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Rev Gastroenterol Mex. 2016 Jan-Mar;81(1):3-10. doi: 10.1016/j.rgmx.2015.07.003. Epub 2015 Oct 30.

Susceptibility of bacteria isolated from acute gastrointestinal infections to rifaximin and other antimicrobial agents in Mexico.

[Article in English, Spanish]

Author information

1
División de Microbiología Clínica, Unidad de Diagnóstico Microbiológico UDMSC, México, D.F., México.
2
Departamento de Medicina Interna, Hospital Médica Sur, México, D.F., México. Electronic address: AFrati@alfawassermann.com.
3
Alliance for the prudent use of antibiotics (APUA), Chapter Mexico. México, D.F. México.

Abstract

BACKGROUND:

Bacterial resistance may hamper the antimicrobial management of acute gastroenteritis. Bacterial susceptibility to rifaximin, an antibiotic that achieves high fecal concentrations (up to 8,000μg/g), has not been evaluated in Mexico.

OBJECTIVE:

To determine the susceptibility to rifaximin and other antimicrobial agents of enteropathogenic bacteria isolated from patients with acute gastroenteritis in Mexico.

MATERIAL AND METHODS:

Bacterial strains were analyzed in stool samples from 1,000 patients with diagnosis of acute gastroenteritis. The susceptibility to rifaximin (RIF) was tested by microdilution (<100, <200, <400 and <800μg/ml) and susceptibility to chloramphenicol (CHL), trimethoprim-sulfamethoxazole (T-S), neomycin (NEO), furazolidone (FUR), fosfomycin (FOS), ampicillin (AMP) and ciprofloxacin (CIP) was tested by agar diffusion at the concentrations recommended by the Clinical & Laboratory Standards Institute and the American Society for Microbiology.

RESULTS:

Isolated bacteria were: enteropathogenic Escherichia coli (E. coli) (EPEC) 531, Shigella 120, non-Typhi Salmonella 117, Aeromonas spp. 80, enterotoxigenic E. coli (ETEC) 54, Yersinia enterocolitica 20, Campylobacter jejuni 20, Vibrio spp. 20, Plesiomonas shigelloides 20, and enterohemorrhagic E. coli (EHEC 0:157) 18. The overall cumulative susceptibility to RIF at <100, <200, <400, and <800μg/ml was 70.6, 90.8, 99.3, and 100%, respectively. The overall susceptibility to each antibiotic was: AMP 32.2%, T-S 53.6%, NEO 54.1%, FUR 64.7%, CIP 67.3%, CLO 73%, and FOS 81.3%. The susceptibility to RIF <400 and RIF <800μg/ml was significantly greater than with the other antibiotics (p<0.001).

CONCLUSIONS:

Resistance of enteropathogenic bacteria to various antibiotics used in gastrointestinal infections is high. Rifaximin was active against 99-100% of these enteropathogens at reachable concentrations in the intestine with the recommended dose.

KEYWORDS:

Antibiotics; Antibióticos; Bacterial resistance; Bacterial susceptibility; Gastroenteritis; Resistencia bacteriana; Rifaximin; Rifaximina; Small intestinal bacterial overgrowth; Sobrepoblación bacteriana intestinal; Susceptibilidad bacteriana

PMID:
26525276
DOI:
10.1016/j.rgmx.2015.07.003
[Indexed for MEDLINE]
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