Infections due to vancomycin-resistant Enterococcus faecium resistant to linezolid

Gonzales, Ronald D; Schreckenberger, Paul C.; Graham, Mary Beth; Kelkar, Sujata; DenBesten, Karen; Quinn, John P.

doi:10.1016/s0140-6736(00)04376-2

Cited by 508 publications

(274 citation statements)

References 2 publications

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“…The therapeutic arsenal presently available is quite scarce, with accounts of resistance to recently developed drugs (e.g. linezolide) [29]; there is also concern over the spread of resistance to Staphylococcus aureus through the vanA gene, recently described in the U.S. [30]. Continuous surveillance of this pathogen is thus required in hospital environments, especially in critical units, where high prevalence generally occurs, to avoid its progressive spread in hospitals, mainly those with unreported prior isolation.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and factors associated with rectal vancomycin-resistant enterococci colonization in two intensive care units in São Paulo, Brazil

Furtado¹,

Martins²,

Coutinho³

et al. 2005

Braz J Infect Dis

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Vancomycin-resistant enterococci (VRE) are important pathogens causing nosocomial infections, and there is reason for concern about their resistance and great ability to spread in hospital environments, especially intensive-care units (ICU). To determine the prevalence of rectal colonization by VRE, and the risk factors associated with their presence, rectal surveillance swabs were taken from patients under treatment in two intensive-care units (one medical and another both medical and surgical) at São Paulo Hospital, over a two-year period. Thirty-three percent of the 147 patients evaluated had VRE. The only significant variable in the logistic regression was the length of stay in the ICU.

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Section: Discussionmentioning

confidence: 99%

Prevalence and factors associated with rectal vancomycin-resistant enterococci colonization in two intensive care units in São Paulo, Brazil

Furtado¹,

Martins²,

Coutinho³

et al. 2005

Braz J Infect Dis

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“…As always, no sooner has a 'wonder drug' such as linezolid been approved than the inevitable converse of antibiotic potency, drug resistance, is reported. 13,14 Thus, empiric use of vancomycin should be sharply restricted to those few centers with a large problem with Streptococcus viridans or other agents that may cause rapid death. 1,15 Widespread, empiric use would almost certainly cause more harm than it would ameliorate: one pathogen (S. viridans) would simply be traded for the next (VRE).…”

Section: Vancomycin-resistant Enterococcusmentioning

confidence: 99%

Antibiotic prophylaxis in patients receiving hematopoietic stem cell transplant

Sepkowitz

2002

Bone Marrow Transplant

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Summary:Effective prophylaxis against specific infections has allowed increasingly potent conditioning regimens to be given, thereby prolonging survival in HSCT recipients. The Centers for Disease Control and Prevention, in collaboration with numerous professional societies, has recently published guidelines to codify and advance this approach. Controversy remains in several areas but, curiously, the most intense debate concerns prevention of bacterial infections, the most extensively studied of all of the approaches. Central to this debate are the competing priorities of a potentially ill patient on the one hand vs the long-term consequences of unchecked antibiotic use. The emergence in the 1990s of vancomycin-resistant Enterococcus demonstrated all too vividly how devastating such an end result could be. This article will review the arguments for and against the routine use of antibacterial prophylaxis in HSCT recipients.

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“…Linezolid is currently approved for the treatment of infections caused by methicillin-susceptible and methicillin-resistant Staphylococcus aureus (MSSA and MRSA, respectively) strains and vancomycin-resistant enterococci. Resistance has developed sporadically during therapy in both enterococci (8) and S. aureus (29). The most common mechanism of linezolid resistance involves mutations in the central loop of domain V of the 23S rRNA.…”

mentioning

confidence: 99%

“…The most common mechanism of linezolid resistance involves mutations in the central loop of domain V of the 23S rRNA. The most frequent mutation associated with linezolid resistance in both staphylococci and enterococcal clinical strains is G2576T (Escherichia coli 23S rRNA gene numbering) (8,25,29). Another mutation (T2500A) was characterized in a single patient bloodstream isolate of MRSA (17).…”

mentioning

confidence: 99%

Clinical and Microbiological Aspects of Linezolid Resistance Mediated by the cfr Gene Encoding a 23S rRNA Methyltransferase

et al. 2008

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The cfr (chloramphenicol-florfenicol resistance) gene encodes a 23S rRNA methyltransferase that confers resistance to linezolid. Detection of linezolid resistance was evaluated in the first cfr-carrying human hospital isolate of linezolid and methicillin-resistant Staphylococcus aureus (designated MRSA CM-05) by dilution and diffusion methods (including Etest). The presence of cfr was investigated in isolates of staphylococci colonizing the patient's household contacts and clinical isolates recovered from patients in the same unit where MRSA CM-05 was isolated. Additionally, 68 chloramphenicol-resistant Colombian MRSA isolates recovered from hospitals between 2001 and 2004 were screened for the presence of the cfr gene. In addition to erm(B), the erm(A) gene was also detected in CM-05. The isolate belonged to sequence type 5 and carried staphylococcal chromosomal cassette mec type I. We were unable to detect the cfr gene in any of the human staphylococci screened (either clinical or colonizing isolates). Agar and broth dilution methods detected linezolid resistance in CM-05. However, the Etest and disk diffusion methods failed to detect resistance after 24 h of incubation. Oxazolidinone resistance mediated by the cfr gene is rare, and acquisition by a human isolate appears to be a recent event in Colombia. The detection of cfr-mediated linezolid resistance might be compromised by the use of the disk diffusion or Etest method.

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Infections due to vancomycin-resistant Enterococcus faecium resistant to linezolid

Cited by 508 publications

References 2 publications

Prevalence and factors associated with rectal vancomycin-resistant enterococci colonization in two intensive care units in São Paulo, Brazil

Prevalence and factors associated with rectal vancomycin-resistant enterococci colonization in two intensive care units in São Paulo, Brazil

Antibiotic prophylaxis in patients receiving hematopoietic stem cell transplant

Clinical and Microbiological Aspects of Linezolid Resistance Mediated by the cfr Gene Encoding a 23S rRNA Methyltransferase

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