Epidemiological profile of linezolid-resistant coagulase-negative staphylococci

Brian A. Potoski, Jennifer Adams, Lloyd Clarke, Kathleen Shutt, Peter K. Linden, Carla Baxter, A. William Pasculle, Blair Capitano, Anton Y. Peleg, Dora Szabo, David L. Paterson

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88 Citations (Scopus)

Abstract

Background. Surveillance studies have shown that <0.1% of coagulase-negative staphylococci are linezolid resistant; however, at our institution, 4% of such organisms were found to be resistant. We investigated the risk factors for and the epidemiological profile of linezolid-resistant coagulase-negative staphylococci. Methods. Susceptibility testing and pulsed-field gel electrophoresis were performed to analyze the genetic relatedness of both linezolid-resistant and linezolid-susceptible isolates. Clinical data were retrieved from medical records, and a case-case-control study was performed to identify unique risk factors for linezolid resistance. Results. Isolates recovered from 25 patients with linezolid-resistant coagulase-negative staphylococci were examined; all but 1 of the isolates were identified as Staphylococcus epidermidis, and all but 1 had a minimum inhibitory concentration of linezolid of >256 μg/mL. Pulsed-field gel electrophoresis showed that 21 (84%) of 25 linezolid-resistant isolates exhibited genetic relatedness, whereas linezolid-susceptible isolates were of diverse clones. Unique, independent predictors of linezolid resistance included receipt of linezolid in the 3 months preceding isolation of the coagulase-negative staphylococci (odds ratio, 20.6; 95% confidence interval, 5.8-73.0). Conclusion. Linezolid-resistant coagulase-negative staphylococci have emerged at our institution and are predominately of a single clone. We believe that the most likely scenario to explain this emergence is that person-to-person spread of linezolid-resistant coagulase-negative staphylococci led to establishment of skin colonization with the strain. Subsequent use of linezolid was followed by selection of the linezolid-resistant strain, which then became the dominant skin flora. The potential for a parallel scenario involving clonal dissemination followed by selection of linezolid-resistant methicillin-resistant Staphylococcus aureus is a real possibility.

Original languageEnglish
Pages (from-to)165-171
Number of pages7
JournalClinical Infectious Diseases
Volume43
Issue number2
DOIs
Publication statusPublished - Jul 15 2006

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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    Potoski, B. A., Adams, J., Clarke, L., Shutt, K., Linden, P. K., Baxter, C., Pasculle, A. W., Capitano, B., Peleg, A. Y., Szabo, D., & Paterson, D. L. (2006). Epidemiological profile of linezolid-resistant coagulase-negative staphylococci. Clinical Infectious Diseases, 43(2), 165-171. https://doi.org/10.1086/505114