Heritage J, Dyke G W, Johnston D, Lacey R W
Department of Microbiology, Old Medical School, University of Leeds, UK.
J Antimicrob Chemother. 1988 Aug;22(2):249-56. doi: 10.1093/jac/22.2.249.
The selection of aminoglycoside-resistant bowel flora, following the administration of either gentamicin or netilmicin in combination with metronidazole for prophylaxis, during colo-rectal surgery in 88 patients has been examined. Both antibiotic regimens resulted in the selection of an aminoglycoside-resistant flora in a total of 57 (65%) of patients: in half of the patients there was a net gain in the aminoglycoside-resistant flora, and in 13 (15%) one aminoglycoside-resistant strain present prior to prophylaxis was displaced by another following operation. Three patients (3%) lost aminoglycoside-resistant strains after prophylaxis. Most of the resistant organisms selected were considered to be of little importance as potential pathogens, at least in the short term. In only a small minority (5%) of patients were aminoglycoside-resistant enterobacteria isolated. Aminoglycoside-resistant Staphylococcus aureus was not isolated. Of the resistant enterobacteria, only one strain, an isolate of Enterobacter cloacae selected in a patient receiving gentamicin, carried a resistance determinant which was self-transmissible to Escherichia coli.
对88例接受结直肠手术的患者在预防性使用庆大霉素或奈替米星联合甲硝唑期间，耐氨基糖苷类肠道菌群的选择情况进行了研究。两种抗生素方案均导致总共57例（65%）患者出现耐氨基糖苷类菌群：一半患者的耐氨基糖苷类菌群净增加，13例（15%）患者在预防前存在的一种耐氨基糖苷类菌株在术后被另一种菌株取代。3例（3%）患者在预防后失去了耐氨基糖苷类菌株。所选择的大多数耐药菌至少在短期内被认为作为潜在病原体的重要性不大。仅在少数（5%）患者中分离出耐氨基糖苷类肠杆菌。未分离出耐氨基糖苷类金黄色葡萄球菌。在耐药肠杆菌中，只有一株，即一名接受庆大霉素治疗患者分离出的阴沟肠杆菌，携带一种可自我传递给大肠杆菌的耐药决定簇。
