Version 3: Emerging challenge of Linezolid and Vancomycin resistant Enterococci faecium:First case report from Northern Pakistan

Enterococcus faecium are among the most versatile pathogens found to infect hospitalized patients. Resistance against anti-enterococcal antibiotics is gaining access day to day and among them linezolid resistant vancomycin resistant Enterococcus faecium are a nightmare for the clinicians especially in a resource limited country.

A 72 year old patient presented with collection of pus and necrosis around the head of pancreases. These pockets of pus resulted as acute postsurgical complication along with surgical site infection. Pus was processed according to clinical guidelines Enterococcus faecium was identified and confirmed by VITEK. Isolate was resistant to vancomycin and linezolid. Tigecyclin was the only option for this patient due to unavailability of quinupristin/dalfopristin as a treatment option. A regular follow up was done and patient was discharged after recovery. LRVRE is the result of non-implementation of antimicrobial stewardship and it can be followed with further resistance in Enterococcus which can be havoc. Clinicians infection control team and microbiologist should work together to overcome antimicrobial resistance crises.