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Control of Aminoglycoside Resistance by Barrier Precautions

Published online by Cambridge University Press:  02 January 2015

Robert P. Gaynes ,
Robert A. Weinstein ,
Judy Smith ,
Margaret Carman  and
Sherwin A. Kabins
Robert P. Gaynes
Affiliation:
Infection Control Program and the Division of Infectious Diseases, Department of Medicine, Michael Reese Hospital and Medical Center, and the University of Chicago, Pritzker School of Medicine
Robert A. Weinstein*
Affiliation:
Infection Control Program and the Division of Infectious Diseases, Department of Medicine, Michael Reese Hospital and Medical Center, and the University of Chicago, Pritzker School of Medicine
Judy Smith
Affiliation:
Infection Control Program and the Division of Infectious Diseases, Department of Medicine, Michael Reese Hospital and Medical Center, and the University of Chicago, Pritzker School of Medicine
Margaret Carman
Affiliation:
Infection Control Program and the Division of Infectious Diseases, Department of Medicine, Michael Reese Hospital and Medical Center, and the University of Chicago, Pritzker School of Medicine
Sherwin A. Kabins
Affiliation:
Infection Control Program and the Division of Infectious Diseases, Department of Medicine, Michael Reese Hospital and Medical Center, and the University of Chicago, Pritzker School of Medicine
*
111 Baumgarten, Department of Medicine, Michael Reese Hospital, Chicago, IL 60616
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Abstract

The efficacy of antibiotic resistance (barrier) precautions for control of aminoglycoside resistance was evaluated from 1978 to 1981. Despite increasing aminoglycoside use and a 13-fold increase in aminoglycoside-resistant isolates on a newly opened oncology unit, the hospital-wide frequency of aminoglycoside resistant Enterobacteriaceae remained low, supporting the continued value of barrier precautions which were initiated in our hospital in 1974. This control enabled us to focus on exceptions to the effectiveness of barrier precautions. These were traced to environmental reservoirs, very chronic and heavily infected patients, asymptomatic carriers of Serratia, and oncology patients receiving oral non-absorbable aminoglycosides. In addition, resistance in Pseudomonas aeruginosa paralleled aminoglycoside use and, as in our prior experience, continued to rise. With increasing adoption of barrier precautions by others such exceptions should be anticipated.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 4 , Issue 4 , August 1983 , pp. 221 - 225
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1983

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References

1.Weinsiein, RA, Kabins, SA: Strategies for prevention and control of multiple drug-resistant nosocomial infection. Am J Med 1981; 70:449–454.Google Scholar
2.Weinstein, RA, Nathan, C, Gruensfeldei, R, el al: Endemie aminoglycoside resistance in gram-negative bacilli: Epidemiology and mechanisms. J Infect Dis 1980; 141:338–345.CrossRefGoogle Scholar
3.Farmer, JJ, Davis, BR, Hickman, FW, et al: Detection of Serratia outbreaks in hospital. Lancet 1976; 2:455–459.Google Scholar
4.Yu, VL: Serratia marcescens. Historical perspective and clinical review. N Engl J Med 1979: 300:887–893.Google Scholar
5.Rutala, WA, Kennedy, VA, Loflin, HB, et al: Serratia marcescens nosocomial infections of the urinary tract associated with urine measuring containers and urinometers. Am J Med 1981; 70:659–663.Google Scholar
6.Knolhe, H, Krcmery, V, Sietzen, W, et al: Transfer of gentamicin resistance from Pseudomonas aerugitwsa strains highly resistant to gentamicin and carbenicillin. Chemotherapy 1973; 18:229–234.Google Scholar
7.Bryan, LE, Van Den Elzen, HM, Tseng, JT: Transferrable drug resistance in Pseudomonas aeruginosa. Antimicrob Agents Chemother 1972; 1:22–29.Google Scholar