Factors Influencing Kanamycin Resistance in Gram-Negative Enteric Neonatal Sepsis

Abstract

Gram-negative enteric organisms are responsible for at least 50% of cases of neonatal septicemia.1,2 Because of the emergence of kanamycin-resistant organisms, gentamicin has become the aminoglycoside agent of choice in many neonatal intensive care units.1 Increased use of gentamicin, however, favors the development of gentamicin resistance,3 which has prompted interest in reducing reliance on gentamicin. Baker et al.4 have suggested that the incidence of kanamycin resistance among Escherichia coli isolates from neonates is low if illness begins during the first few days of life but is greater among isolates from infants with illnesses of later onset. They demonstrated a correlation between pretreatment with kanamycin and subsequent recovery of kanamycin-resistant organisms from these same infants.