Characteristics of Gentamicin Resistant Pseudomonas aeruginosa

녹농균의 항생제 내성의 특성

Fifty-one strains of Pseudomonas aeruginosa were isolated from various clinical specimens. Among them, 26 (51%) strains were gentamicin-resistant (Gm') and 25 (49%) were susceptible to gentamicin (Gm'). The frequencies of resistant strains to piperacillin (Pi), cefotaxime, moxalactam, cefoperazone (Cz), and amikacin (Ak) ranged from 21.6 to 31.4%, and $MIC_{50}$ of these drugs were lower than the critical concentrations of susceptibility and resistance. Thirty (58.8%) strains were multiply resistant to 12 or more drugs. All Gm' strains were multiply resistant to 12 or more drugs and one was resistant to all 18 drugs tested, while only four Gm' strains were multiply resistant to 12 drugs and the multiplicity of resistance of the other Gm' strains were less than 10 drugs. Resistance to Gm appeared to have a significant correlation with the resistance to tobramycin (Tb), Ak, Pi, and Cz. All Gm' strains were resistant to Tb and about 38.4 to 46.1% of them were resistant to Ak, Pi, and Cz. The incorporation of $Ca^{++}$ and $Mg^{++}$ ions in Mueller-Hinton agar (MHA) did not influence the MICs of Gm, Tb, carbenicillin (Cb), Pi, and Cz as compared with the results obtained in MHA without these ions. Gm strains were studied on the combined effect of beta-lactam antibiotics and aminoglycosides by the methods of checkerboard and modified paper strip diffusion. Most Gm' strains showed significant synergistic effects by the FIC index between Ak and three beta-lactam antibiotics; Cb, Pi, and Cz, but these results did not in agreement the results obtained through the method of modified paper strip diffusion test. In order to know the nature of the drug resistance of P. aernginosa, the plasmid profile analysis was studied. Agarose gel electrophoresis of lysates processed by the method of Kado and Liu showed one or more plasmids in 22 (43.1%) strains. A group of 19 strains showed at least one band of plasmid and three strains two bands. The range of the molecular weight of plasmids was 3.8 to 243 Mdal. All strains carrying large plasmids larger than 200 Mdal were isolated from wound specimens. Three Gm' strains also harboured the plasm ids of 13 to 203 Mdal.