Emergence of linezolid-resistant Enterococcus faecium in a tertiary hospital in Copenhagen
Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
Dokumenter
- Fulltext
Forlagets udgivne version, 1,08 MB, PDF-dokument
Linezolid is used as first-line treatment of infections caused by vancomycin-resistant Enterococcus faecium. However, resistance to linezolid is increasingly detected. The aim of the present study was to elucidate the causes and mechanisms for the increase in linezolid-resistant E. faecium at Copenhagen University Hospital – Rigshospitalet. We therefore combined patient information on linezolid treatment with whole-genome sequencing data for vancomycin- or linezolid-resistant E. faecium isolates that had been systematically collected since 2014 (n=458). Whole-genome sequencing was performed for multilocus sequence typing (MLST), identification of linezolid resistance-conferring genes/mutations and determination of phylogenetically closely related strains. The collection of E. faecium isolates belonged to prevalent vancomycin-resistant MLST types. Among these, we identified clusters of closely related linezolid-resistant strains compatible with nosocomial transmission. We also identified linezolid-resistant enterococcus isolates not genetically closely related to other isolates compatible with de novo generation of linezolid resistance. Patients with the latter isolates were significantly more frequently exposed to linezolid treatment than patients with related linezolid-resistant enterococcus isolates. We also identified six patients who initially carried a vancomycin-resistant, linezolid-sensitive enterococcus, but from whom vancomycin-resistant, linezolid-resistant enterococci (LVRE) closely related to their initial isolate were recovered after linezolid treatment. Our data illustrate that linezolid resistance may develop in the individual patient subsequent to linezolid exposure and can be transmitted between patients in a hospital setting.
Originalsprog | Engelsk |
---|---|
Artikelnummer | 001055 |
Tidsskrift | Microbial genomics |
Vol/bind | 9 |
Udgave nummer | 7 |
Antal sider | 9 |
ISSN | 2057-5858 |
DOI | |
Status | Udgivet - 2023 |
Bibliografisk note
Funding Information:
The study was supported by a grant from the Novo-Nordisk Foundation (reference number (NNF16OC0023482) Role of funders: all authors are employed by public hospitals in the Capital Region, Denmark, which are public institutions. The foundations had no role in the design and conduct of the study or in the analyses and interpretation of the data or the writing, review and approval of the manuscript.
Publisher Copyright:
© 2023, Microbiology Society. All rights reserved.
ID: 366386956