Abstract
THE transfer of drug resistance between gram-negative bacteria was first observed in Japan in 1959 during studies on the etiology of multiple drug-resistant shigella.1 , 2 A strain resistant to streptomycin, chloramphenicol, sulfonamides and tetracycline was first isolated in Japan in 1955,3 but by 1959, 8 per cent of all shigella, and 86 per cent of the resistant strains, isolated in 1 area of Japan were resistant to at least 3 of these drugs.4 The usual mechanisms of mutation and selection could not explain this rapid increase in the incidence of multiple resistance or certain epidemiologic findings: patients often excreted sensitive and . . .