在大肠杆菌临床分离株中高水平利福昔明耐药性中，外排泵的相关作用。
Relevant role of efflux pumps in high levels of rifaximin resistance in Escherichia coli clinical isolates.
机构信息
Barcelona Centre for International Health Research CRESIB, Hospital Clinic - Universitat de Barcelona, Spain.
出版信息
Trans R Soc Trop Med Hyg. 2013 Sep;107(9):545-9. doi: 10.1093/trstmh/trt059. Epub 2013 Jul 9.
BACKGROUND
Enteropathogens have shown a high level of resistance against commonly used antibacterial drugs in Peru and it is necessary to explore alternative treatments. The aim of this study was to analyse the in vitro activity of rifaximin against diarrhoeagenic and commensal Escherichia coli in children less than 2 years of age.
METHODS
The minimal inhibitory concentration (MIC) to rifampicin and rifaximin was determined for 210 strains in the presence and absence of phenyl-arginine-β-naphthylamide (PAβN) and the mechanisms of resistance were investigated.
RESULTS
The MIC levels ranged between 8 and >256 mg/litre and the predominant mechanism of resistance to rifaximin was the efflux pumps inhibited by PAβN in 95.2% of the isolates.
CONCLUSIONS
The present MIC values are higher than those observed in other studies. Efflux pumps inhibited by PAβN were the cause of the rifaximin resistance in the majority of cases and suggest the presence of an environmental selective pressure. Consequently, rifaximin should be used with caution in the treatment of diarrhoea in Peru.
背景
在秘鲁，肠病原体对常用的抗菌药物表现出了很高的耐药性，因此有必要探索替代治疗方法。本研究旨在分析利福昔明对 2 岁以下儿童腹泻性和共生性大肠杆菌的体外活性。
方法
在存在和不存在苯丙氨酸-精氨酸-β-萘酰胺（PAβN）的情况下，测定了 210 株菌对利福平利福昔明的最小抑菌浓度（MIC），并研究了耐药机制。
结果
MIC 水平在 8 至>256 毫克/升之间，对利福昔明的主要耐药机制是 95.2%的分离株中被 PAβN 抑制的外排泵。
结论
目前的 MIC 值高于其他研究中观察到的值。被 PAβN 抑制的外排泵是大多数情况下利福昔明耐药的原因，这表明存在环境选择压力。因此，在秘鲁，利福昔明治疗腹泻应谨慎使用。
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