However, the number of aminoglycosides, rifamycin and phenolic resistance genes increased, whereas tetracycline, fosfomycin and cephamycin decreased (P<0.05). No new antimicrobial resistance genes was emergenced. Metabolic pathways such as aromatic amino acids, tryptophan synthesis, urea cycle, and LPS synthesis reduced. The dynamic observations showed the gut microbiota diversity, composition and the number of resistance genes, plasmids, insertion sequences did not change significantly during the period(P>0.05). Rifaximin improved hyperammonemia and cognitive function in the 21 patients who completed rifaximin treatment. Thirty cirrhotic patients who were in remission from recurrent HE was enrolled to receive rifaximin (400mg TID for 12 weeks). Fecal sampling was conducted 1 day before the first rifaximin administration and at Weeks 1, 2, 4, 6, 8, 10, 12 of the study. This prospective study assessed the impact of 12 weeks rifaximin administration on the gut microbiota and resistome in cirrhotic patients. However, whether long-term prophylactic use induces antibacterial resistance and its mechanism for treating HE remains unclear. Rifaximin, an intestinal non-absorbable antibacterial agent, is effective in the treatment of HE. The gut microbiota has an important role in the pathogenesis of hepatic encephalopathy(HE). 3Department of Infectious Disease, ShuLan (Hangzhou) Hospital Affiliated to Zhejiang Shuren University Shulan International Medical College, Hangzhou, China.2Department of Respiratory and Critical Care Medicine, First Hospital of Shanxi Medical University, Taiyuan, China.1State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.Xiao Yu 1,2†, Ye Jin 1†, Wangxiao Zhou 1, Tingting Xiao 1, Zhongwen Wu 1, Junwei Su 1, Hainv Gao 3, Ping Shen 1, Beiwen Zheng 1, Qixia Luo 1, Lanjuan Li 1 and Yonghong Xiao 1*
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