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Antibiotic Usage and Microbial Resistance in an Intensive Care Nursery FREE

Jorge A. Franco, MS; Donald V. Eitzman, MD; Herman Baer, MD
[+] Author Affiliations

Received for publication Nov 20, 1972; accepted April 30, 1973.

Reprint requests to Department of Immunology and Medical Microbiology, College of Medicine, Box 727, University of Florida, Gainesville, FL 32610 (Mr. Franco).


Am J Dis Child. 1973;126(3):318-321. doi:10.1001/archpedi.1973.02110190280006.
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Kanamycin sulfate was replaced by gentamicin sulfate in an effort to control an outbreak of nosocomial infections caused by enteric organisms with R-factor-mediated kanamycin resistance in an intensive care nursery. Within a month the kanamycin-resistant organisms were essentially eliminated from the nursery, indicating that the selective pressure provided by the extensive use of kanamycin was a major factor in causing and propagating the outbreak. Over a period of observation of 15 months, a significant increase in the gentamicin resistance of the Gram-negative intestinal flora of the infants occurred, but no clinical infections due to gentamicin-resistant enteric organisms were observed.

REFERENCES

Eichenwald JF, Shinefield HR:  Antimicrobial therapy in the neonatal period . Pediatr Clin North Am 8:509-523, 1961;.
Buetow KC, Klein SW, Lane RB:  Septicemia in premature infants: The characteristics, treatment and prevention of septicemia in premature infants . Am J Dis Child 110:29-41, 1965;.
Adler JL, et al:  Nosocomial colonization with kanamycin resistant Klebsiella pneumoniae, types 2 and 11 in a premature nursery . J Pediatr 77:376-385, 1970;.
Eisenach K, et al:  Nosocomial infections due to kanamycin resistant (R) factor carrying enteric organisms in an intensive care nursery . Pediatrics 50:395-402, 1972;.
Hable KA, et al:  Klebsiella type 33 septicemia in an infant intensive care unit . J Pediatr 80:920-924, 1972;.
Nelson JD, McCraken GH:  The current status of gentamicin for the neonate and young infant . Am J Dis Child 124:13-14, 1972;.
Baer H, Washington L:  Numerical diagnostic key for the identification of enterobacteriacae . Appl Microbiol 23:108-112, 1972;.
Bauer AW, et al:  Antibiotic susceptibility testing by a single disk method . Am J Clin Pathol 36:493-496, 1966;.
Farmer JJ III, Herman LG:  Epidemiological fingerprinting of Pseudomonas aeruginosa by the production of and sensitivity to pyocine and bacteriophage . Appl Microbiol 18:760-765, 1969;.
Barber M, et al:  Reversal of antibiotic resistance in hospital staphylococcal infections . Br Med J 1:11-17, 1960;.
Ridley M, et al:  Antibiotic resistant Staphylococcus aureus and hospital antibiotic policies . Lancet 1:230-233, 1970;..

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

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References

Eichenwald JF, Shinefield HR:  Antimicrobial therapy in the neonatal period . Pediatr Clin North Am 8:509-523, 1961;.
Buetow KC, Klein SW, Lane RB:  Septicemia in premature infants: The characteristics, treatment and prevention of septicemia in premature infants . Am J Dis Child 110:29-41, 1965;.
Adler JL, et al:  Nosocomial colonization with kanamycin resistant Klebsiella pneumoniae, types 2 and 11 in a premature nursery . J Pediatr 77:376-385, 1970;.
Eisenach K, et al:  Nosocomial infections due to kanamycin resistant (R) factor carrying enteric organisms in an intensive care nursery . Pediatrics 50:395-402, 1972;.
Hable KA, et al:  Klebsiella type 33 septicemia in an infant intensive care unit . J Pediatr 80:920-924, 1972;.
Nelson JD, McCraken GH:  The current status of gentamicin for the neonate and young infant . Am J Dis Child 124:13-14, 1972;.
Baer H, Washington L:  Numerical diagnostic key for the identification of enterobacteriacae . Appl Microbiol 23:108-112, 1972;.
Bauer AW, et al:  Antibiotic susceptibility testing by a single disk method . Am J Clin Pathol 36:493-496, 1966;.
Farmer JJ III, Herman LG:  Epidemiological fingerprinting of Pseudomonas aeruginosa by the production of and sensitivity to pyocine and bacteriophage . Appl Microbiol 18:760-765, 1969;.
Barber M, et al:  Reversal of antibiotic resistance in hospital staphylococcal infections . Br Med J 1:11-17, 1960;.
Ridley M, et al:  Antibiotic resistant Staphylococcus aureus and hospital antibiotic policies . Lancet 1:230-233, 1970;..

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