应对利奈唑酮linezolid耐药的肠球菌引起的爆发感染的措施

David

Emerg Infect Dis. 2007 Jul;13(7):1024-30.Links
Response to emerging infection leading to outbreak of linezolid-resistant enterococci.
应对利奈唑酮linezolid耐药的肠球菌引起的爆发感染的措施
Kainer MA, Devasia RA, Jones TF, Simmons BP, Melton K, Chow S, Broyles J, Moore KL, Craig AS, Schaffner W.
Tennessee Department of Health, Communicable and Environmental Disease Services, Nashville, Tennessee 37243, USA. marion.kainer@state.tn.us

Linezolid was approved in 2000 for treatment of gram-positive coccal infections. We performed a case-control study during a hospital outbreak of linezolid-resistant enterococci (LRE) infections, comparing cases of LRE infection (cases) with linezolid-sensitive enterococci infections (controls). Nasal and perirectal swab samples were obtained from all patients in a 1-day point-prevalence survey. We examined antimicrobial drug use and calculated the defined daily dose of linezolid per 1,000 patient-days. Fifteen LRE cases were identified (13 Enterococcus faecalis and 2 E. faecium); 7 were vancomycin-resistant. Compared with controls, case-patients had increased in-hospital mortality rates and lengths of stay. Multivariate analysis identified independent predictors of LRE infection: prior cultures positive for methicillin-resistant Staphylococcus aureus (adjusted odds ratio [AOR] 27), hospitalization duration before index culture (AOR 1.1 per day), and duration of preceding linezolid therapy (AOR 1.1 per day). Linezolid exposure and patient-to-patient transmission appear to be responsible for LRE infections, an important emeraina hospital problem.