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Emerging linezolid-resistant Enterococcus faecalis and Enterococcus faecium isolated from two Austrian patients in

A P Johnson1, L Tysall, M V Stockdale

  • 1Antibiotic Resistance Monitoring and Reference Laboratory, Central Public Health Laboratory, Colindale, London NW9 5HT, UK. ajohnson@phls.org.uk

European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology
|November 5, 2002
PubMed
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This summary is machine-generated.

Emerging linezolid resistance in enterococci, including vancomycin-susceptible strains, was observed in ICU patients. A specific ribosomal RNA mutation (G2576U) was linked to this resistance, potentially affecting the entire oxazolidinone class.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Clinical Medicine

Background:

  • Linezolid is a crucial antibiotic for treating infections caused by Gram-positive bacteria, including resistant strains.
  • Enterococcus species, particularly Enterococcus faecalis and Enterococcus faecium, are common causes of hospital-acquired infections.
  • Emergence of antibiotic resistance is a significant threat to public health, necessitating continuous monitoring.

Observation:

  • Two intensive care unit patients developed linezolid-resistant Enterococcus infections.
  • One patient had linezolid-resistant Enterococcus faecalis, while the other had linezolid-resistant Enterococcus faecium.
  • Molecular analysis revealed a G2576U mutation in ribosomal RNA in resistant isolates, linked to susceptible strains from the same patient.

Findings:

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  • This study reports the first clinical cases of emerging linezolid resistance in Enterococcus faecalis.
  • It also describes linezolid resistance in vancomycin-susceptible enterococci, distinct from previously reported vancomycin-resistant cases.
  • Resistant isolates exhibited cross-resistance to AZD2563, an experimental oxazolidinone, suggesting a potential class-wide resistance mechanism.

Implications:

  • The findings highlight the emergence of linezolid resistance in clinically relevant enterococcal species.
  • The G2576U mutation appears to be a key mechanism for developing linezolid resistance.
  • Cross-resistance suggests that the development of resistance to linezolid may confer resistance to other oxazolidinones, impacting future treatment options.