Factors influencing linezolid-nonsusceptible coagulase-negative staphylococci dissemination among patients in the intensive care unit: a retrospective cohort study

Chemotherapy. 2013;59(6):420-6. doi: 10.1159/000363281. Epub 2014 Jul 18.

Abstract

Background: The aim of the present study was to identify risk factors for linezolid-nonsusceptible coagulase-negative staphylococci (CNS) dissemination in the intensive care unit.

Methods: Among the 246 patients included, 33 revealed a linezolid-nonsusceptible CNS-positive culture specimen, 68 were positive for linezolid-susceptible CNS and 145 served as controls. Isolates were characterized by phenotypic and genotypic methods to species level, susceptibility to antistaphylococcal agents and clones.

Results: Among the 33 linezolid-nonsusceptible CNS patients, 29 revealed Staphylococcus epidermidis and 4 Staphylococcus capitis. All S. epidermidis strains belonged to the ST22 clone (by multilocus sequence typing), 26 carried both C2534T and T2504A and 3 strains were C2543T mutations. S. capitis strains were stratified as a common pulsed-field gel electrophoresis type and carried the G2576T mutation. Risk factors for linezolid-nonsusceptible CNS isolation were linezolid administration and mean number of linezolid-nonsusceptible CNS-positive patients in nearby beds per day.

Conclusions: These results reinforce the aspect of rational antibiotic usage, but also highlight the need for strict infection control measures to prevent the dissemination of linezolid-nonsusceptible CNS.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acetamides / pharmacology*
  • Acetamides / therapeutic use
  • Adult
  • Aged
  • Anti-Bacterial Agents / pharmacology*
  • Anti-Bacterial Agents / therapeutic use
  • Coagulase / genetics
  • Coagulase / metabolism*
  • Cohort Studies
  • Female
  • Humans
  • Intensive Care Units
  • Linezolid
  • Male
  • Microbial Sensitivity Tests
  • Middle Aged
  • Mutation
  • Oxazolidinones / pharmacology*
  • Oxazolidinones / therapeutic use
  • Phenotype
  • RNA, Ribosomal, 23S / genetics
  • Retrospective Studies
  • Risk Factors
  • Staphylococcal Infections / drug therapy
  • Staphylococcus / drug effects*
  • Staphylococcus / enzymology
  • Staphylococcus / isolation & purification

Substances

  • Acetamides
  • Anti-Bacterial Agents
  • Coagulase
  • Oxazolidinones
  • RNA, Ribosomal, 23S
  • Linezolid