Detection of high levels of resistance to linezolid and vancomycin in Staphylococcus aureus

Azhar, Aysha; Rasool, Samreen; Haque, Asma; Shan, Sidra; Saeed, Muhammad; Ehsan, Beenish; Haque, Abdul

doi:10.1099/jmm.0.000566

Cited by 40 publications

(34 citation statements)

References 17 publications

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“…Also, the European mean proportion of linezolid resistance among MRSA blood isolates included in this study was found to be very 1ow [0.29% (95% CI 0.21-0.40%)], attesting to the overall susceptibility of MRSA isolates to linezolid in Europe. This is also similar to local studies in Germany and Spain (Sierra et al, 2013;Yayan et al, 2015), Russia (Gostev et al, 2015), China (Huang et al, 2019), and Latin America (Vega and Dowzicky, 2017), but remarkably lower compared to results from Pakistan (48.1%) (Azhar et al, 2017) and India (2.8-7.0%) (Kaur and Chate, 2015;Kumar, 2016). In comparison to other multi-country surveillance studies, such as ZAAPS and SENTRY, linezolid activity against VREF and MRSA remains similarly very high (>98%) in Europe (Mendes et al, 2016;Deshpande et al, 2018).…”

Section: Discussionsupporting

confidence: 90%

Low Proportion of Linezolid and Daptomycin Resistance Among Bloodborne Vancomycin-Resistant Enterococcus faecium and Methicillin-Resistant Staphylococcus aureus Infections in Europe

et al. 2021

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Vancomycin-resistant Enterococcus faecium (VREF) and methicillin-resistant Staphylococcus aureus (MRSA) are associated with significant health burden. We investigated linezolid and daptomycin resistance among VREF and MRSA in the EU/EEA between 2014 and 2018. Descriptive statistics and multivariable logistic regression were used to analyze 6,949 VREF and 35,131 MRSA blood isolates from patients with bloodstream infection. The population-weighted mean proportion of linezolid resistance in VREF and MRSA between 2014 and 2018 was 1.6% (95% CI 1.33–2.03%) and 0.28% (95% CI 0.32–0.38%), respectively. Daptomycin resistance in MRSA isolates was similarly low [1.1% (95% CI 0.75–1.6%)]. On the European level, there was no temporal change of daptomycin and linezolid resistance in MRSA and VREF. Multivariable regression analyses showed that there was a higher likelihood of linezolid and daptomycin resistance in MRSA (aOR: 2.74, p < 0.001; aOR: 2.25, p < 0.001) and linezolid in VREF (aOR: 1.99, p < 0.001) compared to their sensitive isolates. The low proportion of linezolid and daptomycin resistance in VREF and MRSA suggests that these last-resort antibiotics remain effective and will continue to play an important role in the clinical management of these infections in Europe. However, regional and national efforts to contain antimicrobial resistance should continue to monitor the trend through strengthened surveillance that includes genomic surveillance for early warning and action.

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Section: Discussionsupporting

confidence: 90%

Low Proportion of Linezolid and Daptomycin Resistance Among Bloodborne Vancomycin-Resistant Enterococcus faecium and Methicillin-Resistant Staphylococcus aureus Infections in Europe

et al. 2021

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“…15,25 In the current study, resistance to linezolid was reported as 37% in S. aureus isolates while in CoNS it was 90%. Previous study conducted in Pakistan reported cfr gene in 78% of linezolid resistant S. aureus isolates 24 which is higher than our results, although we observed high resistance of linezolid in CoNS. The increase in rate of resistance against linezolid is very alarming, particularly among CoNS which are developing resistance to other antibiotics as well.…”

Section: Discussioncontrasting

confidence: 97%

“…One study from Pakistan recorded high levels of vancomycin resistance in MRSA as 13% using E-test method. 24 Reason for increase in rate of resistance to vancomycin could be inadequate use of vancomycin and transfer of vancomycin resistance genes (vanA-C) from other vancomycin resistant organisms such as Enterococcus. Particularly our clinicians should be concerned about these reports on vancomycin resistance so that they can prescribe vancomycin accordingly to avoid therapeutic failure.…”

Section: Discussionmentioning

confidence: 99%

Assessment of inducible clindamycin resistance and Hyper Variable Region (HVR) of mecA gene in clinical staphylococci

et al. 2019

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Objective: To study the prevalence of inducible clindamycin along with vancomycin and methicillin resistance and assessment of hyper variable region (HVR) of mecA gene among different clinical isolates of Staphylococcus spp. Methods: A total of 176 clinical isolates of Staphylococci were collected from Pakistan Institute of Medical Sciences (PIMS), Islamabad during 2014-2015. The sample sources were pus, blood, urine, sputum, tracheal secretions and tissue fluids. Bacterial identification was done by colony morphology and biochemical tests. Kirby-Bauer disc-diffusion method was carried out to assess the susceptibility against different antibiotics. Minimal inhibitory concentrations (MICs) were done for vancomycin resistance. Double Disk Diffusion test (D-test) was used to detect the clindamycin inducible resistance. PCR was performed to detect erm(C), mecA and HVR genes. Results: Clindamycin inducible resistance among Staphylococcal isolates was found to be 7%, whereas in S. aureus it was 4%, and in coagulase negative Staphylococci (CoNS) it was 11%. The highest resistance was observed against fosfomycin, fusidic acid and cefoxitin. Vancomycin resistance was observed in 23 isolates (13%) of Staphylococci. erm(C), mecA and HVR genes were found in 18%, 50% and 42% respectively. Conclusions: D-test must be performed routinely to avoid clindamycin failure. A high level of resistance against vancomycin in Staphylococcal isolates is a concern for public health. doi: https://doi.org/10.12669/pjms.36.2.665 How to cite this:Khan AA, Farooq J, Abid M, Zahra R. Assessment of inducible clindamycin resistance and Hyper Variable Region (HVR) of mecA gene in clinical staphylococci. Pak J Med Sci. 2020;36(2):---------. doi: https://doi.org/10.12669/pjms.36.2.665 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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“…Our data also indicated that linezolid or tedizolid might not be the first-line choices of the antibiotics suitable for the antimicrobial treatment of E. faecalis infections in this hospital settings. Therefore, the resistance mechanism and risk factors of linezolid-resistant/intermediate E. faecalis infections deserve our attention and need to be further studied.Several previous reports have indicated the clonality characteristics of linezolid resistance in Staphylococci and E. faecalis(21,22). ST16 is the predominant STs of linezolidresistant/intermediate E. faecalis clinical isolates in this study.…”

supporting

confidence: 66%

Linezolid Resistance in Enterococcus faecalis Associated With Urinary Tract Infections of Patients in a Tertiary Hospitals in China: Resistance Mechanisms, Virulence, and Risk Factors

Zhang

Bai

et al. 2021

Front. Public Health

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Background:Enterococcus faecalis has been commonly considered as one of the major pathogens of the urinary tract infection (UTI) in human host worldwide, whereas the molecular characteristics of E. faecalis clinical isolates from the patients with UTI in China remains seldomly reported. This study aimed to investigate the resistance mechanism, molecular characteristics and risk factors of E. faecalis clinical isolates from patients with UTI in China.Methods: A total of 115 non-duplicated E. faecalis clinical isolates from patients with UTI were retrospectively collected in a tertiary hospital in China and their clinical data was further analyzed. The linezolid and tedizolid susceptibility were determined by agar dilution. The resistance genes, including erm(A), erm(B), erm(C), tet(M), optrA, cfr, cfr(B), poxtA, and MLST-based housekeeping genes were investigated by PCR.Results: In 115 non-duplicated E. faecalis clinical isolates from the patients with UTI in this hospital setting, the frequency of linezolid or tedizolid-resistant/intermediate isolates were 22.61 and 13.04%, respectively, and the frequency of linezolid-resistant/intermediate E. faecalis clinical isolates carrying with erm(A) were 86%. Among the five linezolid-resistant E. faecalis strains found in this study, three optrA-positive isolates and the other two linezolid-resistant strains were G2576U genetic mutations in the V domain of the 23S rRNA genes. The ST clonality analysis indicated that 31.42% (11/35) of ST16 E. faecalis UTI isolates were not susceptible to linezolid. Moreover, the univariable analysis indicated that the high risk factors of linezolid-resistant/intermediate E. faecalis infections involved the indwelling catheter, trachea cannula catheter and the carriage of erm(A) or optrA. Furthermore, the indwelling catheter and trachea cannula catheter were demonstrated as the independent predictors of linezolid-resistant/intermediate E. faecalis strains in patients with UTI by multivariable analysis.Conclusion: Linezolid-resistant/intermediate E. faecalis associated with urinary tract infections of patients in this hospital setting from China might be explained by the high carriage frequency of optrA genes and moreover, indwelling catheter and trachea cannula should be considered as the independent predictors of linezolid-resistant/intermediate E. faecalis infections. The transmission mechanism of linezolid-resistant/intermediate E. faecalis in this hospital setting should be further studied.

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Detection of high levels of resistance to linezolid and vancomycin in Staphylococcus aureus

Cited by 40 publications

References 17 publications

Low Proportion of Linezolid and Daptomycin Resistance Among Bloodborne Vancomycin-Resistant Enterococcus faecium and Methicillin-Resistant Staphylococcus aureus Infections in Europe

Low Proportion of Linezolid and Daptomycin Resistance Among Bloodborne Vancomycin-Resistant Enterococcus faecium and Methicillin-Resistant Staphylococcus aureus Infections in Europe

Assessment of inducible clindamycin resistance and Hyper Variable Region (HVR) of mecA gene in clinical staphylococci

Linezolid Resistance in Enterococcus faecalis Associated With Urinary Tract Infections of Patients in a Tertiary Hospitals in China: Resistance Mechanisms, Virulence, and Risk Factors

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