ABSTRACT
The aminoglycosides play a central role in the treatment of infectious diseases caused by gram-negative bacteria. During the period of January to June 1984, 45 clinical specimens collected in our neonatal intensive care unit grew Enterobacter cloacae; 41 of them were gentamicin resistant. One neonate developed septicemia. The routine antibiotic protocol was then changed from gentamicin-ampicillin to amikacin-ampicillin for a period of six months. During this period the resistance to gentamicin declined to a minimum. Only eight of 122 specimens proved to harbor gram-negative organisms resistant to gentamicin. The gentamicin-resistant E. cloacae vanished. No isolate was resistant to amikacin. The gentamicin-ampicillin regimen was then reintroduced.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Cross Infection/drug therapy , Enterobacteriaceae Infections/drug therapy , Gentamicins/therapeutic use , Amikacin/therapeutic use , Ampicillin/therapeutic use , Drug Therapy, Combination , Enterobacter/drug effects , Humans , Infant, Newborn , Intensive Care Units, Neonatal , Penicillin Resistance , Sepsis/drug therapyABSTRACT
Ultrasound diagnosis of bilateral hydronephrosis, hydroureters, and megacystis together with oligohydramnios secondary to urethral stenosis was made in a male fetus at 29 weeks' gestation. In utero decompression of the obstructed urinary tract and expansion of the amniotic fluid was achieved by placing an external bladder-amniotic fluid shunt using two catheters, one inserted into the fetal bladder and the other placed in the amniotic sac. The infant was delivered by cesarean section at 35 weeks' gestation and had a favorable outcome.