Case ReportsClinical Characteristics of Linezolid-Resistant Staphylococcus aureus Infections
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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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Synthesis and structure-activity relationship studies of novel [6,6,5] tricyclic oxazolidinone derivatives as potential antibacterial agents
2015, Bioorganic and Medicinal Chemistry LettersLinezolid update: Stable in vitro activity following more than a decade of clinical use and summary of associated resistance mechanisms
2014, Drug Resistance UpdatesCitation Excerpt :These clinical isolates had alterations in the linezolid target site (i.e. PTC at 23S rRNA) and these sporadic reports corroborate the in vitro early experiments suggesting that selection for resistance occurs rarely (Zurenko et al., 1996). These earlier cases of resistance development to linezolid occurred during prolonged therapy (>21 days) (Peeters and Sarria, 2005), as practice contrary to product indications. In addition, these cases were associated with invasive procedures, deep organ involvement, and presence of foreign material.
Co-emergence of linezolid-resistant Staphylococcus aureus and Enterococcus faecium in a patient with methicillin-resistant S. aureus pneumonic sepsis
2011, Diagnostic Microbiology and Infectious DiseaseResistance or decreased susceptibility to glycopeptides, daptomycin, and linezolid in methicillin-resistant Staphylococcus aureus
2010, Current Opinion in PharmacologyNew therapeutic choices for infections caused by methicillin-resistant Staphylococcus aureus
2009, Clinical Microbiology and InfectionCitation Excerpt :Linezolid is active in vitro against most Gram-positive bacteria, including methicillin-susceptible S. aureus (MSSA) and MRSA [51–54]. There have been anecdotal reports of resistance of MRSA to linezolid [55–61]. Linezolid is highly bioavailable after oral administration (more than 90%), and can be administered intravenously [62].
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