Beta-lactam resistance in normal faecal flora from South Africa.

The genetic and biochemical basis of ampicillin resistance amongst the aerobic Gram-negative commensal faecal flora of healthy volunteers in South Africa has been determined. Amongst 608 ampicillin resistant strains isolated from 320 of the participants, 158 were able to transfer their ampicillin resistant determinants into Escherichia coli K-12 J62-2. Iso-electric focusing of the beta-lactamases, extracted from the transconjugants, demonstrated that ampicillin resistance resulted from the presence of the TEM-1, TEM-2 and SHV-1 beta-lactamases in 94.3%, 2.5% and 3.2% of isolates respectively. Endonuclease restriction digests of the plasmids isolated from the transconjugants showed that the beta-lactamase genes were present on a wide variety of plasmid types; 101 distinct plasmid endonuclease restriction patterns were identified. Transferable ampicillin resistance was associated with resistance to other antibiotics at the following frequencies: trimethoprim (48.7%), streptomycin (35.4%), tetracycline (27.2%), spectinomycin (9.5%), chloramphenicol (3.2%) and gentamicin (1.3%). One antibiotic resistance pattern, ampicillin and trimethoprim, predominated (28%). In total, 77.9% of the plasmids conferred resistance to other antibiotics raising the possibility that use of any of these agents, not simply ampicillin, may contribute to the maintenance of resistance genes.