EMERGENCE OF HIGH-LEVEL TRIMETHOPRIM RESISTANCE IN FECAL ESCHERICHIA-COLI DURING ORAL-ADMINISTRATION OF TRIMETHOPRIM OR TRIMETHOPRIM-SULFAMETHOXAZOLE
EMERGENCE OF HIGH-LEVEL TRIMETHOPRIM RESISTANCE IN FECAL ESCHERICHIA-COLI DURING ORAL-ADMINISTRATION OF TRIMETHOPRIM OR TRIMETHOPRIM-SULFAMETHOXAZOLE
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DOI：
10.1056/nejm198201213060302
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发表时间：
1982-01-01
影响因子：
158.5
通讯作者：
DUPONT, HL
中科院分区：
文献类型：
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作者：
MURRAY, BE;RENSIMER, ER;DUPONT, HL
在墨西哥进行的一项为期2周的疟疾预防研究中，对来自美国的136名学生每天服用甲氧苄啶（TMP）、甲氧苄啶-磺胺甲恶唑（TMP-SMX）或安慰剂对需氧粪便革兰氏阴性菌的影响进行了监测。与其他使用这些药物的研究中出现尿路感染或粒细胞减少症的患者不同，本研究中的大多数患者粪便肠杆菌科细菌总数没有变化，并且几乎所有这些菌株都具有高水平的TMP和SMX耐药性。E.大肠埃希菌是最主要的耐药菌，165株耐药大肠埃希菌中96%耐药。大肠埃希菌对至少4种抗菌药物耐药，25%对7种抗菌药物耐药。在100株供试菌株中，40株的TMP耐药性是可转移的。尽管在其他预防性研究中缺乏TMP耐药性，但结果清楚地表明了对该药物的耐药性的出现和传播的显著能力。
The effect of daily administration of trimethoprim (TMP), trimethoprim-sulfamethoxazole (TMP-SMX), or placebo on aerobically grown fecal gram-negative bacteria was monitored in 136 students from the USA during a 2-wk diarrhea-prevention study in Mexico. Unlike patients in other studies with these agents, who had urinary-tract infection or granulocytopenia, most persons in this study had no change in total fecal Enterobacteriaceae and had high-level TMP and SMX resistance in virtually all these strains. E. coli was the predominant TMP-resistant organism isolated; 96 per cent of 165 TMP-resistant E. coli isolates were resistant to at least 4 antimicrobial agents, and 25% were resistant to 7. TMP resistance was transferable in 40 of 100 strains tested. Despite the lack of TMP resistance in other studies of prophylaxis, the results clearly demonstrate the remarkable capacity for emergence and dissemination of resistance to this agent.