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

Ma, Xiaoyu; Zhang, Fan; Bai, Bing; Wang, Qisheng; Xu, Guangjian; Chen, Zhong; Sun, Xinghuai; Zheng, Jinxin; Deng, Qi; Yu, Zhijian

doi:10.3389/fpubh.2021.570650

Cited by 21 publications

(27 citation statements)

References 29 publications

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“…However, the study was conducted in a single center and needs further verification. Enterococcal clinical isolates of E. faecalis from China showed ~6-13 % of the studied isolates to be TDZ non-susceptible (MIC ≥0.5 mg/L) [125]. The non-susceptible isolates displayed an abundant plasmid-mediated ABC transporter optrA [50,121].…”

Section: Resistance To Tdz and Pk/pd Targets/ Magnitudes For Resistan...mentioning

confidence: 97%

Pharmacokinetics and Pharmacodynamics of Tedizolid

2022

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Tedizolid is an oxazolidinone antibiotic with high potency against Gram-positive bacteria and currently prescribed in bacterial skin and skin-structure infections. The aim of the review was to summarize and critically review the key pharmacokinetic and pharmacodynamic aspects of tedizolid. Tedizolid displays linear pharmacokinetics with good tissue penetration. In in vitro susceptibility studies, tedizolid exhibits activity against the majority of Gram-positive bacteria (minimal inhibitory concentration [MIC] of ≤ 0.5 mg/L), is four-fold more potent than linezolid, and has the potential to treat pathogens being less susceptible to linezolid. Area under the unbound concentration-time curve (fAUC) related to MIC (fAUC/MIC) was best correlated with efficacy. In neutropenic mice, fAUC/MIC of ~ 50 and ~ 20 induced bacteriostasis in thigh and pulmonary infection models, respectively, at 24 h. The presence of granulocytes augmented its antibacterial effect. Hence, tedizolid is currently not recommended for immunocompromised patients. Clinical investigations with daily doses of 200 mg for 6 days showed non-inferiority to twice-daily dosing of linezolid 600 mg for 10 days in patients with acute bacterial skin and skin-structure infections. In addition to its use in skin and skin-structure infections, the high pulmonary penetration makes it an attractive option for respiratory infections including Mycobacterium tuberculosis. Resistance against tedizolid is rare yet effective antimicrobial surveillance and defining pharmacokinetic/pharmacodynamic targets for resistance suppression are needed to guide dosing strategies to suppress resistance development.

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Section: Resistance To Tdz and Pk/pd Targets/ Magnitudes For Resistan...mentioning

confidence: 97%

Pharmacokinetics and Pharmacodynamics of Tedizolid

2022

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“…Since, enterococci with vancomycin resistance (VRE) have been described as a primary source of nosocomial outbreaks 11 . Linezolid (LZD), the first synthetic antimicrobial agent of oxazolidinone class, prevents the early ribosome assembly and protein synthesis of several gram-positive bacterial species, directing the 50S ribosome subunits and affecting its binding with formyl methionyl-tRNA is considered good substitute for those infections control 12 , however, enterococci resistant to linezolid have been developed and mediated by several resistance genes, including ermA, ermB, ermC, tetM, , cfr, cfrB, poxtA, as well as optrA 3, 13, 14 .…”

Section: Introductionmentioning

confidence: 99%

Linezolid Susceptibility and Virulence Factors in Vancomycin Resistant Enterococcus faecalis and Enterococcus faecium among Hospitalized Burn Patients

Elaskary

Zaher

2022

Egyptian Journal of Medical Microbiology

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Background: Enterococci are the 3rd cause of HAIs. E. faecalis and E. faecium are the commonest enterococcal species, showed resistance to vancomycin due to resistance genes (vanA, vanB and vanC). Linezolid is considered a good substitute. The virulence factors like asa1, gelE, cylA, esp, and hyl may interfere with antibiotic susceptibility. Objectives: Determine linezolid resistance in VR E. faecalis and E. faecium in relation to virulence factors. Methodology: Enterococcus spp. identified by colony morphology, Gram stain, biochemical reactions and by the VITEK 2 system. Antibiotic susceptibility was done through VITEK 2 system, AST-GP72 card. Vancomycin and linezolid MIC were done according to CLSI. Multiplex PCR for ddl E. faecalis , ddl E. faecium . vanA and vanB detection. Other for asa1, gelE, cylA, esp, and hyl virulence genes determination then conventional PCR for cfr and optrA genes were done. Results: A total of 65 enterococci CIs. (45 E. faecalis & 20 E. faecium) were isolated from different samples. E. faecalis and E. faecium were resistant to vancomycin by 11,1% and 35% and to linezolid by 4.4% and 10% respectively. The vanA, vanB, cfr and optrA genes were present in 100% of VR E. faecalis like E. faecium except that, the cfr was not detected. The gelE was frequently detected in E. faecalis followed by asa1, esp, hyl and finally cylA. And for E. faecium, the most frequent one was asa1followed by gelE. esp, and finally cylA and hyl. Conclusions: LZD resistant enterococci were increasingly detected, with no significant relation between linezolid resistance and vancomycin resistance. And with different impact of virulence genes.

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“…Enterococci are symbiotic bacteria of the gastrointestinal tract of humans and animals [ 1 ]. However, enterococci infection can cause urinary tract and soft tissue infections, and in severe cases, it causes life-threatening infections such as septicemia and meningitis [ 2 ]. Enterococci of animal origin have the potential risk of transferring their antimicrobial resistance genes to human enterococci or disseminating to humans through the food chain [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Prevalence and Characteristics of Phenicol-Oxazolidinone Resistance Genes in Enterococcus Faecalis and Enterococcus Faecium Isolated from Food-Producing Animals and Meat in Korea

Kim

Shin

Kwak

et al. 2021

IJMS

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The use of phenicol antibiotics in animals has increased. In recent years, it has been reported that the transferable gene mediates phenicol-oxazolidinone resistance. This study analyzed the prevalence and characteristics of phenicol-oxazolidinone resistance genes in Enterococcus faecalis and Enterococcus faecium isolated from food-producing animals and meat in Korea in 2018. Furthermore, for the first time, we reported the genome sequence of E. faecalis strain, which possesses the phenicol-oxazolidinone resistance gene on both the chromosome and plasmid. Among the 327 isolates, optrA, poxtA, and fexA genes were found in 15 (4.6%), 8 (2.5%), and 17 isolates (5.2%), respectively. Twenty E. faecalis strains carrying resistance genes belonged to eight sequence types (STs), and transferability was found in 17 isolates. The genome sequences revealed that resistant genes were present in the chromosome or plasmid, or both. In strains EFS17 and EFS108, optrA was located downstream of the ermA and ant(9)-1 genes. The strains EFS36 and EFS108 harboring poxtA-encoding plasmid cocarried fexA and cfr(D). These islands also contained IS1216E or the transposon Tn554, enabling the horizontal transfer of the phenicol-oxazolidinone resistance with other antimicrobial-resistant genes. Our results suggest that it is necessary to promote the prudent use of antibiotics through continuous monitoring and reevaluation.

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

Cited by 21 publications

References 29 publications

Pharmacokinetics and Pharmacodynamics of Tedizolid

Pharmacokinetics and Pharmacodynamics of Tedizolid

Linezolid Susceptibility and Virulence Factors in Vancomycin Resistant Enterococcus faecalis and Enterococcus faecium among Hospitalized Burn Patients

Prevalence and Characteristics of Phenicol-Oxazolidinone Resistance Genes in Enterococcus Faecalis and Enterococcus Faecium Isolated from Food-Producing Animals and Meat in Korea

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