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Epidemiological and Genomic Insights into Linezolid-Non-Susceptible Enterococci in Pediatric Patients

Chao Fang1, Zheng Zhou1, Xiucai Zhang1

  • 1Department of Clinical Laboratory, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children and Adolescents' Health and Diseases, No. 3333 Binsheng road, Hangzhou, Zhejiang Province, China.

Current Microbiology
|February 5, 2026
PubMed

Insights

Linezolid-non-susceptible enterococci (LNSE) are a growing threat in pediatric healthcare. This study reveals key genetic traits of LNSE in children, providing crucial data for infection control strategies.

Area of Science:

  • Microbiology
  • Genomics
  • Infectious Diseases

Background:

  • Enterococci are significant causes of healthcare-associated infections in children.
  • Linezolid-non-susceptible enterococci (LNSE) pose a growing challenge to treating multidrug-resistant Gram-positive infections.
  • Limited epidemiological and genomic data exist for pediatric LNSE.

Purpose of the Study:

  • To investigate the epidemiology and genomics of linezolid-non-susceptible enterococci (LNSE) in a pediatric population.
  • To identify resistance mechanisms and virulence factors in pediatric LNSE strains.
  • To inform targeted prevention and control strategies for LNSE in children.

Main Methods:

  • Analysis of 26 LNSE strains isolated from pediatric patients.
  • Identification and characterization using MALDI-TOF MS, Vitek2 Compact, and micro-broth dilution.
  • Molecular techniques including MLST, resistance/virulence gene detection, and pan-genome analysis.

Main Results:

  • Enterococcus faecalis (88.5%) was the dominant species, with ST16 being the most prevalent sequence type.
  • All analyzed strains carried the optrA and fexA genes, conferring resistance to linezolid.
  • Pan-genome analysis of E. faecalis indicated an open genome with evidence of horizontal gene transfer.

Conclusions:

  • This study provides essential epidemiological and genomic insights into pediatric LNSE.
  • The findings highlight the genetic basis of linezolid resistance in pediatric enterococci.
  • Data generated will aid in developing effective strategies to combat LNSE infections in children.

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