Low prevalence of combined linezolid- and vancomycin-resistant Enterococcus faecium from hospital admission screening in an endemic region in Germany
Background: The emergence and spread of linezolid and combined linezolid/vancomycin resistance in Enterococcus faecium (LVRE) is a major therapeutic challenge. Due to the unavailability of standardized selective culture media for LVRE screening, the detection of LVRE is laborious and costly. Systema...
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| Format: | Article |
| Language: | English |
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Elsevier
2020-09-01
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| Series: | Journal of Global Antimicrobial Resistance |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213716520301296 |
| _version_ | 1818455332444176384 |
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| author | Alexandra Heininger Stefan Zimmermann Carolin Bootsveld Sébastien Boutin Dennis Nurjadi |
| author_facet | Alexandra Heininger Stefan Zimmermann Carolin Bootsveld Sébastien Boutin Dennis Nurjadi |
| author_sort | Alexandra Heininger |
| collection | DOAJ |
| description | Background: The emergence and spread of linezolid and combined linezolid/vancomycin resistance in Enterococcus faecium (LVRE) is a major therapeutic challenge. Due to the unavailability of standardized selective culture media for LVRE screening, the detection of LVRE is laborious and costly. Systematic data on LVRE prevalence are scarce, and therefore, supportive evidence for the correct implementation of preemptive strategies is lacking. Objective: We investigated the prevalence of LVRE in a vancomycin-resistant enterococci (VRE) endemic area in Germany in admission screening of high-risk patients for multidrug-resistant organisms to assess the necessity of LVRE screening. Methods: We performed phenotypic testing for linezolid susceptibility in all patients (n = 2572) admitted to our hospital in the months of January, April, July and October 2018 with a positive VRE culture in their rectal admission screening swab. Eight isolates from seven patients with LVRE colonization were characterized by whole genome sequencing. Results: Twenty-eight percent (712/2572) of screened patients were colonized by VRE. Seventy percent (497/712) of the isolates were available for testing and whole genome sequencing. A total of 1.4% (7/497) of VRE were LVRE, predominantly due to mutations of 23S rRNA. optrA, poxtA or cfr genes were not detected. Patients with LVRE colonization did not develop LVRE infections during their stay. Conclusion: LVRE prevalence was low, and there was no evidence for the dissemination of linezolid resistance genes. Due to the low prevalence and the low risk of infection due to endogenous LVRE, we do not see the immediate necessity to introduce routine LVRE screening in our hospital. |
| first_indexed | 2024-12-14T22:09:06Z |
| format | Article |
| id | doaj.art-9214ee8108f34f98b9226be296762404 |
| institution | Directory Open Access Journal |
| issn | 2213-7165 |
| language | English |
| last_indexed | 2024-12-14T22:09:06Z |
| publishDate | 2020-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Global Antimicrobial Resistance |
| spelling | doaj.art-9214ee8108f34f98b9226be2967624042022-12-21T22:45:48ZengElsevierJournal of Global Antimicrobial Resistance2213-71652020-09-0122646650Low prevalence of combined linezolid- and vancomycin-resistant Enterococcus faecium from hospital admission screening in an endemic region in GermanyAlexandra Heininger0Stefan Zimmermann1Carolin Bootsveld2Sébastien Boutin3Dennis Nurjadi4Department of Infectious Diseases, Medical Microbiology and Hygiene, Heidelberg University Hospital, Heidelberg, GermanyDepartment of Infectious Diseases, Medical Microbiology and Hygiene, Heidelberg University Hospital, Heidelberg, GermanyDepartment of Infectious Diseases, Medical Microbiology and Hygiene, Heidelberg University Hospital, Heidelberg, GermanyDepartment of Infectious Diseases, Medical Microbiology and Hygiene, Heidelberg University Hospital, Heidelberg, GermanyCorresponding author at: Department of Infectious Diseases, Medical Microbiology and Hygiene, Heidelberg University Hospital, Im Neuenheimer Feld 324, 69120 Heidelberg, Germany.; Department of Infectious Diseases, Medical Microbiology and Hygiene, Heidelberg University Hospital, Heidelberg, GermanyBackground: The emergence and spread of linezolid and combined linezolid/vancomycin resistance in Enterococcus faecium (LVRE) is a major therapeutic challenge. Due to the unavailability of standardized selective culture media for LVRE screening, the detection of LVRE is laborious and costly. Systematic data on LVRE prevalence are scarce, and therefore, supportive evidence for the correct implementation of preemptive strategies is lacking. Objective: We investigated the prevalence of LVRE in a vancomycin-resistant enterococci (VRE) endemic area in Germany in admission screening of high-risk patients for multidrug-resistant organisms to assess the necessity of LVRE screening. Methods: We performed phenotypic testing for linezolid susceptibility in all patients (n = 2572) admitted to our hospital in the months of January, April, July and October 2018 with a positive VRE culture in their rectal admission screening swab. Eight isolates from seven patients with LVRE colonization were characterized by whole genome sequencing. Results: Twenty-eight percent (712/2572) of screened patients were colonized by VRE. Seventy percent (497/712) of the isolates were available for testing and whole genome sequencing. A total of 1.4% (7/497) of VRE were LVRE, predominantly due to mutations of 23S rRNA. optrA, poxtA or cfr genes were not detected. Patients with LVRE colonization did not develop LVRE infections during their stay. Conclusion: LVRE prevalence was low, and there was no evidence for the dissemination of linezolid resistance genes. Due to the low prevalence and the low risk of infection due to endogenous LVRE, we do not see the immediate necessity to introduce routine LVRE screening in our hospital.http://www.sciencedirect.com/science/article/pii/S2213716520301296LVREVREEpidemiologylinezolid- and vancomycin-resistant Enterococcus faeciumE. faeciumScreening |
| spellingShingle | Alexandra Heininger Stefan Zimmermann Carolin Bootsveld Sébastien Boutin Dennis Nurjadi Low prevalence of combined linezolid- and vancomycin-resistant Enterococcus faecium from hospital admission screening in an endemic region in Germany Journal of Global Antimicrobial Resistance LVRE VRE Epidemiology linezolid- and vancomycin-resistant Enterococcus faecium E. faecium Screening |
| title | Low prevalence of combined linezolid- and vancomycin-resistant Enterococcus faecium from hospital admission screening in an endemic region in Germany |
| title_full | Low prevalence of combined linezolid- and vancomycin-resistant Enterococcus faecium from hospital admission screening in an endemic region in Germany |
| title_fullStr | Low prevalence of combined linezolid- and vancomycin-resistant Enterococcus faecium from hospital admission screening in an endemic region in Germany |
| title_full_unstemmed | Low prevalence of combined linezolid- and vancomycin-resistant Enterococcus faecium from hospital admission screening in an endemic region in Germany |
| title_short | Low prevalence of combined linezolid- and vancomycin-resistant Enterococcus faecium from hospital admission screening in an endemic region in Germany |
| title_sort | low prevalence of combined linezolid and vancomycin resistant enterococcus faecium from hospital admission screening in an endemic region in germany |
| topic | LVRE VRE Epidemiology linezolid- and vancomycin-resistant Enterococcus faecium E. faecium Screening |
| url | http://www.sciencedirect.com/science/article/pii/S2213716520301296 |
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