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La excreción de ciprofloxacina en el sudor y el Staphylococcus epidermidis multirresistente
1Department of Clinical Microbiology, Rigshospitalet, University of Copenhagen, Denmark.
Lancet (London, England)
|January 18, 1997
Resumen
La excreción de ciprofloxacina en el sudor impulsa rápidamente la resistencia al Staphylococcus epidermidis, incluso en individuos sanos. Esta resistencia a los antibióticos se desarrolló rápidamente en las bacterias de la piel, persistiendo mucho después de que finalizara el tratamiento.
Área de la Ciencia:
- Microbiología Microbiología.
- Farmacología Farmacología.
- Dermatología Dermatología dermatología.
Sus antecedentes:
- El Staphylococcus epidermidis exhibe un rápido desarrollo de resistencia a la ciprofloxacina.
- La ciprofloxacina se excreta en el sudor humano, contribuyendo potencialmente a la resistencia.
- Este estudio investigó el desarrollo de resistencia de S. epidermidis en la axila y la flora nasal después del tratamiento con ciprofloxacina.
Objetivo del estudio:
- Evaluar el desarrollo de la resistencia a la ciprofloxacina en S. epidermidis de la flora axilar y nasal de individuos sanos.
- Para correlacionar la concentración de ciprofloxacina en el sudor con el desarrollo de resistencia.
- Para determinar la persistencia de cepas resistentes después del tratamiento.
Principales métodos:
- Siete voluntarios recibieron ciprofloxacina oral (750 mg dos veces al día durante 7 días).
- Se midió la concentración de ciprofloxacina en el sudor.
- La resistencia de S. epidermidis en la axila y las fosas nasales fue monitoreada durante y después del tratamiento.
- La genotipización de S. epidermidis se realizó utilizando el polimorfismo de longitud de fragmento de restricción.
Principales resultados:
- La concentración de ciprofloxacina en el sudor aumentó durante el tratamiento, alcanzando los 5.5 microgramos/ml.
- Se detectaron cepas de S. epidermidis resistentes a la ciprofloxacina (intermedio y alto nivel) en todos los participantes.
- La resistencia se desarrolló rápidamente en S. epidermidis axilar (media de 2,7 días) y S. epidermidis nasal (media de 11 días).
- Las cepas resistentes persistieron durante aproximadamente 37-39 días después del tratamiento.
Conclusiones:
- El rápido desarrollo de la resistencia a la ciprofloxacina en S. epidermidis está relacionado con la excreción del fármaco en el sudor.
- Este fenómeno puede contribuir a la aparición de bacterias multirresistentes en entornos clínicos y comunitarios.
- El alto uso de ciprofloxacina puede exacerbar el problema de la resistencia a los antibióticos en la flora de la piel.
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