Multiple drug resistance in Klebsiella-Enterobacter, Proteus mirabilis and Pseudomonas aeruginosa--an analysis of all-nation computer-processed data.

This last communication on the results of an one-year computer follow-up of single, double, and multiple antibiotic resistance of so-called problem bacteria in Slovakia presents computerised data on double, and important triple, quadruple and quintuple resistance of Klebsiella-Enterobacter, P. mirabilis and Ps. aeruginosa strains. Bi- and multi-resistant strains absolutely prevail in Klebsiella (more than 60% of many thousands of strains tested), P. mirabilis (90%) and Ps. aeruginosa (95%). Special strict surveillance should be imposed on these strains, namely on those coming from hospitals, and on their resistance developments concerning those few drugs which are fully (gentamicin and colistin, except for Proteus) or individually effective (streptomycin, carbenicillin, septrin, nalidixic acid). Mutual co-selectivity of bi-resistance has been identified in Klebsiella-Aerobacter toward gentamycin-colistin. Although this does not take place in Ps. aeruginosa, it is similar to the development in E. coli, and to the one-way co-selection of combined oxacillin-lincomycin resistance in staphylococci in this country. Should this co-selective trend continue, even promoted by the spread of R plasmids, it may happen that the treatment of infections caused especially by these three (or four) species will be seriously jeopardized.