HIGH-LEVEL RESISTANCE TO AMINOGLYCOSIDES - COMPARISON OF COMMUNITY AND NOSOCOMIAL FECAL ISOLATES OF ENTEROCOCCI

Fecal carriage of enterococci highly resistant to streptomycin, gentam icin, and kanamycin was examined in 64 healthy volunteers with no expo sure to hospitals and in 53 hospitalized individuals. High-level resis tance to streptomycin and gentamicin was found in fecal specimens from 3% and 0, respectively, of the healthy volunteers and in fecal specim ens from 41% and 15%, respectively, of the hospitalized individuals. W e found that high-level resistance to kanamycin was also more common a mong hospitalized individuals than among healthy volunteers (36% vs. 1 7%). The frequent occurrence of high-level resistance to kanamycin in fecal isolates confirms that amikacin is a poor choice when attempting to achieve synergistic therapy for enterococcal infections, in partic ular for those infections that are nosocomially acquired.