Johannesburg. Most isolates are fermentative in nature. A pilot survey among inpatients at the Johannesburg Hospital revealed an intestinal carriage prevalence of 14,3%. A prospective study of intestinal acquisition showed that GRNB are acquired in hospital, and that colonization is associated with prior antibacterial therapy. Analysis of clinical specimens received from the Johannesburg Hospital from 1 July to 30 September 1976 has indicated that intensive care and urology units are worst affected. An assessment of the overall prevalence of GRNB in October 1976 revealed that 16,1% of all Gram-negative bacilli were resistant to gentamicin. Major contributing factors are the widespread use of systemic aminoglycoside antibiotics, and a high rate of cross-contamination. Measures aimed at minimizing these factors have been introduced by the Johannesburg Hospital administration.