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Linezolid resistance and antimicrobial susceptibility in Staphylococci isolated from clinical specimens

Year 2017, Volume: 9 Issue: 1, 19 - 23, 02.03.2017
https://doi.org/10.21601/ortadogutipdergisi.293147

Abstract

Introduction-Purpose: Having detected linezolid resistance
in a number of staphylococcal strains
isolated from clinical specimens in our hospital, in this study, we aimed to
investigate the resistance profile of staphylococci to linezolid and other
antimicrobial drugs.

Materials and Methods: A
total of 883
staphylococcal strains isolated
in the Clinical Microbiology Laboratory taken from various clinical specimens from hospitalized patients in Kartal
Dr. Lutfi Kirdar Training and Research Hospital from 1 January 2014 to 31 March
2015 were included in our study. Antimicrobial susceptibilities of these
isolates were tested by VITEK2 Automatized System (bioMérieux, France) in
addition to conventional methods.
The detection of the strains identified as linezolid-resistant was
confirmed by Antibiotic Gradient Test (E-Test, bioMérieux, France).

Results: Out of the 883 staphylococcal isolates,
183 (20.7%) and 700 (79.3%) were identified as S.aureus and coagulase-negative staphylococci (CNS), respectively.
Among
them, 14.1% were isolated from intensive care unit (ICU) patients, 79.9% were
isolated from blood specimens. Thirty-four per cent of 183 S.aureus isolates and 79% of 700 CNS isolates were found to be
methicillin-resistant.
Among
125 CNS blood isolates from ICU patients, three (2.4%) isolates were resistant
to linezolid. While two of these isolates were methicillin-resistant S.epidermidis, the third isolate was
methicillin-resistant S. hominis.







Conclusion: Although the rate of resistance to linezolid, an
antibiotic used clinically in our country since 2005, appears to be low, it has
a potential to increase. Therefore, investigation into resistance is suggested,
particularly in case of long-term linezolid use and unresponsiveness to
treatment.

References

  • Efe Ş, Sınırtaş M, Özakın C. Metisiline direncli Staphylococcus aureus (MRSA) ve vankomisine direncli enterokok suşlarının in vitro Linezolid duyarlılığı. Mikrobiyol Bul. 2009; 43: 639-43.
  • Mendes RE, Deshpande LM, Jones RN. Linezolid update: stable in vitro activity following more than a decade of clinical use and summary of associated resistance mechanisms. Drug Resist Updat. 2014; 17(1-2):1-12.
  • Küçükbayrak A, Özdemir D. İki yeni protein sentez inhibitörü: Linezolid ve streptograminler (Kinopristin/Dalfoprustin). İnfeksiyon Derg. 2006; 20(2): 145-51.
  • Hancock RE. Mechanism of action of newer antibiotics for gram-positive pathogens. Lancet Infect Dis. 2005; 5(4): 209-18.
  • Bozdogan B, Appelbaum PC. Oxazolidinones: activity, mode of action, andmechanism of resistance. Int J Antimicrob Agents. 2004; 23:113–9.
  • Diekema DJ, Jones RN. Oxazolidinoneantibiotics. Lancet. 2001; 358(9297):1975-82.
  • Altun U H , Sancak B. Staphylococcus aureus’un Tedavisinde Yeni Antibiyotikler. Türk Mikrobiyol Cem Derg. 2010; 40 (2): 63-74.
  • Cui L, Wang Y, Li Y, et al. (2013) Cfr-Mediated Linezolid-Resistance among Methicillin-Resistant Coagulase-Negative Staphylococci from Infections of Humans. PLoS ONE 8(2): e57096. doi:10.1371/journal.pone.0057096.
  • CLSI. Performance Standarts for Antimicrobial Susceptibility Testing; Twenty-Fourth Informational supplement. CLSI document M100-S24. Wayne, PA: Clinical and Laboratory Standarts Institute; 2014.
  • George A. Pankey. Tigecycline. J Antimicrob Chemother. 2005; 56: 470-80.
  • Hiramatsu K, Hanaki H, Ino T, Yabuta K, Oguri T, Tenover FC. Methicillin-resistant Staphylococcus aureus clinical strain with reduced vancomycin susceptibility. J Antimicrob Chemother. 1997; 40: 135-46.
  • Garcia MS, Torre MA, Morales G, et al. Clinical outbreak of linezolid-resistance Staphylococcus aureus in intensive care unit. JAMA 2010; 303(22): 2260-4.
  • Tsiodras S, Gold HS, Sakoulas G, et al. Linezolid resistance in a clinicalisolate of Staphylococcus aureus. Lancet. 2001; 358(9277):207-8.
  • Bender J, Strommenger B, Steglich M, et al. Linezolid resistance in clinical isolates of Staphylococcus epidermidis from German hospitals and characterization of two cfr-carrying plasmids. J Antimicrob Chemother. 2015;70(6):1630-8.
  • Ikeda-Dantsuji Y, Hanaki H, Sakai F ,et al. Linezolid-resistant Staphylococcus aureus isolated from 2006 through 2008 at six hospitals in Japan. J Infect Chemother. 2011; 17:45-51.
  • Jones RN, Kohno S, Ono Y, Ross JE, Yanagihara K. ZAAPS International Surveillance Program (2007) for linezolid resistance: results from 5591 Gram-positive clinical isolates in 23 countries. Diagn Microbiol Infect Dis. 2009; 64(2):191-201.
  • Seral C, Sáenz Y, Algarate S, et al. Nosocomial outbreak of methicillin- and linezolid-resistant Staphylococcus epidermidis associated with catheter-related infections in intensive care unit patients. International Journal of Medical Microbiology. 2011; 301(4):354-8.
  • Jones RN, Fritsche TR, Sader HS, Ross JE. LEADER surveillance Program results for 2006: an activity and spectrum analysis of Linezolid using clinical isolates from the United States(50 medical centers). Diagn Microbiol Infect Dis. 2007; 59:309-17.
  • Baddour MM, Abuelkheir MM, Fatani AJ. Trends in antibiotic susceptibility patterns and epidemiology of MRSA isolates from several hospitals in Riyadh, SaudiArabia. Ann Clin Microbiol Antimicrob. 2006; 5: 30.
  • Ertem T G, Öztürk B, Hatipoğlu A Ç, et al. Stafilok ve Enterokok İzolatlarının Linezolid, Daptomisin, Teikoplanin ve Fusidik Aside İn Vitro Duyarlılığı. Turkiye Klinikleri J Med Sci. 2013; 33(6):1381-7.
  • Ağalar C, Göçmen J S, Kılıç D, Kaygusuz S, Karabıçak Ç. Üçüncü basamak bir referans hastanesinde izole edilen metisilin dirençli stafilokok suşlarında duyarlılık. JCEI /2012; 3(1):71-4.
  • Cesur S, Irmak H, Şimşek H, ve ark. Türkiye’de Yedi İldeki Hastanelerin Yoğun Bakım Ünitelerinden İzole Edilen MRSA Suşlarında VISA-VRSA Araştırılması ve Antibiyotik Duyarlılık Durumlarının Saptanması. Mikrobiyol Bul. 2012; 46(3): 352-8.

Klinik örneklerden izole edilen stafilokoklarda linezolid direnci ve antibiyotik duyarlılıkları

Year 2017, Volume: 9 Issue: 1, 19 - 23, 02.03.2017
https://doi.org/10.21601/ortadogutipdergisi.293147

Abstract

Amaç: Bu çalışmada, hastanemizde klinik
örneklerde üreyen bazı stafilokoklarda linezolide direnç tespit edilmesi
üzerine, linezolide ve diğer antibiyotiklere direnç durumunu araştırmayı
amaçladık.

Gereç ve Yöntemler:
1 Ocak 2014-31 Mart 2015 tarihleri arasında, Kartal Dr. Lütfi Kırdar Eğitim ve
Araştırma Hastanesi Klinik Mikrobiyoloji laboratuvarında, yatan hastalara ait
çeşitli klinik örneklerden izole edilen toplam 883 stafilokok suşu çalışmaya
alınmıştır. Suşların antibiyotiklere duyarlılıkları geleneksel yöntemlere
ilaveten VITEK2 Otomatize Sistemi (bioMérieux, Fransa) çalışılmıştır. Linezolide
dirençli olduğu saptanan suşlar antibiyotik gradient test (Etest, bioMérieux,
Fransa) ile doğrulanmıştır.

Bulgular: Sekiz
yüz seksen üç stafilokok suşunun 183’ü S.aureus
(%20,7) ve 700’ü koagülaz negatif stafilokok (KNS) (%79,3)  olarak identifiye edilmiştir. Bu suşların %14,1’i
yoğun bakım ünitesi (YBÜ) kökenli olup %79,7’ü kan örneklerinden izole
edilmiştir. Yüzseksenüç S.aureus
suşunun %34’ ü ve 700 KNS suşunun %79’u metisiline dirençli olarak bulunmuştur.
YBÜ’nde yatan hastaların örneklerinde üreyen 125 KNS suşu arasından kanda
üreyen 3 suşta (%2,4) linezolid direnci saptanmıştır. Bu suşlardan 2 tanesi
metisiline dirençli S.epidermidis, 1
tanesi metisiline dirençli S. hominis
olarak tanımlanmıştır.







Sonuç
ve yorum:
Ülkemizde 2005 yılından
beri kullanımda olan bu antibiyotiğe direnç düşük gibi görünse de direncin
artma ihtimali mevcuttur. Bu nedenle, uzun süreli kullanımlarda ve klinik yanıt
elde edilmediği durumlarda direnç takibinin yapılması uygun olacaktır.   



References

  • Efe Ş, Sınırtaş M, Özakın C. Metisiline direncli Staphylococcus aureus (MRSA) ve vankomisine direncli enterokok suşlarının in vitro Linezolid duyarlılığı. Mikrobiyol Bul. 2009; 43: 639-43.
  • Mendes RE, Deshpande LM, Jones RN. Linezolid update: stable in vitro activity following more than a decade of clinical use and summary of associated resistance mechanisms. Drug Resist Updat. 2014; 17(1-2):1-12.
  • Küçükbayrak A, Özdemir D. İki yeni protein sentez inhibitörü: Linezolid ve streptograminler (Kinopristin/Dalfoprustin). İnfeksiyon Derg. 2006; 20(2): 145-51.
  • Hancock RE. Mechanism of action of newer antibiotics for gram-positive pathogens. Lancet Infect Dis. 2005; 5(4): 209-18.
  • Bozdogan B, Appelbaum PC. Oxazolidinones: activity, mode of action, andmechanism of resistance. Int J Antimicrob Agents. 2004; 23:113–9.
  • Diekema DJ, Jones RN. Oxazolidinoneantibiotics. Lancet. 2001; 358(9297):1975-82.
  • Altun U H , Sancak B. Staphylococcus aureus’un Tedavisinde Yeni Antibiyotikler. Türk Mikrobiyol Cem Derg. 2010; 40 (2): 63-74.
  • Cui L, Wang Y, Li Y, et al. (2013) Cfr-Mediated Linezolid-Resistance among Methicillin-Resistant Coagulase-Negative Staphylococci from Infections of Humans. PLoS ONE 8(2): e57096. doi:10.1371/journal.pone.0057096.
  • CLSI. Performance Standarts for Antimicrobial Susceptibility Testing; Twenty-Fourth Informational supplement. CLSI document M100-S24. Wayne, PA: Clinical and Laboratory Standarts Institute; 2014.
  • George A. Pankey. Tigecycline. J Antimicrob Chemother. 2005; 56: 470-80.
  • Hiramatsu K, Hanaki H, Ino T, Yabuta K, Oguri T, Tenover FC. Methicillin-resistant Staphylococcus aureus clinical strain with reduced vancomycin susceptibility. J Antimicrob Chemother. 1997; 40: 135-46.
  • Garcia MS, Torre MA, Morales G, et al. Clinical outbreak of linezolid-resistance Staphylococcus aureus in intensive care unit. JAMA 2010; 303(22): 2260-4.
  • Tsiodras S, Gold HS, Sakoulas G, et al. Linezolid resistance in a clinicalisolate of Staphylococcus aureus. Lancet. 2001; 358(9277):207-8.
  • Bender J, Strommenger B, Steglich M, et al. Linezolid resistance in clinical isolates of Staphylococcus epidermidis from German hospitals and characterization of two cfr-carrying plasmids. J Antimicrob Chemother. 2015;70(6):1630-8.
  • Ikeda-Dantsuji Y, Hanaki H, Sakai F ,et al. Linezolid-resistant Staphylococcus aureus isolated from 2006 through 2008 at six hospitals in Japan. J Infect Chemother. 2011; 17:45-51.
  • Jones RN, Kohno S, Ono Y, Ross JE, Yanagihara K. ZAAPS International Surveillance Program (2007) for linezolid resistance: results from 5591 Gram-positive clinical isolates in 23 countries. Diagn Microbiol Infect Dis. 2009; 64(2):191-201.
  • Seral C, Sáenz Y, Algarate S, et al. Nosocomial outbreak of methicillin- and linezolid-resistant Staphylococcus epidermidis associated with catheter-related infections in intensive care unit patients. International Journal of Medical Microbiology. 2011; 301(4):354-8.
  • Jones RN, Fritsche TR, Sader HS, Ross JE. LEADER surveillance Program results for 2006: an activity and spectrum analysis of Linezolid using clinical isolates from the United States(50 medical centers). Diagn Microbiol Infect Dis. 2007; 59:309-17.
  • Baddour MM, Abuelkheir MM, Fatani AJ. Trends in antibiotic susceptibility patterns and epidemiology of MRSA isolates from several hospitals in Riyadh, SaudiArabia. Ann Clin Microbiol Antimicrob. 2006; 5: 30.
  • Ertem T G, Öztürk B, Hatipoğlu A Ç, et al. Stafilok ve Enterokok İzolatlarının Linezolid, Daptomisin, Teikoplanin ve Fusidik Aside İn Vitro Duyarlılığı. Turkiye Klinikleri J Med Sci. 2013; 33(6):1381-7.
  • Ağalar C, Göçmen J S, Kılıç D, Kaygusuz S, Karabıçak Ç. Üçüncü basamak bir referans hastanesinde izole edilen metisilin dirençli stafilokok suşlarında duyarlılık. JCEI /2012; 3(1):71-4.
  • Cesur S, Irmak H, Şimşek H, ve ark. Türkiye’de Yedi İldeki Hastanelerin Yoğun Bakım Ünitelerinden İzole Edilen MRSA Suşlarında VISA-VRSA Araştırılması ve Antibiyotik Duyarlılık Durumlarının Saptanması. Mikrobiyol Bul. 2012; 46(3): 352-8.
There are 22 citations in total.

Details

Subjects Health Care Administration
Journal Section Original article
Authors

Ayşegül Dokutan This is me

Demet Hacıseyitoğlu

Yasemin Çağ This is me

Elvin Pazar Yıldırım This is me

Ayşe Batırel This is me

Serdar Özer This is me

Nevriye Gönüllü This is me

Publication Date March 2, 2017
Published in Issue Year 2017 Volume: 9 Issue: 1

Cite

Vancouver Dokutan A, Hacıseyitoğlu D, Çağ Y, Pazar Yıldırım E, Batırel A, Özer S, Gönüllü N. Klinik örneklerden izole edilen stafilokoklarda linezolid direnci ve antibiyotik duyarlılıkları. omj. 2017;9(1):19-23.

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