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Year : 1987  |  Volume : 5  |  Issue : 2  |  Page : 71-83

Emergence Of Drug Resistance Amongst Common Hospital Pathogens


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A prospective study was initiated to find out the most suitable method for in vitro antibacterial sensitivity, frequency of organisms causing postoperative infections since 1977, their antimicrobial resistance and whether the drug resistance was plasmid mediated in P. aeruginosa and if it is possible to transfer drug resistance from resistant P. aeruginosa to other species of bacteria. Both Stoke’s and Kirby-Baer methods of in vitro antibacterial sensitivity testing were found to be quite good and gave almost similar results when carried out under standardized conditions, though Stoke’s method gave better agreement with the MIC in most of the cases. The simplicity, accuracy, speed of performance and reproducibility under standardized conditions makes the Stoke’s method ideally suited for a busy diagnostic laboratory to carry out in vitro antimicrobial sensitivity. Staphylococcus aureus was responsible for more than 255 of the postoperative infections in 1977, while in 1985 this reduced to 13%. The reverse was observed with Klebsiella group of organism; about 13% in 1977 and 25% in 1985. Klebsiellae have become more resistant to more drugs. No change was seen in frequent of infections due to P. aeruginosa, E. coli, Proteus species and other gram negative bacilli. It is interesting to note that the resistance to gentamicin has increased for all the organisms during this period. However, inspite of increase in resistance to many other antimicrobial agents, resistance of P. aeruginosa to Poly-myxin B-sulphate has not changed. There has been a major charge for carbenicillin; in 1972 only 14.3% isolates were resistant as against 82.8% in 1977 and 64.9% in 1985. On the basis of different studies carried out to demonstrate presence of R. plasmids in P. aeruginosa, it can be (concluded that multiple drug resistant P. aeruginosa strains of clinical origin carrying transferable drug resistance plasmids are prevalent in a hospital. These strains can transfer resistance to sensitive strains of P. aeruginosa more frequently than to sensitive strains of other related bacteria. They carry both conjugative and nonconjugative drug resistance plasmids. They seem to be an important factor in spread of resistance in a hospital.






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2004 - Indian Journal of Medical Microbiology
Published by Wolters Kluwer - Medknow

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