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Emergence of rifampin-resistant staphylococci after rifaximin administration in cirrhotic patients

Title
Emergence of rifampin-resistant staphylococci after rifaximin administration in cirrhotic patients
Authors
Chang J.Y.Kim S.-E.Kim T.H.Woo S.-Y.Ryu M.S.Joo Y.-H.Lee K.E.Lee J.Lee K.H.Moon C.M.Jung H.-K.Shim K.-N.Jung S.-A.
Ewha Authors
정성애우소연김태헌김성은
SCOPUS Author ID
정성애scopus; 우소연scopus; 김태헌scopus; 김성은scopus
Issue Date
2017
Journal Title
PLoS ONE
ISSN
1932-6203JCR Link
Citation
vol. 12, no. 10
Publisher
Public Library of Science
Indexed
SCIE; SCOPUS WOS scopus
Abstract
Objectives: Rifaximin, a poorly absorbed antibiotics, has gut-specific therapeutic effects. Although frequently prescribed to manipulate intestinal luminal bacterial population in various diseases, the possible induction of antibacterial cross-resistance to a target pathogen is a major concern in long-term rifaximin administration. We aimed to evaluate whether rifampin-resistant staphylococci could evolve after rifaximin treatment in cirrhotic patients. Method: A total of 25 cirrhotic patients who were administered rifaximin for the prevention of hepatic encephalopathy were enrolled. Swabs from both hands and the perianal skin were acquired on day 0 (before rifaximin treatment), period 1 (1–7 weeks after treatment), and period 2 (8–16 weeks after treatment) the staphylococcal strain identification and rifampin-resistance testing. Results: A total of 198 staphylococcal isolates from 15 species were identified. Staphylococcus epidermidis was isolated most frequently, and Staphylococcus haemolyticus was the most common resistant species both from hands and perianal skin. Eleven patients (44.0%) developed rifampin-resistant staphylococcal isolates in period 1. Among these patients, only six (54.5%) were found to have rifampin-resistant isolates in period 2, with no significant infectious events. Rifampin-resistant staphylococcal isolates were more frequently found in perianal skin than from the hands. No patients acquired a newly resistant strain in period 2. Conclusions: About one-half of cirrhotic patients in this study developed rifampin-resistant staphylococcal isolates after rifaximin treatment. Although the resistant strains were no longer detected in about half of the patients in the short-term, the long-term influence of this drug treatment should be determined. © 2017 Chang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
DOI
10.1371/journal.pone.0186120
Appears in Collections:
의학전문대학원 > 의학과 > Journal papers
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