Portal de investigación
Linezolid- and Vancomycin-resistant Enterococcus faecium in Solid Organ Transplant Recipients: Infection Control and Antimicrobial Stewardship Using Whole Genome Sequencing
Fecha de publicación:
Autores organización
Autores
- Abbo, L
- Shukla, BS
- Giles, A
- Aragon, L
- Jimenez, A
- Camargo, JF
- Simkins, J
- Sposato, K
- Tran, TT
- Diaz, L
- Rios, R
- Cardozo, J
- Ruiz, M
- Rosello, G
- Cardona, AP
- Martinez, O
- Guerra, G
- Beduschi, T
- Vianna, R
- Arias, CA
Grupos de investigación
Resumen
Background. Vancomycin-resistant enterococci are an important cause of healthcare-associated infections and are inherently resistant to many commonly used antibiotics. Linezolid is the only drug currently approved by the US Food and Drug Administration to treat vancomycin-resistant enterococci; however, resistance to this antibiotic appears to be increasing. Although outbreaks of linezolid-and vancomycin-resistant Enterococcus faecium (LR-VRE) in solid organ transplant recipients remain uncommon, they represent a major challenge for infection control and hospital epidemiology. Methods. We describe a cluster of 4 LR-VRE infections among a group of liver and multivisceral transplant recipients in a single intensive care unit. Failure of treatment with linezolid in 2 cases led to a review of standard clinical laboratory methods for susceptibility determination. Testing by alternative methods including whole genome sequencing (WGS) and a comprehensive outbreak investigation including sampling of staff members and surfaces was performed. Results. Review of laboratory testing methods revealed a limitation in the VITEK 2 system with regard to reporting resistance to linezolid. Linezolid resistance in all cases was confirmed by E-test method. The use of WGS identified a resistant subpopulation with the G2376C mutation in the 23S ribosomal RNA. Sampling of staff members' dominant hands as well as sampling of surfaces in the unit identified no contaminated sources for transmission. Conclusions. This cluster of LR-VRE in transplant recipients highlights the possible shortcomings of standard microbiology laboratory methods and underscores the importance of WGS to identify resistance mechanisms that can inform patient care, as well as infection control and antibiotic stewardship measures.
© The Author(s) 2018. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.
Datos de la publicación
- ISSN/ISSNe:
- 1058-4838, 1537-6591
- Tipo:
- Article
- Páginas:
- 259-265
- DOI:
- 10.1093/cid/ciy903
CLINICAL INFECTIOUS DISEASES Oxford University Press
Citas Recibidas en Web of Science: 19
Citas Recibidas en Scopus: 23
Documentos
- No hay documentos
Filiaciones
Keywords
- linezolid resistance; E. faecium; organ transplant; infection control; whole genome sequencing
Proyectos asociados
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Investigador Principal: JINNETHE CRISTINA REYES MANRIQUE
2017
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Investigador Principal: JINNETHE CRISTINA REYES MANRIQUE
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Investigador Principal: JINNETHE CRISTINA REYES MANRIQUE
UEB-2018-476 . 2018
Citar la publicación
Abbo L,Shukla BS,Giles A,Aragon L,Jimenez A,Camargo JF,Simkins J,Sposato K,Tran TT,Diaz L,Reyes J,Rios R,Carvajal LP,Cardozo J,Ruiz M,Rosello G,Cardona AP,Martinez O,Guerra G,Beduschi T,Vianna R,Arias CA. Linezolid- and Vancomycin-resistant <i>Enterococcus faecium</i> in Solid Organ Transplant Recipients: Infection Control and Antimicrobial Stewardship Using Whole Genome Sequencing. Clin Infect Dis. 2019. 69. (2):p. 259-265. IF:8,313. (1).