Emergence of linezolid-resistant Enterococcus faecium in a tertiary hospital in Copenhagen
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Emergence of linezolid-resistant Enterococcus faecium in a tertiary hospital in Copenhagen. / Misiakou, Maria Anna; Hertz, Frederik Boetius; Schønning, Kristian; Häussler, Susanne; Nielsen, Karen Leth.
I: Microbial genomics, Bind 9, Nr. 7, 001055, 2023.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Emergence of linezolid-resistant Enterococcus faecium in a tertiary hospital in Copenhagen
AU - Misiakou, Maria Anna
AU - Hertz, Frederik Boetius
AU - Schønning, Kristian
AU - Häussler, Susanne
AU - Nielsen, Karen Leth
N1 - Publisher Copyright: © 2023, Microbiology Society. All rights reserved.
PY - 2023
Y1 - 2023
N2 - Linezolid is used as first-line treatment of infections caused by vancomycin-resistant Enterococcus faecium. However, resistance to linezolid is increasingly detected. The aim of the present study was to elucidate the causes and mechanisms for the increase in linezolid-resistant E. faecium at Copenhagen University Hospital – Rigshospitalet. We therefore combined patient information on linezolid treatment with whole-genome sequencing data for vancomycin- or linezolid-resistant E. faecium isolates that had been systematically collected since 2014 (n=458). Whole-genome sequencing was performed for multilocus sequence typing (MLST), identification of linezolid resistance-conferring genes/mutations and determination of phylogenetically closely related strains. The collection of E. faecium isolates belonged to prevalent vancomycin-resistant MLST types. Among these, we identified clusters of closely related linezolid-resistant strains compatible with nosocomial transmission. We also identified linezolid-resistant enterococcus isolates not genetically closely related to other isolates compatible with de novo generation of linezolid resistance. Patients with the latter isolates were significantly more frequently exposed to linezolid treatment than patients with related linezolid-resistant enterococcus isolates. We also identified six patients who initially carried a vancomycin-resistant, linezolid-sensitive enterococcus, but from whom vancomycin-resistant, linezolid-resistant enterococci (LVRE) closely related to their initial isolate were recovered after linezolid treatment. Our data illustrate that linezolid resistance may develop in the individual patient subsequent to linezolid exposure and can be transmitted between patients in a hospital setting.
AB - Linezolid is used as first-line treatment of infections caused by vancomycin-resistant Enterococcus faecium. However, resistance to linezolid is increasingly detected. The aim of the present study was to elucidate the causes and mechanisms for the increase in linezolid-resistant E. faecium at Copenhagen University Hospital – Rigshospitalet. We therefore combined patient information on linezolid treatment with whole-genome sequencing data for vancomycin- or linezolid-resistant E. faecium isolates that had been systematically collected since 2014 (n=458). Whole-genome sequencing was performed for multilocus sequence typing (MLST), identification of linezolid resistance-conferring genes/mutations and determination of phylogenetically closely related strains. The collection of E. faecium isolates belonged to prevalent vancomycin-resistant MLST types. Among these, we identified clusters of closely related linezolid-resistant strains compatible with nosocomial transmission. We also identified linezolid-resistant enterococcus isolates not genetically closely related to other isolates compatible with de novo generation of linezolid resistance. Patients with the latter isolates were significantly more frequently exposed to linezolid treatment than patients with related linezolid-resistant enterococcus isolates. We also identified six patients who initially carried a vancomycin-resistant, linezolid-sensitive enterococcus, but from whom vancomycin-resistant, linezolid-resistant enterococci (LVRE) closely related to their initial isolate were recovered after linezolid treatment. Our data illustrate that linezolid resistance may develop in the individual patient subsequent to linezolid exposure and can be transmitted between patients in a hospital setting.
KW - outbreak
KW - oxazolidinone
KW - resistance mutation
KW - selection pressure
KW - SNP
KW - VRE
KW - whole-genome sequencing
U2 - 10.1099/mgen.0.001055
DO - 10.1099/mgen.0.001055
M3 - Journal article
C2 - 37410656
AN - SCOPUS:85164259933
VL - 9
JO - Microbial genomics
JF - Microbial genomics
SN - 2057-5858
IS - 7
M1 - 001055
ER -
ID: 366386956