Wu Mengying, Kang Jia, Tao Jia, Yang Yanwen, Li Gang, Jia Wei
Medical Experimental Center, General Hospital of Ningxia Medical University, Yinchuan, People's Republic of China.
Department of Neurology, General Hospital of Ningxia Medical University, Yinchuan, People's Republic of China.
Infect Drug Resist. 2024 Feb 8;17:485-494. doi: 10.2147/IDR.S442105. eCollection 2024.
To understand the detection rate and distribution characteristics of Linezolid-nonsusceptible (LNSE) and analyze the molecular typing and main drug resistance mechanisms of LNSE, providing a theoretical basis for the precision prevention and control of LNSE hospital infections.
A total of 40 LNSE strains isolated from clinical specimens between January 1, 2012, and December 31, 2022, were collected. The LNSE isolates identified by instrument detection were confirmed using a microbroth dilution method. The WHONET 5.0 software was used for statistical analysis of LNSE detection rate, and the LNSE judgment was based on the 2022 CLSI criteria. PCR methods were used to detect 23S rRNA, , and L3, L4 ribosomal RNA sites for linezolid resistance genes, and gene sequencing was used to verify the amplified PCR products. Multiple locus sequence typing (MLST) was performed to analyze the homology of LNSE strains.
A total of 6924 isolates were separated and identified from January 1, 2012, to December 31, 2022, of which 40 were LNSE strains (26 , 14 ), with a detection rate of 0.58% (40/6924). Among them, 28 Linezolid-intermediated (LIE) were detected, accounting for 0.4% (28/6924), and 12 Linezolid-resistant (LRE) were detected, with a detection rate of 0.17% (12/6924). Among the LNSE strains, 23 were resistant to genes. The 40 LNSE strains could be divided into 20 different ST types, with ST16 being the main type, accounting for 12.5% (5/40).
The detection of LNSE strains was dominated by , and the main resistance mechanism of LRE strains was carrying the gene, with 23S rRNA gene mutations also contributing to resistance. New resistance gene phenotypes ( +/23S rRNA+) emerged. Most LRE cases were sporadic, and clonal dissemination was observed in some strains.
了解利奈唑胺不敏感（LNSE）的检出率及分布特征，分析LNSE的分子分型及主要耐药机制，为精准防控LNSE医院感染提供理论依据。
收集2012年1月1日至2022年12月31日期间从临床标本中分离出的40株LNSE菌株。采用微量肉汤稀释法对仪器检测鉴定的LNSE分离株进行确认。使用WHONET 5.0软件对LNSE检出率进行统计分析，LNSE判断依据2022年CLSI标准。采用PCR方法检测利奈唑胺耐药基因的23S rRNA、L3、L4核糖体RNA位点，基因测序验证扩增的PCR产物。进行多位点序列分型（MLST）分析LNSE菌株的同源性。
2012年1月1日至2022年12月31日共分离鉴定出6924株菌株，其中40株为LNSE菌株（26株 ，14株 ），检出率为0.58%（40/6924）。其中，检测到28株利奈唑胺中介（LIE）菌株，占0.4%（28/6924），12株利奈唑胺耐药（LRE）菌株，检出率为0.17%（12/6924）。在LNSE菌株中，23株对 基因耐药。40株LNSE菌株可分为20种不同的ST型，其中ST16为主要类型，占12.5%（5/40）。
LNSE菌株的检出以 为主，LRE菌株的主要耐药机制是携带 基因，23S rRNA基因突变也参与耐药。出现了新的耐药基因表型（ +/23S rRNA+）。多数LRE病例为散发，部分菌株存在克隆传播。
