Case Reports
Clinical Characteristics of Linezolid-Resistant Staphylococcus aureus Infections

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ABSTRACT:

Case reports have previously identified linezolid resistance in 6 clinical isolates of Staphylococcus aureus. We describe an additional case and discuss clinical characteristics of these patients. Invasive procedures, deep organ involvement, and presence of foreign material were predominant in these cases. Resistance followed prolonged (> 21 days) linezolid therapy in most cases. The development of resistance to linezolid should be taken into account when selecting this drug as a therapeutic option.

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Case Report

A 51-year-old female, developed an enterocutaneous fistula, secondary peritonitis, and a surgical wound infection after undergoing a gastric bypass operation for morbid obesity. She required open drainage and treatment with broad-spectrum antibiotics. Linezolid was added when vancomycin-resistant Enterococcus was isolated from abdominal wound cultures. Thirty days later, a strain of methicillin-resistant Staphylococcus aureus with a linezolid minimal inhibitory concentration (MIC) less than 4

Discussion

Clinical characteristics of 7 patients with linezolid-resistant Staphylococcus aureus infections reported thus far are summarized in Table 1. All patients had underlying diseases or invasive procedures, complicated clinical courses, and pretreatment with broad-spectrum antimicrobials. Resistance occurred with linezolid exposure in all cases, and followed prolonged therapy (> 21 days) in 6 cases. Presence of foreign material or deep organ involvement was documented in most cases. Antimicrobial

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Copyright © 2005 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.