Endocarditis due to Corynebacterium pseudodiphtheriticum.
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Aged↗
Biomedical subjects
D J Hardy
Publications and source records attributed to D J Hardy.
Klebsiella neonatal injections: mechanism of broadening aminoglycoside resistance.
Kanamycin resistance in eight strains of Klebsiella pneumoniae isolated during an outbreak of infection in a neonatal intensive care unit was found to be transferable and mediated by neomycin phosphotransferase. After gentamicin was used to control infections caused by kanamycin-resistant organisms, a strain resistant to gentamicin emerged. Gentamicin resistance in this ninth strain was not transferable and was accompanied by resistance to tobramycin, amikacin, and streptomycin. Enzymatic modifications of aminoglycosides other than neomycin and kanamycin could not be demonstrated either by filter binding assays or by electrophoresis of a radioactive aminoglycoside substrate. The strain with broad aminoglycoside resistance contained six plasmid deoxyribonucleic acid bands, none of which appeared to be different in molecular weight from plasmid deoxyribonucleic acid bands in strains isolated before the institution of gentamicin therapy. The broadening of resistance was accompanied by reduced uptake of radioactively labeled streptomycin and gentamicin. The relationship between aminoglycoside resistance and reduced drug transport in the absence of any enzymatic modification is discussed.
Aminoglycosides↗
In vitro activity of ampicillin, amoxicillin, ampicillin-sulbactam, and amoxicillin-clavulanic acid against consecutive clinical isolates of Enterobacteriaceae.
Ampicillin was generally twice as active as amoxicillin against 2440 consecutive isolates of Enterobacteriaceae from five medical centers. When beta-lactamase inhibitors were added to the penicillins, there was a significant increase in susceptibility. The magnitude of the increased susceptibility to ampicillin-sulbactam (A-S) and amoxicillin-clavulanic (A-C) acid varied with the species and types of beta-lactamases elaborated. Although cross-susceptibility and cross-resistance between ampicillin and amoxicillin was nearly complete, major differences were documented between A-S and A-C with 6.7% of our consecutive isolates of Enterobacteriaceae. The clinical significance of these findings remains uncertain, but they may help explain some of the discrepancies occasionally observed by clinical microbiologists with the combination drugs.
Amoxicillin↗