Seven (27%) of 26 gentamicin-resistant human clinical isolates of were resistant to the veterinary aminoglycoside antibiotic apramycin. A gentamicin-resistant isolate from a patient infected with gentamicin/apramycin-resistant was also resistant to apramycin. DNA hybridisation studies showed that all gentamicin/apramycin-resistant isolates contained a gene encoding the enzyme 3-N-aminoglycoside acetyltransferase type IV (AAC[3]IV) that mediates resistance to gentamicin and apramycin in bacteria isolated from animals. Seven of the eight gentamicin/apramycin-resistant isolates were also resistant to the veterinary antihelminthic agent hygromycin B, a phenomenon observed previously in gentamicin/apramycin-resistant Enterobacteriaceae isolated from animals. Resistance to gentamicin/apramycin and hygromycin B was cotransferable in six of the isolates. Restriction enzyme analysis of plasmids in apramycin-resistant transconjugants derived from and isolates from the same patient were virtually identical, suggesting that inter-generic transfer of plasmids encoding apramycin resistance had occurred . These findings support the view that resistance to gentamicin and apramycin in clinical isolates of results from the spread of resistant organisms from animals to man, with subsequent inter-strain or inter-species spread, or both, of resistance genes on transferable plasmids.


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