Kanamycin-resistant strains

Strains of multidrug-resistant Mycobacterium tuberculosis, including streptomycin-resistant strains, are usually susceptible to amikacin. Kanamycin-resistant strains may be cross-resistant to amikacin. The dosage of amikacin for tuberculosis is... 

It is pertinent to add here that the capreomycin-resistant strains are not foimd to be completely resistant to kanamycin, whereas the corresponding kanamycin-resistant strains are invariably resistant to capreomycin. 

The compoimds 181,183 and 184 are very effective against such kanamycin resistant strains, which produce phosphotransferases I and II and nucleotidyl-transferase. The following isomeric HABA-3, 4 -dideoxykanamydn B derivatives have been synthesised ) 3-,2 - and 3"-HABA-DKB and 1,2 - or 3,2 -bis-HABA-DKB. l,2 -bis-HABA-DKB is a little less active than 1-N-HABA-DKB, whereas the other derivatives have very low activity. 

Included among the modified components of aminoglycoside antibiotics reported during the past year were 3, 4, 5,6-tetradeoxy- and 5- and 6-deoxy-and 5,6-dideoxy-neamine removal of HO-6 from the 2-deoxystreptamine residue of neamine decreased the antimicrobial activity relative to that of the parent neamine, whereas removal of HO-5 enhanced the activity, especially against kanamycin-resistant strains. l,2, 3,6 -Tetra-JV-benzyloxycarbonyl-5,6-0-cyclo-hexylideneneamine has been synthesized and converted into nebramine derivatives for use in the synthesis of tobramycin and 4"-epi-tobramycin. 2, 4, 6 -Triacetyl-3,3 -0-carbonyl-3 -deoxydihydrostreptobiosamine, a precursor for the synthesis of 3"-deoxydihydrostreptomycin, has been synthesized from benzyl a-dihydrostreptobiosaminide. The synthesis involved chlorination of the key... 

The aminoglycoside antibiotics are discussed in Chapter 45. Kanamycin has been used for treatment of tuberculosis caused by streptomycin-resistant strains, but the availability of less toxic alternatives (eg, capreomycin and amikacin) has rendered it obsolete. 

R factor mediated kanamycin resistance in strains of Ps. aeruginosa has been observed by a number of workers. The pseudomonas R factor RPl (142) carries the neomycin-kanamycin phosphorylating enzyme [205]. A study of the prevalence of R factor carrying strains of Ps. aeruginosa in Japanese hospitals showed a number of strains capable of transferring both kanamycin and neomycin resistance [206]. 

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