[Development of Escherichia coli strands resistant to quinolones in stools of patients with liver cirrhosis submitted to selective bowel decontamination].

Background: Selective intestinal decontamination (SID) with norfloxacin in patients with cirrhosis may promote the development of quinolone-resistant (QR) gram-negative bacteria in stools. It is not known wether this fact may become a predisposing factor for the development of infections due to these bacteria.

Material And Methods: We designed a prospective study to evaluate the incidence of Escherichia coli in stools at admission in patients with cirrhosis that had previously received norfloxacin as primary or secondary prophylaxis of spontaneous bacterial peritonitis (SBP) (group I, n = 28) vs those who did not (group II, n = 55).

Results: QR strains of E. coli were observed in 37.5 and in 1.47% of patients from groups I and II, respectively (p < 0.001). During admission, 36 patients underwent norfloxacin prophylaxis (group III), and 40 did not (group IV). Eleven patients from group III and one patient from group IV showed QR E. coli in stools. We observed 5 bacterial infections in group III and 14 in group IV (p = 0.0039). No patient with QR E. coli in stools developed infections due to this bacteria.

Conclusion: The incidence of QR E. coli in stools of patients with cirrhosis is significantly increased in patients previously treated with prophylactic norfloxacin. However, this fact seems not to be associated with an increment in the prevalence of QR E. coli infections.