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Irish Journal of Medical Science (1971 -)

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Open Access 10-09-2021 | Care | Original Article

Prevalence of linezolid-resistant organisms among patients admitted to a tertiary hospital for critical care or dialysis

Authors: Kornelia Maria Dembicka, James Powell, Nuala H. O’Connell, Noreen Hennessy, Grainne Brennan, Colum P. Dunne

Published in: Irish Journal of Medical Science (1971 -) | Issue 4/2022

Abstract

Background

Linezolid is an oxazolidinone antimicrobial regarded as a “last resort” antimicrobial, used typically for treatment of Gram-positive bacterial infections. It is acknowledged that prevalence of resistance to linezolid is increasing in Europe. In Ireland, a number of outbreaks of linezolid-resistant isolates have been reported, including an outbreak at the location for this study, the Intensive Care Unit (ICU) of University Hospital Limerick (UHL).

Methods

The Chromagar™ Lin-R selective medium was validated using a panel of linezolid-sensitive and linezolid-resistant strains. Subsequently, the prevalence exercise focused on a convenience sample of patients (n = 159) in critical care wards, ICU (n = 23) and High-Dependency Unit (HDU, n = 51), in addition to patients undergoing dialysis therapy (n = 77). Eight additional patients had specimens collected when attending more than one location. Growth on Chromagar™ Lin-R agar was followed by drug sensitivity testing by disc diffusion and minimum inhibitory concentration (MIC) testing.

Results

A validation exercise was performed on 23 isolates: seven target and sixteen non-target organisms. Isolates performed as intended (100% sensitivity, 100% specificity). For the prevalence study, of 398 tests, 40 resulted in growth of non-target organisms (specificity approx. 90%). A sole patient (1/159) was identified as colonized by a linezolid-resistant Staphylococcus epidermidis, a prevalence of 0.63%. Molecular investigation confirmed presence of the G2576T mutation in the 23S rRNA.

Conclusion

While this point prevalence study identified extremely low carriage of linezolid-resistant bacteria, it remains prudent to maintain vigilance as reports of outbreaks associated with linezolid-resistant S. epidermidis (LRSE) in European critical care units are increasing.

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Title: Prevalence of linezolid-resistant organisms among patients admitted to a tertiary hospital for critical care or dialysis
Authors: Kornelia Maria Dembicka
James Powell
Nuala H. O’Connell
Noreen Hennessy
Grainne Brennan
Colum P. Dunne
Publication date: 10-09-2021
Publisher: Springer International Publishing
Keywords: Care
Linezolid
Published in: Irish Journal of Medical Science (1971 -) / Issue 4/2022
Print ISSN: 0021-1265
Electronic ISSN: 1863-4362
DOI: https://doi.org/10.1007/s11845-021-02773-2

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Abstract

Background

Methods

Results

Conclusion

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