Turner et al 2024; Rifaximin prophylaxis causes resistance to the last-resort antibiotic daptomycin - Supplementary Table 9

This study found that daptomycin resistance is linked with the presence of specific <i>rpoB</i> mutations in vancomycin resistant <i>Enterococcus faecium</i> (VREfm), with resistance emerging <i>de novo</i> in <i>E. faecium</i><i> </i>following exposure to rifaximin (RIFAX), a commonly prescribed antibiotic used prophylactically to prevent hepatic encephalopathy in liver disease patients. This work has uncovered a major mechanism of daptomycin resistance in VREfm and identified rifaximin, an antibiotic considered to be low-risk for the emergence of bacterial AMR, as an important driver of last-resort antibiotic resistance.