C Rodríguez-Lucas1, M R Rodicio2, J Càmara3, M Á Domínguez4, M Alaguero5, J Fernández6. 1. Unidad de Microbiología, Hospital El Bierzo, Ponferrada, Spain; Departamento de Biología Funcional, Área de Microbiología, Universidad de Oviedo, Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain. 2. Departamento de Biología Funcional, Área de Microbiología, Universidad de Oviedo, Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain. 3. Servicio de Microbiología, Hospital Universitari de Bellvitge-Universitat de Barcelona-IDIBELL, Barcelona, Spain; CIBER de Enfermedades Respiratorias, Spain. 4. Servicio de Microbiología, Hospital Universitari de Bellvitge-Universitat de Barcelona-IDIBELL, Barcelona, Spain; Spanish Network for Research in Infectious Diseases, Instituto de Salud Carlos III, Madrid, Spain. 5. Servicio de Farmacia Hospitalaria, Hospital Universitario Central de Asturias, Oviedo, Spain. 6. Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain; Servicio de Microbiología, Hospital Universitario Central de Asturias, Oviedo, Spain. Electronic address: javifdom@gmail.com.
Abstract
BACKGROUND: Linezolid (LZD)-resistant Staphylococcus epidermidis (LRSE) are increasing, and are mainly associated with outbreaks in hospital wards with high LZD consumption. AIM: To investigate the frequency of LRSE in a tertiary hospital in the context of LZD use. METHODS: The frequency of LRSE and the data on LZD usage [expressed as defined daily dose (DDD) per 100 patient-days], from 2011 to 2017, were analysed retrospectively. Selected LRSE were typed by pulsed-field gel electrophoresis (PFGE) and screened for transferable LZD resistance genes. Representative isolates were typed by multi-locus sequence typing, and ribosomal mechanisms of LZD resistance were investigated. FINDINGS: In total, 435 LRSE were detected, with frequencies ranging from 13.56% to 32.93% in the intensive care unit (ICU) where LZD consumption was high (6.34-8.10 DDDs), and from 2.48 to 6.80% in the remaining wards where LZD use was considerably lower (0.63-2.49 DDDs). The first 44 LRSE isolates recovered (June 2013-June 2014) were closely related according to PFGE patterns, and all except one were resistant to meticillin due to mecA production. Selected isolates belonged to ST2, carried SCCmec III, and had the G2576T mutation in the V domain of each of the six copies of the 23S rRNA gene. Five of the 44 isolates (11.36%) were positive for the cfr gene. CONCLUSION: An ST2 LZD- and meticillin-resistant clone was found in the ICU and also in wards with low consumption of LZD. This highlights the need to implement and maintain infection control measures as well as antimicrobial stewardship programmes in all hospital units in order to preserve the efficacy of LZD.
BACKGROUND:Linezolid (LZD)-resistant Staphylococcus epidermidis (LRSE) are increasing, and are mainly associated with outbreaks in hospital wards with high LZD consumption. AIM: To investigate the frequency of LRSE in a tertiary hospital in the context of LZD use. METHODS: The frequency of LRSE and the data on LZD usage [expressed as defined daily dose (DDD) per 100 patient-days], from 2011 to 2017, were analysed retrospectively. Selected LRSE were typed by pulsed-field gel electrophoresis (PFGE) and screened for transferable LZD resistance genes. Representative isolates were typed by multi-locus sequence typing, and ribosomal mechanisms of LZD resistance were investigated. FINDINGS: In total, 435 LRSE were detected, with frequencies ranging from 13.56% to 32.93% in the intensive care unit (ICU) where LZD consumption was high (6.34-8.10 DDDs), and from 2.48 to 6.80% in the remaining wards where LZD use was considerably lower (0.63-2.49 DDDs). The first 44 LRSE isolates recovered (June 2013-June 2014) were closely related according to PFGE patterns, and all except one were resistant to meticillin due to mecA production. Selected isolates belonged to ST2, carried SCCmec III, and had the G2576T mutation in the V domain of each of the six copies of the 23S rRNA gene. Five of the 44 isolates (11.36%) were positive for the cfr gene. CONCLUSION: An ST2 LZD- and meticillin-resistant clone was found in the ICU and also in wards with low consumption of LZD. This highlights the need to implement and maintain infection control measures as well as antimicrobial stewardship programmes in all hospital units in order to preserve the efficacy of LZD.
Authors: Cihan Papan; Matthias Schröder; Mathias Hoffmann; Heike Knoll; Katharina Last; Frederic Albrecht; Jürgen Geisel; Tobias Fink; Barbara C Gärtner; Alexander Mellmann; Thomas Volk; Fabian K Berger; Sören L Becker Journal: Antimicrob Resist Infect Control Date: 2021-06-30 Impact factor: 4.887
Authors: Stefan Schwarz; Wanjiang Zhang; Xiang-Dang Du; Henrike Krüger; Andrea T Feßler; Shizhen Ma; Yao Zhu; Congming Wu; Jianzhong Shen; Yang Wang Journal: Clin Microbiol Rev Date: 2021-06-02 Impact factor: 50.129