title: Emergence of trimethoprim-resistant Escherichia coli in healthy persons in the absence of prophylactic or therapeutic antibiotics during travel to Guadalajara, Mexico.
abstract: Thirty-nine healthy US students without diarrheal disease and who had not received prophylactic or therapeutic antibiotics were monitored for emergence of trimethoprim-resistant gram-negative fecal flora for a 3-week period after arrival in Guadalajara, Mexico. During this time period, most students showed no change in total fecal gram-negative bacteria (p > 0.05) but showed an increasing level of trimethoprim (TMP) resistance (p < 0.01) among fecal coliforms. Escherichia coli was the TMP-resistant organism isolated in 18 of 39 (46%) healthy students. These 18 TMP-resistant E. coli were also resistant to ampicillin (44%), azithromycin (11%), chloramphenicol (39%), ciprofloxacin (11%), doxycycline (89%), erythromycin (100%), furazolidone (72%), levofloxacin (17%), trimethoprim-sulfamethoxazole (89%) and trovafloxacin (17%). In the absence of prophylactic and therapeutic antibiotics, increased acquisition of TMP-resistant gram-negative fecal flora in this developing country is probably due to poor sanitary conditions and the recurrent and heavy exposure to antimicrobial-resistant indigenous flora as a result of contaminated food and drink.
authors.affiliation: Department of Internal Medicine, University of Texas at Southwestern Medical School, Dallas 75390-9030, USA. dhuang82@hotmail.com
authors.forename: D B
authors.initials: DB
authors.lastname: Huang
authors.forename: Z D
authors.initials: ZD
authors.lastname: Jiang
authors.forename: C D
authors.initials: CD
authors.lastname: Ericsson
authors.forename: J
authors.initials: J
authors.lastname: Adachi
authors.forename: H L
authors.initials: HL
authors.lastname: Dupont
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis; D004352:Drug Resistance, Microbial; D004926:Escherichia coli / Q000187:drug effects* / Q000302:isolation & purification; D005243:Feces / Q000382:microbiology*; D005260:Female; D006801:Humans; D008297:Male; D008800:Mexico; D014195:Travel; D014296:Trimethoprim Resistance
chemical_list: D000900:Anti-Bacterial Agents