Molecular characteristics and risk factors associated with linezolid-resistant Enterococcus faecalis infection in Southwest China.

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Molecular characteristics and risk factors associated with linezolid-resistant Enterococcus faecalis infection in Southwest China.

J Glob Antimicrob Resist. 2020 May 18;:

Authors: Zou J, Xia Y

Abstract
BACKGROUND: Linezolid is one of the last lines of defense for Gram-positive bacteria, and the increasing emergence of linezolid-resistant enterococci (LRE) has become an important problem in nosocomial infections.
OBJECTIVE: To explore the mechanism of linezolid resistance and analyze the risk factor for the infection with LRE.
METHOD: The known resistance mechanisms of linezolid were detected by PCR. Clinical data of patients with LRE infection were collected from the electronic medical record system. Risk factors associated with LRE were determined by comparing 2 case groups (LRE group and linezolid-susceptible enterococci (LSE) group) with control group (without enterococci infection) at a ratio of 1:1:2. Multivariate logistic regression models were used to evaluate independent risk factors for acquiring LRE and LSE.
RESULTS: A total of 85 (4.5%) LRE isolates were detected during 5-year period. The main resistance mechanism was the acquisition of transferable gene optrA (98.8%), followed by the L4 protein mutation (37.7%), L3 protein mutation (4.7%). Then 85 LRE cases, 85 LSE cases, and 170 controls were enrolled in our study and multivariable analysis indicated that transfer from another hospital (odds ratio [OR], 3.2; 95% confidence interval [CI], 1.5-7.3; P=0.004), malignant tumor (OR, 3.7; 95% CI, 1.6-8.8; P=0.003), polymicrobial infection (OR, 12.2; 95% CI, 1.4-106.2; P=0.023), and urinary tract infection (OR, 42.7; 95% CI, 11.4-159.3; P=0.000) were independent predictors for acquiring LRE. In addition, polymicrobial infection (OR, 43.3; 95% CI, 14.1-132.8; P=0.000), total length of hospital stay(≥30d) (OR, 5.7; 95% CI, 1.9-17.3; P=0.002) and exposure to glycopeptide (OR, 6.6; 95% CI, 1.1-38.8; P=0.035) were independently associated with LSE infection.
CONCLUSION: Proper antibiotic management programs and monitoring of patient risk factors are necessary to control LRE infections.

PMID: 32439566 [PubMed - as supplied by publisher]