万古霉素耐药屎肠球菌分离株在治疗期间对利奈唑胺的敏感性变化：1例病例报告

Varying linezolid susceptibility of vancomycin-resistant Enterococcus faecium isolates during therapy: a case report.

作者信息

Swoboda Stefanie, Fritz Stefan, Martignoni Marcus E, Feldhues Rita A, Hoppe-Tichy Torsten, Buchler Markus W, Geiss Heinrich K

机构信息

Pharmacy Department, University of Heidelberg, Im Neuenheimer Feld 670, D-69120 Heidelberg, Germany.

出版信息

J Antimicrob Chemother. 2005 Oct;56(4):787-9. doi: 10.1093/jac/dki318. Epub 2005 Sep 5.

DOI:10.1093/jac/dki318

PMID:16143710

Abstract

OBJECTIVES

Linezolid is an oxazolidinone antibiotic used in the treatment of infections caused by vancomycin-resistant enterococci. Resistance to linezolid has been associated with a G2576U mutation in domain V of the 23S rRNA.

PATIENT AND METHODS

We present clinical details and susceptibility data from multiple Enterococcus faecium strains isolated from a liver transplant patient over 13 months. MICs of linezolid, vancomycin and quinupristin/dalfopristin were determined using Etest. Molecular typing was performed by pulsed-field gel electrophoresis. Domain V of the 23S rRNA gene in the vancomycin-resistant Enterococcus faecium was amplified. Linezolid concentrations were analysed by HPLC.

RESULTS

We report the emergence of resistance to linezolid in a vancomycin-resistant Enterococcus faecium during linezolid treatment. After discontinuation of the linezolid therapy, the isolate reverted to susceptibility. However, after re-administration of linezolid the vancomycin-resistant Enterococcus faecium became resistant to linezolid again. The isolates that were resistant to linezolid had a G2576T mutation in their 23S rDNA.

CONCLUSION

We describe a clinical case that shows the shift of a vancomycin-resistant Enterococcus faecium from linezolid resistance to susceptibility and then back to resistance again related to linezolid therapy.

摘要