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Background. It is well documented that antibiotic therapy exerts selective pressure on bacteria.
Conversion of bacteria from susceptible to resistant to antibiotics has been observed
often during antimicrobial therapy. It has been postulated that human intestinal reservoirs
facilitate communication of transposons that can transfer resistance determinants
among various bacterial species.
Methods. This study examined the susceptibilities of organisms isolated from infected abdomens
to a number of antibiotic agents during a 12-year time interval. Analysis included
1102 isolates recovered from 255 specimens, representing the following genera: Bacteroides,
Clostridium, Gemella, Fusobacterium, Peptostreptococcus, Porphyromonas, Prevotella,
Enterococcus, Staphylococcus, Streptococcus, Pseudomonas, and Enterobacteriaceae.
Strains were tested against β-lactam agents, β-lactams in combination with β-lactamase
inhibitors, first, second, and third generation cephalosporins, aminoglycosides, clindamycin,
metronidazole, chloramphenicol, and imipenem.
Results. The results indicated that during a time period of more than a decade essentially
no change occurred in the antibiotic susceptible fraction of all species tested.
Conclusions. Abdominal sepsis is caused by leakage of endogenous intestinal flora. This study
suggests that the intestinal flora is not permanently affected by short-term antibiotic
therapy and that older antibiotics are appropriate first-line therapeutic agents for
community-acquired infections caused by normal intestinal flora.
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Article info
Publication history
Accepted:
October 17,
1994
Identification
Copyright
© 1995 Mosby-Year Book, Inc. Published by Elsevier Inc.
