Successful Treatment of Persistent Vancomycin‐Resistant Enterococcus faecium Bacteremia with Linezolid and Gentamicin

Noskin, Gary A.; Siddiqui, Farida; Stosor, Valentina; Kruzynski, Julie; Peterson, Lance R.

doi:10.1086/517221

Cited by 57 publications

(21 citation statements)

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“…As the first US Food and Drug Administration (FDA)-approved oxazolidinone, linezolid has a broad spectrum of activity against Gram-positive bacteria, including meticillin-resistant Staphylococcus aureus (MRSA), penicillin-resistant pneumococci and vancomycin-resistant Enterococcus faecalis and Enterococcus faecium [4][5][6][7]. Recent studies have indicated that linezolid treatment for high-incidence ICU infections, including pneumonia and catheter-related bacteraemia, resulted in favourable clinical and microbiological responses [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Clinical pharmacokinetic/pharmacodynamic profile of linezolid in severely ill Intensive Care Unit patients

Dong¹,

Wang²,

Dong³

et al. 2011

International Journal of Antimicrobial Agents

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Section: Introductionmentioning

confidence: 99%

Clinical pharmacokinetic/pharmacodynamic profile of linezolid in severely ill Intensive Care Unit patients

Dong¹,

Wang²,

Dong³

et al. 2011

International Journal of Antimicrobial Agents

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“…The success of Enterococcus as a nosocomial pathogen relies on the organism's ability to colonize the human gut, shed into the environment, and survive on surfaces such as the hands of health care workers for up to 60 min or on surfaces in the rooms of colonized patients for as long as 4 months (9,10). Transmission from person to person or from surface to person is a serious threat, as infection with VRE has been associated with increased mortality rates (11).…”

mentioning

confidence: 99%

Automatic Digital Analysis of Chromogenic Media for Vancomycin-Resistant-Enterococcus Screens Using Copan WASPLab

et al. 2016

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Vancomycin-resistant enterococci (VRE) are an important cause of health care-acquired infections (HAIs). Studies have shown that active surveillance of high-risk patients for VRE colonization can aid in reducing HAIs; however, these screens generate a significant cost to the laboratory and health care system. Digital imaging capable of differentiating negative and "nonnegative" chromogenic agar can reduce the labor cost of these screens and potentially improve patient care. In this study, we evaluated the performance of the WASPLab Chromogenic Detection Module (CDM) (Copan, Brescia, Italy) software to analyze VRE chromogenic agar and compared the results to technologist plate reading. Specimens collected at 3 laboratories were cultured using the WASPLab CDM and plated to each site's standard-of-care chromogenic media, which included Colorex VRE (BioMed Diagnostics, White City, OR) or Oxoid VRE (Oxoid, Basingstoke, United Kingdom). Digital images were scored using the CDM software after 24 or 40 h of growth, and all manual reading was performed using digital images on a high-definition (HD) monitor. In total, 104,730 specimens were enrolled and automation agreed with manual analysis for 90.1% of all specimens tested, with sensitivity and specificity of 100% and 89.5%, respectively. Automation results were discordant for 10,348 specimens, and all discordant images were reviewed by a laboratory supervisor or director. After a second review, 499 specimens were identified as representing missed positive cultures falsely called negative by the technologist, 1,616 were identified as containing borderline color results (negative result but with no package insert color visible), and 8,234 specimens were identified as containing colorimetric pigmentation due to residual matrix from the specimen or yeast (Candida). Overall, the CDM was accurate at identifying negative VRE plates, which comprised 84% (87,973) of the specimens in this study. Members of the genus Enterococcus are commensal colonizers of the gastrointestinal tract but can cause a variety of serious nosocomial infections, including bacteremia, endocarditis, intraabdominal and pelvic infections, urinary tract infections, and, in rare cases, central nervous system infections (1-4). Treatment can be difficult, as E. faecalis has been observed to be 10 to 100 times more resistant to ␤-lactams than other streptococcal species and E. faecium is 4 to 16 times more resistant than E. faecalis (5). Vancomycin had been used for years to successfully treat enterococcal infections; however, in 1988, the first case of a vancomycinresistant-enterococcus (VRE) infection was reported (6). Resistance is conferred by the van operon, carried in either the chromosome or a plasmid, and is inducible in response to membrane disruption caused by vancomycin (7,8). Currently, resistance is widespread, with prevalence rates ranging from 1.0% to 35.5% of all Enterococcus specimens isolated, depending on the geographical location, and is more commonly found in E. faecium (4).The success of ...

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“…The E. faecium isolate from blood had high-level resistance to vancomycin and ampicillin and was resistant to all antimicrobial agents except chloramphenicol and gentamicin. The MIC for linezolid was 2 mg/L and especially significant was that the bacteremia cleared while the patient remained profoundly neutropenic (B 100/mm 3 ) [29].…”

Section: Clinical and Microbiologic Efficacy And Safety Profile Of LImentioning

confidence: 98%

Clinical and microbiologic efficacy and safety profile of linezolid, a new oxazolidinone antibiotic

Corti

Cinelli

Paradisi

2000

International Journal of Antimicrobial Agents

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Gram-positive cocci are important causes of infection both in the community and in the hospital, with repercussions on mortality and increased economic costs. Treatment of these infections is made difficult by the increasing emergence of multi-resistant organisms, primarily among Gram-positive cocci, such as vancomycin-resistant enterococci, methicillin-resistant Staphylococcus aureus and coagulase-negative staphylococci, and penicillin-resistant pneumococci. Linezolid, a member of the new class of synthetic antimicrobials named oxazolidinones, has several favourable characteristics including high activity against multiresistant Gram-positive cocci. In a number of clinical trials, linezolid showed good clinical and microbiologic efficacy in the therapy of infections caused by these organisms. It can be considered a valid option for treating both community-and hospital-acquired infections due to multiresistant Gram-positive cocci.

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Successful Treatment of Persistent Vancomycin‐Resistant Enterococcus faecium Bacteremia with Linezolid and Gentamicin

Cited by 57 publications

References 0 publications

Clinical pharmacokinetic/pharmacodynamic profile of linezolid in severely ill Intensive Care Unit patients

Clinical pharmacokinetic/pharmacodynamic profile of linezolid in severely ill Intensive Care Unit patients

Automatic Digital Analysis of Chromogenic Media for Vancomycin-Resistant-Enterococcus Screens Using Copan WASPLab

Clinical and microbiologic efficacy and safety profile of linezolid, a new oxazolidinone antibiotic

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