Abstract

When trimethoprim-sulfamethoxazole was given to US travelers in Mexico to prevent diarrheal illness, high-level resistance to the drug emerged [2], although in previous studies such resistance had not been observed among enteric flora following administration of trimethoprim-sulfamethoxazole as prophylaxis against urinary tract infection [3]. Since food has been shown to be an important vehicle of transmission of travelers' diarrhea, food samples were examined for the presence of drug-resistant bacteria to explain the acquisition of high-level resistance among enteric flora of individuals taking antibiotics as prophylaxis against traveler's diarrhea. Of 34 strains of ETEC isolated from US students in Guadalajara, Mexico, who had acute gastroenteritis, one was resistant to trimethoprim and one was resistant to trimethoprim-sulfamethoxazole. Eight of the ETEC strains tested demonstrated multiple drug resistance. Twenty-two of 149 isolates from food produced enterotoxin. Only one isolate, which was nontoxigenic, was resistant to trimethoprim, and no coliforms were resistant to trimethoprim-sulfamethoxazole; however, 16 isolates demonstrated multiple drug resistance. Of 235 gram-negative organisms recovered from frozen food samples grown on antibiotic-containing media and tested for enterotoxin production, no isolates were enterotoxigenic. Thirty-four isolates were resistant to trimethoprim, 15 were resistant to trimethoprim-sulfamethoxazole, and 33 demonstrated multiple resistance. Multiple drug resistance was demonstrated among gram-negative organisms isolated from patients' stools and foods in Mexico.(ABSTRACT TRUNCATED AT 250 WORDS)

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