Linezolid-resistant Staphylococcus spp. at a tertiary care hospital of Andhra Pradesh

Kalawat, Usha; Sharma, K. K.; Reddy, Shilpa P.

doi:10.4103/0255-0857.83923

Cited by 11 publications

(11 citation statements)

References 5 publications

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“…[27] Linezolid, a novel synthetic antibiotic, is considered one of the few effective ways to treat severe methicillin-resistant infections in critically ill patients. Recently, linezolid resistance is reported in our country which may be a consequence of prolonged and injudicious use of this drug[2728] and is an imperative threat to lose an effective and safe drug for treating MRS. HLAR in Enterococcus spp. was also alarming (60%) in our study.…”

Section: Discussionmentioning

confidence: 99%

Bacteriological and resistance profile in isolates from diabetic patients

et al. 2012

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Background:Diabetes mellitus has become a global epidemic illness and poses a threat for development of resistant bacterial infections.Aim:This study was aimed to know the bacteriological and resistance profile of isolates obtained from diabetic patients.Materials and Methods:The bacterial isolates obtained from various samples of diabetic patients admitted in medicine department in 6-month period were identified and tested for antibiotic susceptibility. The extended spectrum beta-lactamases (ESβL), AmpC, and metallo-beta-lactamases (MβL) enzymes were detected in gram-negative bacilli. Methicillin, macrolide-lincosamide-streptogramin (MLS), and linezolid resistance in Staphylococcus spp. were detected. High-level aminoglycoside resistance (HLAR) in Enterococcus spp. was also tested.Results:In all, 38 of 125 diabetic patients (30.4%) had bacterial infection, 18 patients had wound infections, 18 had urinary tract infections (UTIs), and 2 had respiratory tract infections. Escherichia coli among gram-negative bacteria and Staphylococcus aureus among gram-positive bacteria were the predominant pathogens. 32.5% gram-negative bacilli were AmpC producers, 37.5% were MβL producers, and 40% were ESβL producers. Methicillin and MLS resistance was found in 50% and 33.3% isolates of Staphylococcus spp., respectively. HLAR resistance was alarming in Enterococcus spp. Polymyxin among gram-negative bacteria and vancomycin for gram-positive bacteria were the last resort with highest susceptibility rates to treat infections among diabetic patients.Conclusion:Resistant bacterial infections in diabetic patients are common. The presence of various resistance mechanisms in isolates of our study shows that therapeutic failure can occur if empirical prescription is unsubstantiated.

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Section: Discussionmentioning

confidence: 99%

Bacteriological and resistance profile in isolates from diabetic patients

et al. 2012

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“…Linezolid (LZD) is a synthetic drug of oxazolidinone class of antibiotics, which is approved for treatment of severe bacterial infections in adults caused by drug-resistant gram-positive bacteria, such as multidrug-resistant S. aureus, coagulase negative staphylococci, penicillin-resistant Streptococcus pneumoniae and vancomycin-resistant Enterococci (VRE) [5–7]. When introduced, it was claimed that LZD has no cross-tolerance against other antibiotics and resistance developed rarely, due to its unique mechanism of action [8, 9] However, a year after the introduction, the first LZD resistant clinical strain appeared in 2001 [5]. Despite a decade of its clinical use, resistance to LZD has remained stable and extremely low with only sporadic cases being reported mostly from the USA and Europe [10].…”

Section: Introductionmentioning

confidence: 99%

Linezolid resistant coagulase negative staphylococci (LRCoNS) with novel mutations causing blood stream infections (BSI) in India

et al. 2019

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Background Coagulase-negative Staphylococci (CoNS) have emerged as a major causative agent of blood-stream infections (BSI). Linezolid (LZD) is currently used for treating glycopeptide and methicillin-resistant staphylococci. It is important to understand the resistance mechanism and probable transmission of LZD resistant (LR) CoNS within the hospital. Methods Clinically significant LRCoNS from patients with BSI were characterized using MALDI-TOF and 16S rRNA gene sequence analysis. Antimicrobial susceptibility and MIC of vancomycin and LZD were determined. LZD resistance mechanisms using PCR for the cfr gene and mutation in the V domain of the 23S rRNA gene were studied. Results The MIC of LZD ranged from 8 to 32 μg/ml. LR was observed in three different CoNS species from diverse locations within the hospital. The cfr gene was identified in all the isolates. Sequence analysis of V domain region of 23S rRNA gene confirmed mutation in single copy among 12/15 isolates with novel mutations: G2614 T and C2384T. All infections were nosocomially acquired and LZD resistance was emerging in the absence of prior LZD use. Horizontal spread of resistant isolates and cfr gen e among diverse species were the probable mechanisms of transmission. Conclusion The study highlights the novel mutations associated with LRCoNS and the importance of surveillance & transmission pathway within the hospital. It also systematically discusses the published information on LRCoNS.

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“…In the Indian scenario, case reports of linezolid-resistant Staphylococcus has been reported from Andhra Pradesh[8] and Kashmir. [9] The first case report of linezolid resistance in E. faecium was reported from India in 2014 by Kumar et al .…”

Section: Discussionmentioning

confidence: 99%