#105 - Rifaximin and Antimicrobial Resistance in Enterococci in Patients With Cirrhosis: Analysis of the Latin American Surveillance Registry
Year: 2026
Type: article
Study design: Observational Study
Abstract: Introduction and Objectives Rifaximin could favor selection of clinically relevant antimicrobial resistance phenotypes, particularly in enterococci. To evaluate, in patients with cirrhosis and bacterial infection, the association between rifaximin use at infection diagnosis and vancomycin-resistant enterococci (VRE) and multidrug resistance (MDR). Materials and Methods Cross-sectional study using the Latin American Registry of Bacterial Infections in Patients with Cirrhosis (ClinicalTrials.gov: NCT03919032). Bacterial isolates from culture-positive infections in adults with cirrhosis were included. VRE was assessed using two complementary approaches: within the enterococcal subgroup and across all isolates. Results We included 1061 bacterial isolates from 758 patients; 394 (37.1%) were from patients receiving rifaximin. There were 113 Enterococcus spp. isolates and 48 Enterococcus faecium isolates. Within enterococcal isolates, VRE frequency was similar in Enterococcus spp. (26.7% vs 29.5%; RR 1.11, 95% CI 0.59–2.08) and Enterococcus faecium (61.5% vs 55.0%; RR 0.89, 95% CI 0.54–1.48). Across all isolates, VRE frequencies were 2.6% vs 3.3% for Enterococcus spp. (RR 1.26, 95% CI 0.61–2.62) and 2.6% vs 2.8% for Enterococcus faecium (RR 1.07, 95% CI 0.50–2.30). MDR frequencies were 38.5% vs 43.0% (RR 1.12, 95% CI 0.94–1.33). No daptomycin- or linezolid-resistant enterococci were observed (Table 1). Conclusions No clear association was observed between rifaximin use and vancomycin resistance or multidrug resistance. These findings provide some reassurance regarding the enterococcal phenotypes of greatest relevance, although rifaximin should continue to be used prudently.
Source: Annals of Hepatology
Authors: Gonzalo Gomez, Maria Murga, Esteban Gonzalez, Diego Giunta, Ana Palazzo, Astrid Smud, Emilse Diaz, Ilse Pardo, Maria Perez, Lorena Notari, Josefina Pages, Manuel Mendizabal, Camila Briz, Agustin Di Santo, Julia Brutti, Brenda Osso, Margarita Anders, Javier Diaz, Angelo Mattos, Maria Schinoni, Ana Martins, Alina Zerega, Pablo Calzetta, Laura Maboni, Maximiliano Castro, Fernando Cairo, Lucia Navarro, Martin Elizondo, Gisela Gualano, Maria Garrido, Diego Arufe, Marcelo Valverde, Agostina Romero, Natalie Vilcinskas, Jorge Garavito, Rommel Zambrano, Laura Tenorio, Karla Aquino, Esther Veramendi, Melisa Dirchwolf, Jesica Tomatis, Adrian Gadano, Sebastian Marciano
Institutions: Hospital Italiano de Buenos Aires, Hospital de Niños Superiora Sor María Ludovica, Hospital de Clínicas "José de San Martín", Universidad Hospital Italiano, Hospital Universitario Austral, Hospital Alemán, Hospital Nacional Edgardo Rebagliati Martins, Universidade Federal de Ciências da Saúde de Porto Alegre, Universidade Federal da Bahia, Complexo Hospitalar Universitário Professor Edgard Santos, Fundacion Allende, Hospital Fernández, Hospital El Cruce, Instituto Médico Río Cuarto
Language: English
Subfield: Microbiology (medical)
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,500
OpenAlex ID: W7204253205