Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You or Your Team.

Learn More →

Emergence of linezolid-resistant coagulase-negative Staphylococcus in a cancer centre linked to increased linezolid utilization

Emergence of linezolid-resistant coagulase-negative Staphylococcus in a cancer centre linked to... ObjectivesThe prevalence of linezolid-resistant coagulase-negative Staphylococcus (CoNS) in the MD Anderson Cancer Center rose from 0.6 in 2007 to 5.5 in 2009. The aim of our study was to analyse the relationship between linezolid use and an outbreak of linezolid-resistant CoNS.Patients and methodsWe retrospectively identified 27 infection or colonization events. Eleven isolates were available for supplemental investigation; species identification, clonal relatedness and linezolid resistance mutation analysis. The medical records of the affected patients were reviewed and linezolid utilization data were obtained from the pharmacy.ResultsAvailable isolates were confirmed as clonally related Staphylococcus epidermidis. Partial 23S rRNA gene sequencing found a G2576T mutation in all of the isolates tested. All patients received linezolid within 3 months prior to an event. Patients without a prior hospitalization had a longer time from admission to event; 29 versus 3.5 days (P0.002). The outbreak was preceded by a 51 increase in inpatient linezolid utilization and 64 of affected patients belonged to the leukaemia service, which had a utilization rate 3.1 times that of the other services (95 confidence interval: 2.963.23).ConclusionsIncreased linezolid utilization preceded the appearance of a linezolid-resistant CoNS clone. Patients probably acquired the clonal strain nosocomially, given the longer time from admission to event among patients with no previous admission to the MD Anderson Cancer Center. Linezolid administration then selected this strain, since all patients received linezolid prior to an event. A linezolid utilization rate of 13 defined daily doses/100 patient-days was similar to that reported in two other outbreaks and may be the threshold required to generate an outbreak. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Antimicrobial Chemotherapy Oxford University Press

Emergence of linezolid-resistant coagulase-negative Staphylococcus in a cancer centre linked to increased linezolid utilization

Loading next page...
 
/lp/oxford-university-press/emergence-of-linezolid-resistant-coagulase-negative-staphylococcus-in-eLE90KSIMF

References (11)

Publisher
Oxford University Press
Copyright
The Author 2010. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissionsoxfordjournals.org
Subject
Original research
ISSN
0305-7453
eISSN
1460-2091
DOI
10.1093/jac/dkq238
pmid
20581120
Publisher site
See Article on Publisher Site

Abstract

ObjectivesThe prevalence of linezolid-resistant coagulase-negative Staphylococcus (CoNS) in the MD Anderson Cancer Center rose from 0.6 in 2007 to 5.5 in 2009. The aim of our study was to analyse the relationship between linezolid use and an outbreak of linezolid-resistant CoNS.Patients and methodsWe retrospectively identified 27 infection or colonization events. Eleven isolates were available for supplemental investigation; species identification, clonal relatedness and linezolid resistance mutation analysis. The medical records of the affected patients were reviewed and linezolid utilization data were obtained from the pharmacy.ResultsAvailable isolates were confirmed as clonally related Staphylococcus epidermidis. Partial 23S rRNA gene sequencing found a G2576T mutation in all of the isolates tested. All patients received linezolid within 3 months prior to an event. Patients without a prior hospitalization had a longer time from admission to event; 29 versus 3.5 days (P0.002). The outbreak was preceded by a 51 increase in inpatient linezolid utilization and 64 of affected patients belonged to the leukaemia service, which had a utilization rate 3.1 times that of the other services (95 confidence interval: 2.963.23).ConclusionsIncreased linezolid utilization preceded the appearance of a linezolid-resistant CoNS clone. Patients probably acquired the clonal strain nosocomially, given the longer time from admission to event among patients with no previous admission to the MD Anderson Cancer Center. Linezolid administration then selected this strain, since all patients received linezolid prior to an event. A linezolid utilization rate of 13 defined daily doses/100 patient-days was similar to that reported in two other outbreaks and may be the threshold required to generate an outbreak.

Journal

Journal of Antimicrobial ChemotherapyOxford University Press

Published: Sep 25, 2010

Keywords: coagulase-negative staphylococci linezolid resistance antibiotic usage

There are no references for this article.