RESUMO
Available information indicates that antibiotic resistance is increasing throughout the world and that it is a greater problem in developing countries than in the more developed countries. A comparison of antibiotic susceptibility of gram negative aerobic bacilli from Holberton Hospital in St. John's, Antigua and Genessee Hospital in Rochester, New York, USA was undertaken to test that hypothesis. Escherichia coli, Klebsiella spp and Enterobacter spp isolates had antibiotic susceptibility tested by the disk diffusion method. Antibiograms of isolates from similar sources from both institutions from 1992 to 1995 were compared: ampicillin, gentamicin and cotrimoxazole. Results reveal that E. coli isolates in Antigua in 1992 had a higher prevalence of resistance to ampicillin (71 percent vs 31 percent, p=0.001) and no significant difference in resistance to gentamicin (4 percent vs 2 percent, p=NS) or co-trimoxazole (20 percent vs 11 percent, p=NS) compared to Rochester. By 1995, the prevalence of resistance was significantly greater for all three drugs (ampicillin 76 percent vs 31 percent, p=0.001, gentamicin 21 percent vs 2 percent p=0.001, co-trimoxazole 34 percent vs 9 percent, p=0.001) in Antigua compared with Rochester. Klebsiella and Enterobacter isolates in Antigua had a higher rate of resistance early and late compared with Rochester. Isolates from Holberton Hospital in Antigua developed a higher prevalence of resistance between 1992-3 and 1994-5, with E. coli having more resistance to gentamicin (4 percent vs 20 percent, p=0.01) and Klebsiella having more resistance to gentamicin (16 percent vs 43 percent, p=0.001) and co-trimoxazole (34 percent vs 57, p=0.001). In no instance did the resistance of any bacilli to any antibiotic improve significantly in that interval in Antigua. These data show that antibiotic resistance in Antigua is more prevalent than in Rochester and that the gap is widening.(AU)
