Overturf G D, Zawacki B E, Wilkins J
Surgery. 1976 Feb;79(02):224-8.
Amikacin has been used to treat Providencia stuarii infections on the Burn Service at Los Angeles County/University of Southern California Medical Center since March, 1973. The median minimal inhibitory concentration (MIC) of strains collected on this service prior to the introduction of amikacin was 3.13 mug. per milliliter, whereas the median MIC of strains collected during the last 4 months of the study was 12.5 mug per milliliter. High bactericidal concentrations (MBC) noted at the time of initial studies predicted the emergence of resistant clones, with MBV values rising to as great as 100 mu per milliliter. Further, isolates from burn patients during the initial 5 days of treatment with amikacin had a median MIC of 6925 mug per milliliter, in contrast to values of 25 mug per milliliter in strains isolated after 5 days of treatment. The epidemiologic significance of intensive treatment of gram-negative infections occurring in a close population with selected antibiotics is discussed. The performance of susceptibility tests which included determination of bactericidal concentrations was a major tool in the recognition of the potential for selection of resistant micro-organisms.
自1973年3月以来，阿米卡星一直被用于洛杉矶县/南加州大学医学中心烧伤科治疗斯氏普罗威登斯菌感染。在引入阿米卡星之前，该科室收集的菌株的最低抑菌浓度（MIC）中位数为每毫升3.13微克，而在研究的最后4个月收集的菌株的MIC中位数为每毫升12.5微克。初步研究时记录的高杀菌浓度（MBC）预示着耐药克隆的出现，MBC值升至每毫升高达100微克。此外，在使用阿米卡星治疗的最初5天内，烧伤患者分离株的MIC中位数为每毫升6925微克，而治疗5天后分离的菌株的值为每毫升25微克。本文讨论了在密切接触人群中使用特定抗生素强化治疗革兰氏阴性感染的流行病学意义。包括杀菌浓度测定在内的药敏试验是识别选择耐药微生物可能性的主要工具。
