Studies on the Epidemiology of Resistance (R) Factors

I. Analysis of Klebsiella Isolates in a General Hospital

II. A Prospective Study of R Factor Transfer in the Host

  1. PIERCE GARDNER, M.D.; and
  2. DAVID H. SMITH, M.D.
  1. Boston, Massachusetts
  1. Requests for reprints should be addressed to David H. Smith, M.D., Children's Hospital—Beth Israel Infectious Disease Unit,
    300 Longwood Ave., Boston, Mass. 02115

SUMMARY

In a nosocomial outbreak due to multidrug-resistant Klebsiella, resistance (R) factors were found to mediate drug resistance in 90% of the isolates tested. An analysis of Klebsiella isolates and a prospective study of interbacterial transfer of R factors in hospital patients both suggested that environmental selection by antibiotics and colonization of patients with resistant organisms are of far greater epidemiological significance than transfer of R factors in the gastrointestinal tract. The public health implications are discussed.

Article and Author Information

  • From the Departments of Medicine, Harvard Medical School and the Massachusetts General Hospital (Infectious Disease Unit); and the Departments of Pediatrics, Harvard Medical School and the Children's Hospital Medical Center (Infectious Disease Unit); Boston, Mass.

  • This study was supported by grants 2T 01 AI 00215-06 and AI 0836201, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md.

  • Dr. Smith was supported in this study by career development award AI 20376, National Institute of Allergy and Infectious Diseases.

    • Received February 6, 1969.
    • Accepted March 14, 1969.
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  1. Ann Intern Med July 1, 1969 vol. 71 no. 1 1-9
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