Linezolid Resistance Genes and Mutations among Linezolid-Susceptible Enterococcus spp.-A Loose Cannon?

被引:7
作者
Bender, Jennifer K. [1 ]
Fleige, Carola [1 ]
Funk, Finn [1 ]
Moreto-Castellsague, Clara [1 ,2 ]
Fischer, Martin A. [1 ]
Werner, Guido [1 ]
机构
[1] Robert Koch Inst, Dept Infect Dis, Nosocomial Pathogens & Antibiot Resistances Unit, D-38855 Wernigerode, Germany
[2] Univ Hosp Bellvitge, Dept Microbiol & Parasitol, Barcelona 08907, Spain
来源
ANTIBIOTICS-BASEL | 2024年 / 13卷 / 01期
关键词
linezolid resistance; Enterococcus spp; silent resistance genes; genotype-phenotype correlation; ANTIBIOTIC-RESISTANCE; FAECIUM; PREVALENCE; MECHANISMS;
D O I
10.3390/antibiotics13010101
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
The National Reference Centre for Enterococci receives an increasing number of linezolid-resistant Enterococcus isolates. Linezolid (LIN) resistance is mediated by G2576T 23S rDNA gene mutations and/or acquisition of resistance genes (cfr, optrA, poxtA). There are anecdotal reports that those resistance traits may be present in phenotypically linezolid-susceptible isolates. We aimed to determine the prevalence of LIN resistance genes and mutations in enterococci with a LIN MIC of 4 mg/L in broth microdilution (EUCAST = susceptible) isolated from German hospital patients 2019-2021. LIN MICs were additionally determined by ETEST (R) and VITEK2. Selected strains were subjected to LIN selective pressure and growth was monitored with increasing antibiotic concentrations. We received 195 isolates (LIN MIC = 4 mg/L). In total, 78/195 (40%) isolates contained either a putative resistance gene, the G2576T mutation, or a combination thereof. Very major error was high for broth microdilution. The ability to predict phenotypic resistance from genotypic profile was highest for G2576T-mediated resistance. Selection experiments revealed that, in particular, E. faecium isolates with resistance gene mutations or poxtA rapidly adapt to MICs above the clinical breakpoint. In conclusion, LIN resistance genes and mutations can be observed in phenotypically linezolid-susceptible enterococci. Those isolates may rapidly develop resistance under LIN selective pressure potentially leading to treatment failure.
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页数:11
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