1887

Abstract

Both methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-sensitive S. aureus (MSSA) are rapidly overcoming the current array of drugs. One hundred and fifty isolates from a hospital were studied for resistance towards linezolid and vancomycin. Fifty-four (36.0 %) isolates were MRSA. Both MRSA and MSSA showed high resistance towards linezolid when using the disc diffusion method, with the figures being 48.1 and 29.2 %, respectively. The figures for the E-test were 46.3 and 27.0 %, respectively. The vancomycin resistance was remarkable in MRSA (14.8 %), but relatively low in MSSA (3.1 %). The E-test results were 13.0 and 4.16 %, respectively. The cfr gene was detected in 78 % of linezolid-resistant isolates and the vanA operon was detected in 74 % of vancomycin-resistant isolates. This level of resistance against linezolid and vancomycin is unprecedented. These results are alarming and highlight the threat of non-treatable S. aureus strains.

Keyword(s): linezolid , S. aureus and vancomycin
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2017-08-31
2019-10-15
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References

  1. Vogelaers D. MRSA: total war or tolerance?. Nephrol Dial Transplant 2006;21:837–838 [CrossRef][PubMed]
    [Google Scholar]
  2. Gu B, Kelesidis T, Tsiodras S, Hindler J, Humphries RM. The emerging problem of linezolid-resistant Staphylococcus. J Antimicrob Chemother 2013;68:4–11 [CrossRef][PubMed]
    [Google Scholar]
  3. Eliopoulos GM, Meka VG, Gold HS. Antimicrobial resistance to linezolid. Clin Infect Dis 2004;39:1010–1015 [CrossRef][PubMed]
    [Google Scholar]
  4. Tenover FC, Williams PP, Stocker S, Thompson A, Clark LA et al. Accuracy of six antimicrobial susceptibility methods for testing linezolid against staphylococci and enterococci. J Clin Microbiol 2007;45:2917–2922 [CrossRef][PubMed]
    [Google Scholar]
  5. Long KS, Vester B. Resistance to linezolid caused by modifications at its binding site on the ribosome. Antimicrob Agents Chemother 2012;56:603–612 [CrossRef][PubMed]
    [Google Scholar]
  6. Quiles-Melero I, Gómez-Gil R, Romero-Gómez MP, Sánchez-Díaz AM, de Pablos M et al. Mechanisms of linezolid resistance among staphylococci in a tertiary hospital. J Clin Microbiol 2013;51:998–1001 [CrossRef][PubMed]
    [Google Scholar]
  7. Périchon B, Courvalin P. VanA-type vancomycin-resistant Staphylococcus aureus. Antimicrob Agents Chemother 2009;53:4580–4587 [CrossRef][PubMed]
    [Google Scholar]
  8. Skinner S, Murray M, Walus T, Karlowsky JA. Failure of cloxacillin in treatment of a patient with borderline oxacillin-resistant Staphylococcus aureus endocarditis. J Clin Microbiol 2009;47:859–861 [CrossRef][PubMed]
    [Google Scholar]
  9. Cockerill FR. Performance Standards for Antimicrobial Susceptibility Testing: Twenty-First Informationbal Supplement Wayne, PA: Clinical and Laboratory Standards Institute (CLSI); 2011
    [Google Scholar]
  10. CLSI Performance Standards for Antimicrobial Susceptibility Testing17 Wayne, PA: Clinical and Laboratory Standards Institute; 2007
    [Google Scholar]
  11. Al-Talib H, Yean CY, Al-Khateeb A, Ravichandran M. Comparative evaluation of three different methods of genomic DNA extraction for Staphylococcus aureus. World Applied Sci J 2013;21:424–427
    [Google Scholar]
  12. Mehrotra M, Wang G, Johnson WM. Multiplex PCR for detection of genes for Staphylococcus aureus enterotoxins, exfoliative toxins, toxic shock syndrome toxin 1, and methicillin resistance. J Clin Microbiol 2000;38:1032–1035[PubMed]
    [Google Scholar]
  13. Petinaki E, Arvaniti A, Dimitracopoulos G, Spiliopoulou I. Detection of mecA, mecR1 and mecI genes among clinical isolates of methicillin-resistant staphylococci by combined polymerase chain reactions. J Antimicrob Chemother 2001;47:297–304 [CrossRef][PubMed]
    [Google Scholar]
  14. Gade ND, Qazi MS. Fluoroquinolone therapy in Staphylococcus aureus infections: where do we stand?. J Lab Physicians 2013;5:109–112 [CrossRef][PubMed]
    [Google Scholar]
  15. Tiwari HK, Sapkota D, Sen MR. High prevalence of multidrug-resistant MRSA in a tertiary care hospital of northern India. Infect Drug Resist 2008;1:57–61 [CrossRef][PubMed]
    [Google Scholar]
  16. Butt T, Ahmad RN, Usman M, Mahmood A. Methicillin-resistant Staphylococcus aureus, Pakistan, 1996–2003. Emerg Infect Dis 2004;10:1691–1692 [CrossRef][PubMed]
    [Google Scholar]
  17. Gandham P. Linezolid resistant Staphylococcus aureus. Int J Res Med Sci 2014;2:1253–1256 [CrossRef]
    [Google Scholar]
  18. Morales G, Picazo JJ, Baos E, Candel FJ, Arribi A et al. Resistance to linezolid is mediated by the cfr gene in the first report of an outbreak of linezolid-resistant Staphylococcus aureus. Clin Infect Dis 2010;50:821–825 [CrossRef][PubMed]
    [Google Scholar]
  19. Srinivasan A, Dick JD, Perl TM. Vancomycin resistance in staphylococci. Clin Microbiol Rev 2002;15:430–438 [CrossRef][PubMed]
    [Google Scholar]
  20. Limbago BM, Kallen AJ, Zhu W, Eggers P, Mcdougal LK et al. Report of the 13th vancomycin-resistant Staphylococcus aureus isolate from the United States. J Clin Microbiol 2014;52:998–1002 [CrossRef][PubMed]
    [Google Scholar]
  21. Okolie CE, Cockayne A, Wooldridge K, James R. Development and validation of a new diagnostic PCR assay for vanA gene encoding vancomycin resistance in Staphylococcus aureus. IJAMBR 2014;2:1–10
    [Google Scholar]
  22. Levinson W. Review of Medical Microbiology and Immunology New York, NY: McGraw-Hill Education; 2014
    [Google Scholar]
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