Mechanisms of Resistance to Aminoglycosides in Gram-negative Nosocomial Bacteria in Russia: Results of Multicenter Study | CMAC

Mechanisms of Resistance to Aminoglycosides in Gram-negative Nosocomial Bacteria in Russia: Results of Multicenter Study

Clinical Microbiology and Antimicrobial Chemotherapy. 2001; 3(2):111-125

​ Reshedko G.K.
aminoglycosides nosocomial infections epidemiology antimicrobial resistance
Section
Antimicrobial Resistance
Type
Journal article
Publication
Clinical Microbiology and Antimicrobial Chemotherapy. 2001; 3(2):111-125

Abstract

The mechanisms of resistance to aminoglycoside antibiotics in Gram-negative nosocomial pathogens isolated in four Russian hospitals were studied. The most common and almost exclusive mechanism of aminoglycoside resistance was production of aminoglycoside-modifying enzymes. Various phenotypes of resistance were found. In Smolensk Regional Hospital the most common phenotype of resistance was gentamicin-tobramycin (54,4%, due to ANT(2”) enzyme) and gentamicin-tobramycin-netilmycin (36,1% – AAC(3)-V or combination of ANT(2”)+AAC(3)-Ia enzymes). The same phenotypes were predominant in Krasnodar Regional Hospital. In Central Clinical Hospital (Moscow) in addition to gentamicin-tobramycin (29,2%) and gentamicin-tobramycin-netilmycin (36,6%) phenotypes the cross-resistance to 2nd and 3rd aminoglycoside generations has been found: gentamicin-amikacin-isepamycin phenotype of resistance [due to combination of APH(3’)-VI+AAC(3)-I enzymes] – in 4,9% of strains, gentamicin-tobramycin-amikacin-isepamycin phenotype [due to combination of APH(3’)-VI+ANT(2”)] – in 9,8%, gentamicin-tobramycin-netilmycin-amikacin phenotype [due to combination of AAC(6’)-I+ANT(2”) enzymes] – in 4,9%. In Main Military Clinical Hospital (Moscow) the following resistance phenotypes were detected: gentamicin-tobramycin [production of ANT(2”) enzyme] – 20,4%, gentamicin-tobramycin-netilmycin [AAC(3)-V or combination of ANT(2”)+AAC(6’)-I enzymes] – 24,1%, gentamicin-tobramycin-netilmycin-amikacin-isepamycin [due to combination of APH(3’)-VI+AAC(3)-V or APH(3’)-VI+ANT(2”)+AAC(6’)-I enzymes] – 12,9%, gentamicin-tobramycin-amikacin-isepamycin [due to combination of APH(3’)-VI+ANT(2”) enzymes] – 25,9%, amikacin-isepamycin [APH(3’)-VI enzyme] – 11,1%.

  • 1. Spencer R.C. Prevalence studies in nosocomial infections. Eur J Microbiol Infect Dis 1992; 11:95-8.
  • 2. Белокрысенко С.С., Дугашева Л.С. Множественноустойчивые штаммы семейства Enterobacteriaceae и их плазмиды в стационаре. Медицинские и теоретические аспекты Антибиотики 1984; 12:924-31.
  • 3. Maniatis A.N., Trougakos I.P., Katsanis G., Palermos J., Maniatis N.A., Legakis N.J. Changing patterns of bacterial nosocomial infections: a nine year study in a general hospital. Chemother 1997; 43:69-76.
  • 4. Siegenthaler W.E., Bonetti A., Luthy R. Aminoglycoside antibiotics in infectious diseases. Am J Med 1986; 80:2-14.
  • 5. Dornbusch K., Miller G.H., Hare R.S. Resistance to aminoglycoside antibiotics in Gram-negative bacilli and staphylococci isolated from blood. Report from a European collaborative study. J Antimicrob Chemother 1990; 26:131-44.
  • 6. Garcia-Agata M.I., Alarcon T., Lopez-Brea M. Emergence of resistant isolates of Acinetobacter calcoaceticus – A. baumannii complex in a Spanish hospital over a five-year period. Eur J Clin Microbiol Infect Dis 1996; 15:512-5.
  • 7. Gould I.M. Risk factors for acquisition of multiply drug-resistant gram-negative bacteria. Eur J Clin Microb Infect Dis 1994; 13:30-8.
  • 8. Miller G.H. and aminoglycoside resistance study groups. Increasing complexity of aminoglycoside resistance mechanisms in gram-negative bacteria. APUA Newsletter 1994; 12.
  • 9. Weinstein R.A., Nathan C., Gruensfelder R. Endemic aminoglycoside resistance in gram-negative bacilli: epidemiology and mechanisms. J Infect Dis 1980; 141:338-45.
  • 10. Навашин С.М., Сазыкин Ю.О. Фундаментальные основы создания новых эффективных антибиотиков. Антибиотики 1992; 4:5-11.
  • 11. Лившиц М.Л., Брусина Е.Б. Госпитальные инфекции: проблемы и пути решения. Журн микробиол 1992;1:22-4.
  • 12. Goldmann D.A., Huskins W.C. Control of nosocomial antimicrobial-resistant bacteria: a strategic priority for hospitals worldwide. Clin Infect Dis 1997; 24(suppl. 1): S139-45.
  • 13. Correa Lima M.B., Almeida de Oliveira C.F., Galvao L.F. Trends in bacterial resistance and implications for treatment of infections. J Internat Med Research 1990; 18(suppl. 4):3D-5D.
  • 14. Hammond J.M.J., Potgieter P.D. Influence of amikacin as the primary aminoglycoside on bacterial isolates in the intensive care unit. Critical Care Medicine 1990; 18: 607-10.
  • 15. Miller G.H., Sabatelli F. J., Hare R.S. The most frequent aminoglycoside resistance mechanisms – changes with time and geographic area: a reflection of aminoglycoside usage patterns? Clin Infect Dis 1997; 24:S46-62.
  • 16. Goldmann D.A. Contemporary challenges for hospital epidemiology. Am J Med 1991; 91:8S-15S.
  • 17. Gourgouli K., Mouroutsou M., Varjioti E., Kondii L., Chronopoulos G., Baliaga S. et al. Comparison of bacterial resistance before and after restriction policy in the use of antibiotics. Proceedings of the 7th ESCMID; 1995;Vienna, 1995. p. 57.
  • 18. Courvalin P. Impact of molecular biology on antibiotic susceptibility: testing and therapy. Am J Med 1995; 99:21S-25S.
  • 19. Marr J.J., Moffet H.L., Kurin C.M. Guidelines for improving the use of antimicrobial agents in hospitals: a statement by the infectious diseases society of America. J Infect Desease 1988; 157:869-76.
  • 20. Сидоренко С.В. Механизмы антибиотикорезистентности. В кн.: Антибактериальная терапия. Под ред. Л.С. Страчунского, Ю.Б. Белоусова, С.Н. Козлова. Москва; 2000. с. 1-6.
  • 21. Вакуленко С.Б. Бактериальные ферменты, инактивирующие аминогликозидные антибиотики и кодирующие их гены. Антибиотики 1992; 4:49-54.
  • 22. Rice L.B., Bonomo R.A. Genetic and biochemical mechanisms of bacterial resistance to antimicrobial agents. In: Lorian V., editor. Antibiotics in laboratory medicine. New York: Williams & Wilkins; 1996. p. 453-501.
  • 23. Van Landuyt H.W., Boelaert J., Glibert B., Gordts B. Surveillance of aminoglycoside resistance. Am J Med 1986; 80:76-81.
  • 24. Miller G.H. and aminoglycoside resistance study groups. Resistance to aminoglycosides in Pseudomonas. Trends Microb 1994; 2:347-53.
  • 25. Naber K.G., Grimm H., Rosenthal E.J.K., Shah P.M., Wiedemann B. Resistance to aminoglycosides: the situation in the Federal Republic of Germany. J Int Med Research 1990; 18:6-26.
  • 26. Miller G.H. Aminoglycoside Resistance Surveys Team. USA: Schering-Plough Research Institute. 1992. Data on file.
  • 27. Колганов А.Н., Вакуленко С.Б. Гены резистентности к аминогликозидным антибиотикам клинических штаммов и кодируемые ими ферменты. Антибиотики 1992; 11:10-4.
  • 28. NCCLS. Performance standards for antimicrobial disk susceptibility tests – sixth edition; Approved Standard. NCCLS document M2-A6. 1997; 17.
  • 29. NCCLS. Methods for dilution antimicrobial susceptibility tests for bacteria that grow aerobically – fourth edition; Approved Standard. NCCLS document M7-A4. 1997; 17.
  • 30. Miller G. H., Sabatelli F. J., Naples L. The utilization of aminoglycoside resistance phenotypes for the determination of aminoglycoside resistance mechanisms. Schering-Plough research institute 1995. Data on file.
  • 31. McGowan J. E. Antimicrobial resistance in hospital organisms and its relation to antibiotic use. Antimicrob Resist 1983; 5:1033-48.
  • 32. Montie T., Patamasucon P. Aminoglycosides: the complex problem of antibiotic mechanisms and clinical applications. Eur J Clin Microbiol Infect Dis 1995; 14:85-7.
  • 33. Phillips I., Shannon K.P. Aminoglycosides and aminocyclitols. In: O'Grady F.W., Lambert H.P., Finch R.G. and Greenwood D., editors. Antibiotic and chemotherapy: Anti-infective agents ahd their use in therapy. 7th ed. Edinburg: Churchill Livingstone; 1997. p. 164-201.
  • 34. Состояние антибиотикорезистентности грамотрицательных возбудителей нозокомиальных инфекций в отделениях интенсивной терапии. Межведомственный научный совет по внутрибольничным инфекциям при РАМН и Минздраве РФ, Межрегиональная ассоциация по клинической микробиологии и антимикробной химиотерапии. Информационное письмо. Смоленск: Амипресс, 1997.
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