Response to Emerging Infection Leading to Outbreak of Linezolid-Resistant Enterococci

Details

• Alternative Title:
  Emerg Infect Dis
• Personal Author:
  Kainer, Marion A. ; Devasia, Rose A. ; Jones, Timothy F. ; Simmons, Bryan P. ; Melton, Kelley ; Chow, Susan ; Broyles, Joyce ; Moore, Kelly L. ; Craig, Allen S. ; Schaffner, William
• Description:
  Linezolid was approved in 2000 for treatment of gram-positive coccal infections. We performed a case-control study during a hospital outbreak of linezolid-resistant enterococci (LRE) infections, comparing cases of LRE infection (cases) with linezolid-sensitive enterococci infections (controls). Nasal and perirectal swab samples were obtained from all patients in a 1-day point-prevalence survey. We examined antimicrobial drug use and calculated the defined daily dose of linezolid per 1,000 patient-days. Fifteen LRE cases were identified (13 Enterococcus faecalis and 2 E. faecium); 7 were vancomycin-resistant. Compared with controls, case-patients had increased in-hospital mortality rates and lengths of stay. Multivariate analysis identified independent predictors of LRE infection: prior cultures positive for methicillin-resistant Staphylococcus aureus (adjusted odds ratio [AOR] 27), hospitalization duration before index culture (AOR 1.1 per day), and duration of preceding linezolid therapy (AOR 1.1 per day). Linezolid exposure and patient-to-patient transmission appear to be responsible for LRE infections, an important emeraina hospital problem.
• Subjects:
  Acetamides Anti-Infective Agents Antimicrobial Agents Bacterial Case-Control Studies Colony Count, Microbial Communicable Diseases, Emerging Cross Infection Disease Outbreaks Disease Transmission Drug Resistance Drug Resistance, Bacterial Drug Utilization Review Enterococcus Enterococcus Faecalis Enterococcus Faecium Gram-Positive Bacterial Infections Horizontal Hospital Mortality Humans Length Of Stay Methicillin Resistance Microbial Sensitivity Tests Multivariate Analysis Oxazolidinones Research Staphylococcus Aureus Vancomycin Resistance

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• Source:
  Emerg Infect Dis. 13(7):1024-1030.
• Document Type:
  Journal Article
• Volume:
  13
• Issue:
  7
• Collection(s):
  Emerging Infectious Diseases
• Main Document Checksum:
  urn:sha256:0600246025c05ec09f3dcba1ab6ad4147c419162f6834c3f403721be3806e81b
• Download URL:
  https://stacks.cdc.gov/view/cdc/16669/cdc_16669_DS1.pdf
• File Type:
  [PDF - 227.89 KB ]