Mechanisms of resistance to five aminoglycoside antibiotics: gentamicin (G), tobramycin (T), netilmicin (N), amikacin (A) and isepamicin (I), were assessed in 16 clinical isolates of Pseudomonas aeruginosa serotype O11, originating from five hospitals in Bratislava. All isolates were in vitro highly resistant to all mentioned aminoglycoside antibiotics (MIC > 32 mg/l). Thirteen isolates produced three aminoglycoside-modifying enzymes (AGME), responsible for resistance to the respective aminoglycosides: AAC(6')-I (T, N, A); APH (2") (G, T); APH (3')-VI (I). In addition to this, in four isolates a production of AAC(3)-II (G, T, N) was observed. In three isolates no production of AGME was observed. The strains studied were isolated mainly from urine. Several isolates were able to transfer aminoglycoside resistance by bacterial conjugation to P. aeruginosa 1008 rifr recipient. The transconjugants from these transfers expressed the same resistance pattern and nearly the same mechanisms of resistance as the donor strains.

Aminoglycosides↗

PubMedDate not supplied

Ethics and reproductive medicine.

This article surveys relevant moral and ethical implications of reproductive medicine, excluding any aspects of contraception. To maintain the methodological priority of a moral perspective, it focuses on moral theory and ethics in general before looking at the impact of ethics on the different techniques applied in reproductive medicine. We suggest that discourse ethics should be centre-stage among the moral perspectives, since it has a unique capacity to synthesize, gauge and emulate other moral perspectives without necessarily replacing them. Questions of spousal fidelity, parental identity, sexual relations, reshaping of family ties, preimplantation diagnosis, discarding of human life, up to the question of what kind of life is generally acknowledged as worth living, and which is not, all these are morally significant topics. As well as providing a description of the techniques used in reproductive medicine, our article presents a rationale for charting potentials for moral problems. This renders it possible to elucidate the moral costs of each of the options offered by reproductive medicine in the light of whatever moral view one identifies with.

Cryopreservation↗

PubMedDate not supplied

Transferable amikacin resistance in gram-negative bacterial isolates.

Seven amikacin-resistant strains of Enterobacteriaceae isolated in Slovakia and Germany were included in this study. The strains were also resistant in vitro to high levels of gentamicin, tobramycin, netilmicin and isepamicin. Phosphocellulose paper binding assays indicated that resistance to aminoglycosides was due to synthesis of aminoglycoside acetyltransferase AAC(6')-I a mechanism until now only identified in staphylococci and streptococci. This mechanism of aminoglycoside resistance has also been found in two isolates of Klebsiella pneumoniae from Germany. The substrate profile suggested that in addition to AAC(6')-I and APH(2"), several strains also produced AAC(3)-II. Aminoglycoside resistance was found to be transferable to Escherichia coli 3110 rifr in all isolates, and R plasmids of 36-45 MD were detected in donor and transconjugant strains. All isolated plasmids from transconjugants encoded resistance to aminoglycosides by genes encoding the enzymes AAC(6')-I and APH(2").

Acetyltransferases↗

PubMedDate not supplied

Pharmacokinetics of gentamicin administered intratracheally or as an inhalation aerosol to guinea pigs.

The pharmacokinetics of gentamicin were studied after intratracheal, inhalation, and iv administration to guinea pigs. Gentamicin injected intratracheally was almost completely systemically available. The comparison of the gentamicin plasma AUCs after inhalation and iv administration showed that an inhalation exposure lasting 10 min resulted in an absorption of 1.13 mg gentamicin/kg body weight into systemic circulation. This absorbed dose was 40.4 or 67.3% of the amount of gentamicin inhaled, depending on tidal volume assumed, and 1.4% of the amount of gentamicin aerosolized. The postinhalation gentamicin concentration in the lungs decreased with a half-life of 67.3 min. The data differentiate topical pulmonary gentamicin from systemic gentamicin and give a rational basis for study of the mechanism of the therapeutic effect of gentamicin inhalation aerosol in bronchopulmonary infections.

Aerosols↗