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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, Ji YoungKim, Seong-EunKim, Tae HunWoo, So-YounRyu, Min SunJoo, Yang-HeeLee, Ko EunLee, JihyunLee, Kang HoonMoon, Chang MoJung, Hye-KyungShim, Ki-NamJung, Sung-Ae
Ewha Authors
정성애정혜경심기남우소연김태헌김성은문창모
SCOPUS Author ID
정성애scopusscopus; 정혜경scopus; 심기남scopus; 우소연scopus; 김태헌scopusscopus; 김성은scopusscopusscopus; 문창모scopus
Issue Date
2017
Journal Title
PLOS ONE
ISSN
1932-6203JCR Link
Citation
PLOS ONE vol. 12, no. 10
Publisher
PUBLIC LIBRARY SCIENCE
Indexed
SCIE; SCOPUS WOS scopus
Document Type
Article
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.
DOI
10.1371/journal.pone.0186120
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의과대학 > 의학과 > Journal papers
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