Emergence of cfr-harbouring coagulase-negative staphylococci among patients receiving linezolid therapy in two hospitals in China

J Med Microbiol. 2013 Jun;62(Pt 6):845-850. doi: 10.1099/jmm.0.051003-0. Epub 2013 Feb 28.

Abstract

This study reports on the emergence of cfr-harbouring coagulase-negative staphylococci (CoNS) among patients who received linezolid therapy in two hospitals in Hangzhou, China. The mechanisms of resistance and transmission were analysed for these resistant isolates. Eight Staphylococcus capitis isolates, one Staphylococcus epidermidis isolate and one Staphylococcus hominis isolate, obtained from patients who had received linezolid therapy in two hospitals in Hangzhou, China, were confirmed as linezolid resistant, with MICs ranging from 8 to >256 mg l(-1). The linezolid usage data of the ten patients before isolation of the linezolid-resistant CoNS were collected. PFGE analysis showed that the eight S. capitis isolates from the two hospitals belonged to the same clone. Nine of the linezolid-resistant CoNS isolates carried the cfr gene, which was located on plasmids of a similar size. A 5.3 kb fragment containing the cfr gene, revealing 99 % identity to the sequence of the cfr-harbouring plasmid pSS-01 reported previously, was determined by PCR mapping for all cfr-positive isolates, and the cfr gene was flanked by two copies of IS256-like elements. Thus, these results document the emergence of linezolid-resistant CoNS isolates carrying the cfr gene in Hangzhou, China. Effective nosocomial infection control strategies and the judicious use of antibiotics will be required to prevent further spread of this resistance mechanism.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acetamides / pharmacology*
  • Aged
  • Aged, 80 and over
  • Anti-Infective Agents / pharmacology*
  • Bacterial Proteins / genetics*
  • Bacterial Proteins / metabolism
  • China
  • Coagulase / metabolism*
  • Cross Infection / epidemiology
  • Cross Infection / microbiology
  • Drug Resistance, Multiple, Bacterial / genetics*
  • Humans
  • Linezolid
  • Male
  • Microbial Sensitivity Tests
  • Middle Aged
  • Molecular Sequence Data
  • Oxazolidinones / pharmacology*
  • Plasmids / genetics
  • Sequence Analysis, DNA
  • Staphylococcal Infections / epidemiology
  • Staphylococcal Infections / microbiology
  • Staphylococcus / classification
  • Staphylococcus / drug effects*
  • Staphylococcus / enzymology
  • Staphylococcus / isolation & purification
  • Staphylococcus epidermidis / classification
  • Staphylococcus epidermidis / drug effects
  • Staphylococcus epidermidis / enzymology
  • Staphylococcus epidermidis / isolation & purification
  • Staphylococcus hominis / classification
  • Staphylococcus hominis / drug effects
  • Staphylococcus hominis / enzymology
  • Staphylococcus hominis / isolation & purification

Substances

  • Acetamides
  • Anti-Infective Agents
  • Bacterial Proteins
  • Coagulase
  • Oxazolidinones
  • Linezolid

Associated data

  • GENBANK/JX232067