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

Gajanand Mittal1, Vasundhra Bhandari2, Rajni Gaind3

  • 1Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, 110029, India.

BMC Infectious Diseases
|August 16, 2019
PubMed
Abstract

Insights

Linezolid-resistant Coagulase-negative Staphylococci (CoNS) infections are emerging due to novel mutations and horizontal gene transfer. Hospital surveillance is crucial to understand transmission pathways of these resistant bacteria.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Antimicrobial Resistance

Background:

  • Coagulase-negative Staphylococci (CoNS) are significant causes of bloodstream infections (BSI).
  • Linezolid (LZD) is a critical treatment for resistant staphylococcal infections.
  • Understanding Linezolid resistance (LR) in CoNS is vital for infection control.

Purpose of the Study:

  • To characterize Linezolid-resistant CoNS (LRCoNS) from bloodstream infections.
  • To investigate the genetic mechanisms and transmission of Linezolid resistance in CoNS.
  • To identify novel mutations associated with Linezolid resistance.

Main Methods:

  • Bacterial identification using MALDI-TOF and 16S rRNA sequencing.
  • Antimicrobial susceptibility testing and Minimum Inhibitory Concentration (MIC) determination for Linezolid and vancomycin.
  • Molecular analysis including PCR for the cfr gene and sequencing of the 23S rRNA gene for mutations.

Main Results:

  • Linezolid resistance (MIC 8-32 μg/ml) was found in three CoNS species.
  • The cfr gene was detected in all isolates; novel mutations (G2614T, C2384T) were identified in the 23S rRNA gene of 12/15 isolates.
  • Nosocomial acquisition and horizontal spread of resistant isolates and the cfr gene were identified as probable transmission mechanisms, even without prior Linezolid use.

Conclusions:

  • Novel mutations in the 23S rRNA gene are associated with Linezolid resistance in CoNS.
  • Hospital surveillance and understanding transmission pathways are essential for managing LRCoNS.
  • The study provides insights into the emergence and spread of Linezolid-resistant CoNS.
Keywords:
CoNSIndiaLinezolid resistanceNovel mutationS. arlettaecfr

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