R factors determining multiple resistance including both gentamicin and carbenicillin have been identified in high incidence among hospital isolates of Pseudomonas aeruginosa. The factors are readily transmitted to other P. aeruginosa but not to Escherichia coli strains K-12 or C, or to Proteus mirabilis. R factor-containing isolates are predominantly immunotype 7 isolated from urinary sources.Pseudomonas aeruginosa, although resistant to many antibiotics, has been generally susceptible to gentamicin and carbenicillin. Recently, descriptions have appeared of R factors in this organism, including reports of factors determining resistance to one or the other of these antibiotics (3,4,8,9,11,12,14,15, 17 with L-amino acids at 20 ,ug/ml as required. Antibiotics were used in selection plates at the following concentrations (;g/ml): gentamicin, 1 to 20; carbenicillin, 50, 500, or 750; streptomycin, 100; tetracycline, 100; kanamycin, 50; and rifampin, 100.Antibiotic resistance. Antibiotic disk susceptibilities were determined by the Bauer-Kirby method (2) with Mueller-Hinton agar (Difco). For determination of minimal inhibitory concentrations, single drops with 101 organisms from ovemight culture were spotted on similar agar media containing serial twofold supplements of antibiotic. In cases where strain interactions were likely, single samples per culture dish were examined with 35 by 10 mm dishes.Bacterial strains. All clinical strains studied were isolated and identified at Veterans Administration Hospital, Cincinnati. These and other locally derived strains are designated with the PL prefix of this laboratory. The origins and pertinent characteristics of the major mating strains are presented in Table 1. Strain PL1 is a leu mutant of strain 280 met rit. 'Ihe mutant was isolated from a stock of the parental strain which had been exposed to diethylsulfate and subjected to carbenicillin selection (1.3 mg/ml). All strains were maintained at room temperature on complex medium solidified with agar (0.75%) in sealed, screw-capped glass vials.Bacterial matings and selection of transcipients.