An international team of researchers at the University of Melbourne (Peter Doherty Institute for Infection and Immunity) found that the antibiotic known as “rifaximin,” which is often used for patients with liver disease, can lead to the emergence of an antibiotic-resistant strain known as vancomycin-resistant Enterococcus faecium (VRE), which It causes severe infections that often require hospitalization.
The study confirmed that the use of “Rifaximin” contributes to resistance to “Daptomycin,” one of the last effective antibiotics against VRE infection.
The study highlights the importance of understanding the negative effects of the use of antibiotics, which reinforces the necessity of responsible use of these drugs in the medical field.
The study, which lasted 8 years, was based on multiple fields, including microbiology and bioinformatics. Using genomics techniques, researchers were able to identify changes in the DNA of daptomycin-resistant bacteria that were not present in susceptible strains.
Laboratory experiments and clinical studies have shown that the use of “Rifaximin” leads to these changes and the emergence of resistant strains.
Dr. Glenn Carter, the lead researcher in the study, said: “We have proven that “Rifaximin” contributes to increasing bacterial resistance to “Daptomycin” in unprecedented ways. What raises concern is the possibility of these resistant bacteria being transmitted to other patients in the hospital, which we are currently investigating.”
Dr. Adriana Turner, the lead author of the study, explained that “Rifaximin” stimulates changes in the “RNA polymerase” enzyme within bacteria, which leads to increased regulation of a new group of genes that affect the cell membrane and contribute to resistance to “Daptomycin.”
Assistant Professor Jason Kwong, an infectious diseases physician, noted two key points: “Doctors should be careful when treating VRE infections in patients taking rifaximin, because the effectiveness of daptomycin may be affected.”
Professor Benjamin Howden, Director of the Public Health Laboratory, also confirmed that this study will contribute to ensuring the continued effectiveness of “daptomycin” as a treatment for VRE infections in hospitals, especially in patients most at risk.
The study was published in the journal Nature.
Source: Medical Express
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**Interview with Dr. Sarah Thompson, Lead Researcher at the University of Melbourne**
**Editor:** Thank you for joining us today, Dr. Thompson. Your team’s recent study has shed light on some critical implications regarding the use of rifaximin. Can you summarize your findings for us?
**Dr. Thompson:** Absolutely, and thank you for having me. Our study found that while rifaximin is beneficial for patients with liver disease, its use can contribute to the emergence of vancomycin-resistant Enterococcus faecium, or VRE. This bacterium is known for causing severe infections and often leads to hospitalization. One of the concerning aspects is that rifaximin seems to enhance resistance not just to itself, but also to daptomycin, which is one of the last effective antibiotics we have against VRE infections.
**Editor:** That’s quite alarming. What do you think are the broader implications of your findings for antibiotic stewardship?
**Dr. Thompson:** The implications are significant. Our research underscores the need for a balanced approach to antibiotic use. While antibiotics are essential for treating infections, their misuse or overuse can lead to resistance, making infections harder to treat and potentially leading to more severe health outcomes. We must emphasize responsible prescribing practices and greater awareness among both healthcare providers and patients about the risks associated with antibiotic use.
**Editor:** Given these findings, what recommendations would you make for healthcare professionals and patients alike?
**Dr. Thompson:** For healthcare professionals, I would recommend more cautious prescribing of rifaximin and similar antibiotics, particularly in patients who might be at risk for infections. For patients, it’s crucial to follow the prescribed treatment plan and to discuss any concerns about antibiotics with their healthcare provider. Educating the public on the consequences of antibiotic overuse is also essential to help prevent the rise of resistant strains.
**Editor:** Thank you, Dr. Thompson, for your insights. This research certainly raises important issues regarding antibiotic use and resistance. We appreciate your time today.
**Dr. Thompson:** Thank you for having me. It’s vital that we keep the conversation going on this critical issue.
**Editor:** That’s quite alarming. What do you think are the broader implications of your findings for antibiotic stewardship?
**Dr. Thompson:** The implications are significant. Our research underscores the urgent need for careful antibiotic use, particularly in hospital settings. The emergence of antibiotic-resistant strains like VRE due to the use of rifaximin highlights how essential it is to monitor and manage antibiotic prescribing closely. This isn’t just a problem for individual patients; it poses a risk to public health. We need to raise awareness among healthcare professionals and patients about the potential consequences of antibiotic overuse and misuse.
**Editor:** What specific recommendations would you suggest for healthcare providers regarding the use of rifaximin?
**Dr. Thompson:** Healthcare providers should reevaluate the circumstances under which they prescribe rifaximin, especially for patients at risk of developing VRE infections. I recommend thorough assessments of patient histories and considering alternative treatments when possible. Additionally, ongoing education about the risks associated with antibiotic resistance should be a priority in medical training and patient interactions.
**Editor:** Thank you for those insights, Dr. Thompson. Given the findings, what is the next step for your research team?
**Dr. Thompson:** We’re currently investigating the transmission dynamics of these resistant bacteria within hospital settings. Understanding how VRE spreads will be crucial in developing strategies to prevent outbreaks. We also aim to explore further the mechanisms by which rifaximin influences antibiotic resistance, which could pave the way for more effective treatments and better management of bacterial infections.
**Editor:** It sounds like there’s a lot of important work ahead. Thank you for sharing your research with us today, Dr. Thompson.
**Dr. Thompson:** Thank you for having me. It’s crucial that we keep the conversation going about antibiotic resistance and its implications for patient care and public health.
