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Resistance mechanisms and clinical characteristics of linezolid-resistant Enterococcus faecium isolates: A single-centre study in South Korea.

Abstract：

OBJECTIVES:This study aimed to determine the prevalence of linezolid-resistant (LR) vancomycin-resistant enterococci and to investigate the mechanisms of linezolid resistance with clinical and microbiological characterisation. METHODS:All vancomycin-resistant Enterococcus faecium (VREF) isolated from blood and rectal swab cultures during 2012-2015 were tested for linezolid resistance. LR-VREF isolates were tested for antimicrobial susceptibility, glycopeptide resistance genes and virulence genes. Multilocus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE) were performed. Isolates were tested for known mechanisms of linezolid resistance. RESULTS:Among 389 VREF isolates, 7 (1.8%) were found to be resistant to linezolid. All LR-VREF isolates carried the vanA gene. Five isolates had both hyl and esp genes. The isolates were susceptible to tigecycline, daptomycin and quinupristin/dalfopristin, except for one isolate with daptomycin resistance. Two LR-VREF isolates recovered from patients with previous linezolid exposure contained the G2576T mutation in 23S rRNA and exhibited high-level resistance to linezolid (MIC>64mg/L). The other five isolates recovered from linezolid-naïve patients revealed no known linezolid resistance mechanism and exhibited low-level resistance to linezolid (MICs=8-16mg/L). Plasmid-mediated genes encoding cfr or optrA were not detected. LR-VREF isolates were represented by six different sequence types, belonging to hospital lineages, and were assigned to seven PFGE types. CONCLUSIONS:The prevalence of LR-VREF in this centre was low. Both linezolid exposure and horizontal transmission appear to be responsible for acquisition of LR-VREF in hospitalised patients. Prudent use of linezolid and improved infection control strategies are needed to limit the spread of LR-VREF.

journal_name

J Glob Antimicrob Resist

journal_title

Journal of global antimicrobial resistance

authors

Cho SY,Kim HM,Chung DR,Kim SH,Huh HJ,Kang CI,Peck KR,Lee NY,Song JH

doi

10.1016/j.jgar.2017.09.009

subject

Has Abstract

pub_date

2018-03-01 00:00:00

pages

44-47

eissn

2213-7165

issn

2213-7173

pii

S2213-7165(17)30175-3

journal_volume

12

pub_type

杂志文章

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