Linezolid Resistance in Tanta University Hospitals: a Cross-sectional Study

Abdelkhalek, Mariam

doi:10.21608/ejmm.2021.197466

Cited by 2 publications

(3 citation statements)

References 18 publications

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“…Our analyses proved the existence of cfr gene in all linezolid-resistant isolates, congruent with a previous study from France 39 . Also, these findings support results from previous studies conducted in Egypt 34, 40 .…”

Section: Discussionsupporting

confidence: 92%

Tedizolid versus linezolid activity against Staphylococcus aureus clinical isolates

Elnagar

Mahmoud

El-Kady

2022

Egyptian Journal of Medical Microbiology

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Background:In recent years, emergence of linezolid-resistant strains has gained a considerable clinical concern. Tedizolid, a relatively new antibiotic, showed strong effectiveness against S. aureus; however, few data are available from Egypt in this regard. Objectives: This study aimed to assess the in vitro susceptibility of S. aureus clinical isolates from Mansoura University Hospitals (MUHs), Egypt to linezolid and tedizolid, and to unveil the underlying molecular mechanisms for resistance. Methodology: In vitro susceptibility of 113 S. aureus isolates from various clinical samples was determined by disc diffusion method. The broth microdilution method was used to determine the MICs of linezolid and tedizolid. Detection of mecA and cfr genes among MRSA and linezolid-resistant isolates, respectively was performed using polymerase chain reaction (PCR). Results: In this study, 16.8% of S. aureus isolates were methicillin-resistant. On the other hand, resistance to vancomycin and linezolid was identified in 15%, and 9.7 % of the isolates, respectively. All the isolates were susceptible to tedizolid. In comparison between methicillin-sensitive S. aureus (MSSA) and MRSA as regards tedizolid and linezolid susceptibility, tedizolid retained low MIC 50 , and MIC 90 (0.25, and 0.5 µg/L) for all S. aureus isolates. On the other hand, the MICs of linezolid were 0.5-2 µg/L for MSSA, and 0.5->4 µg/L for MRSA isolates. All MRSA isolates (n= 19) were found to harbor the mecA gene. The cfr gene was identified in 57.9% of linezolid-resistant MRSA isolates. Conclusion: Tedizolid is highly effective against S. aureus clinical isolates, including linezolid-resistant strains.

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Section: Discussionsupporting

confidence: 92%

Tedizolid versus linezolid activity against Staphylococcus aureus clinical isolates

Elnagar

Mahmoud

El-Kady

2022

Egyptian Journal of Medical Microbiology

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“…Also, prevalence of linezolid resistance was 2.74% among Gram-positive isolates in Tanta University Hospital, as reported by Abdelkhalek et al . 2021 [ 57 ]. In the same context, linezolid resistance of Staphylococci isolates obtained from 15 different countries were 0.1% and 0.3% among MRSA and CoNS isolates, respectively [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

“…To the best of our knowledge, this is the first report on the detection of cfr(B) gene in clinically isolated MRSA in Egypt. The only amplified linezolid resistance gene in Egyptian hospitals was cfr gene [ 46 , 57 ].…”

Section: Discussionmentioning

confidence: 99%

Phenotypic and genotypic characterization of linezolid resistance and the effect of antibiotic combinations on methicillin-resistant Staphylococcus aureus clinical isolates

AbdAlhafiz

Elleboudy

Aboshanab

et al. 2023

Ann Clin Microbiol Antimicrob

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Background Methicillin-Resistant Staphylococcus aureus (MRSA) causes life-threatening infections, with narrow therapeutic options including: vancomycin and linezolid. Accordingly, this study aimed to characterize phenotypically and genotypically, the most relevant means of linezolid resistance among some MRSA clinical isolates. Methods A total of 159 methicillin-resistant clinical isolates were collected, of which 146 were indentified microscopically and biochemically as MRSA. Both biofilm formation and efflux pump activity were assessed for linezolid-resistant MRSA (LR-MRSA) using the microtiter plate and carbonyl cyanide 3-chlorophenylhydrazone (CCCP) methods, respectively. Linezolid resistance was further characterized by polymerase chain reaction (PCR) amplification and sequencing of domain V of 23 S rRNA; rplC; rplD;and rplV genes. Meanwhile, some resistance genes were investigated: cfr; cfr(B); optrA; msrA;mecA; and vanA genes. To combat LR-MRSA, the effect of combining linezolid with each of 6 different antimicrobials was investigated using the checkerboard assay. Results Out of the collected MRSA isolates (n = 146), 5.48% (n = 8) were LR-MRSA and 18.49% (n = 27) were vancomycin-resistant (VRSA). It is worth noting that all LR-MRSA isolates were also vancomycin-resistant. All LR-MRSA isolates were biofilm producers (r = 0.915, p = 0.001), while efflux pumps upregulation showed no significant contribution to development of resistance (t = 1.374, p = 0.212). Both mecA and vanA genes were detected in 92.45% (n = 147) and 6.92% (n = 11) of methicillin-resistant isolates, respectively. In LR-MRSA isolates, some 23 S rRNA domain V mutations were observed: A2338T and C2610G (in 5 isolates); T2504C and G2528C (in 2 isolates); and G2576T (in 1 isolate). Amino acids substitutions were detected: in L3 protein (rplC gene) of (3 isolates) and in L4 protein (rplD gene) of (4 isolates). In addition, cfr(B) gene was detected (in 3 isolates). In 5 isolates, synergism was recorded when linezolid was combined with chloramphenicol, erythromycin, or ciprofloxacin. Reversal of linezolid resistance was observed in some LR-MRSA isolates when linezolid was combined with gentamicin or vancomycin. Conclusions LR-MRSA biofilm producers’ phenotypes evolved in the clinical settings in Egypt. Various antibiotic combinations with linezolid were evaluated in vitro and showed synergistic effects.

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Linezolid Resistance in Tanta University Hospitals: a Cross-sectional Study

Cited by 2 publications

References 18 publications

Tedizolid versus linezolid activity against Staphylococcus aureus clinical isolates

Tedizolid versus linezolid activity against Staphylococcus aureus clinical isolates

Phenotypic and genotypic characterization of linezolid resistance and the effect of antibiotic combinations on methicillin-resistant Staphylococcus aureus clinical isolates

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