Clinical Characteristics and Drug Resistance Mechanisms of Linezolid-Non-Susceptible Enterococcus in a Tertiary Hospital in Northwest China

Mengying Wu,1 Jia Kang,1 Jia Tao,1 Yanwen Yang,2 Gang Li,1 Wei Jia1,3 1Medical Experimental Center, General Hospital of Ningxia Medical University, Yinchuan, People’s Republic of China; 2Department of Neurology, General Hospital of Ningxia Medical University, Yinchuan, People’s Republic of China; 3N...

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Main Authors: Wu M, Kang J, Tao J, Yang Y, Li G, Jia W
Format: Article
Language:English
Published: Dove Medical Press 2024-02-01
Series:Infection and Drug Resistance
Subjects:
Online Access:https://www.dovepress.com/clinical-characteristics-and-drug-resistance-mechanisms-of-linezolid-n-peer-reviewed-fulltext-article-IDR
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author Wu M
Kang J
Tao J
Yang Y
Li G
Jia W
author_facet Wu M
Kang J
Tao J
Yang Y
Li G
Jia W
author_sort Wu M
collection DOAJ
description Mengying Wu,1 Jia Kang,1 Jia Tao,1 Yanwen Yang,2 Gang Li,1 Wei Jia1,3 1Medical Experimental Center, General Hospital of Ningxia Medical University, Yinchuan, People’s Republic of China; 2Department of Neurology, General Hospital of Ningxia Medical University, Yinchuan, People’s Republic of China; 3Ningxia Key Laboratory of Clinical and Pathogenic Microbiology, General Hospital of Ningxia Medical University, Yinchuan, People’s Republic of ChinaCorrespondence: Wei Jia, Medical Experimental Center, General Hospital of Ningxia Medical University, Yinchuan, 750001, People’s Republic of China, Tel +86 951-6744013, Email Jiawei220803@163.comPurpose: To understand the detection rate and distribution characteristics of Linezolid-nonsusceptible Enterococcus (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.Methods: 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, cfr, optrA, 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.Results: A total of 6924 Enterococcus isolates were separated and identified from January 1, 2012, to December 31, 2022, of which 40 were LNSE strains (26 Enterococcus faecalis, 14 Enterococcus faecium), with a detection rate of 0.58% (40/6924). Among them, 28 Linezolid-intermediated Enterococcus(LIE) were detected, accounting for 0.4% (28/6924), and 12 Linezolid-resistant Enterococcus(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).Conclusion: The detection of LNSE strains was dominated by Enterococcus faecalis, and the main resistance mechanism of LRE strains was carrying the optrA gene, with 23S rRNA gene mutations also contributing to resistance. New resistance gene phenotypes (optrA +/23S rRNA+) emerged. Most LRE cases were sporadic, and clonal dissemination was observed in some strains.Keywords: linezolid-nonsusceptible Enterococcus, PCR, MLST, ST16, optrA
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spelling doaj.art-dc42b369cb1943a993bfd15c828da8fa2024-02-08T18:28:26ZengDove Medical PressInfection and Drug Resistance1178-69732024-02-01Volume 1748549490329Clinical Characteristics and Drug Resistance Mechanisms of Linezolid-Non-Susceptible Enterococcus in a Tertiary Hospital in Northwest ChinaWu MKang JTao JYang YLi GJia WMengying Wu,1 Jia Kang,1 Jia Tao,1 Yanwen Yang,2 Gang Li,1 Wei Jia1,3 1Medical Experimental Center, General Hospital of Ningxia Medical University, Yinchuan, People’s Republic of China; 2Department of Neurology, General Hospital of Ningxia Medical University, Yinchuan, People’s Republic of China; 3Ningxia Key Laboratory of Clinical and Pathogenic Microbiology, General Hospital of Ningxia Medical University, Yinchuan, People’s Republic of ChinaCorrespondence: Wei Jia, Medical Experimental Center, General Hospital of Ningxia Medical University, Yinchuan, 750001, People’s Republic of China, Tel +86 951-6744013, Email Jiawei220803@163.comPurpose: To understand the detection rate and distribution characteristics of Linezolid-nonsusceptible Enterococcus (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.Methods: 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, cfr, optrA, 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.Results: A total of 6924 Enterococcus isolates were separated and identified from January 1, 2012, to December 31, 2022, of which 40 were LNSE strains (26 Enterococcus faecalis, 14 Enterococcus faecium), with a detection rate of 0.58% (40/6924). Among them, 28 Linezolid-intermediated Enterococcus(LIE) were detected, accounting for 0.4% (28/6924), and 12 Linezolid-resistant Enterococcus(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).Conclusion: The detection of LNSE strains was dominated by Enterococcus faecalis, and the main resistance mechanism of LRE strains was carrying the optrA gene, with 23S rRNA gene mutations also contributing to resistance. New resistance gene phenotypes (optrA +/23S rRNA+) emerged. Most LRE cases were sporadic, and clonal dissemination was observed in some strains.Keywords: linezolid-nonsusceptible Enterococcus, PCR, MLST, ST16, optrAhttps://www.dovepress.com/clinical-characteristics-and-drug-resistance-mechanisms-of-linezolid-n-peer-reviewed-fulltext-article-IDRlinezolid-nonsusceptible enterococcuspcrmlstst16optra
spellingShingle Wu M
Kang J
Tao J
Yang Y
Li G
Jia W
Clinical Characteristics and Drug Resistance Mechanisms of Linezolid-Non-Susceptible Enterococcus in a Tertiary Hospital in Northwest China
Infection and Drug Resistance
linezolid-nonsusceptible enterococcus
pcr
mlst
st16
optra
title Clinical Characteristics and Drug Resistance Mechanisms of Linezolid-Non-Susceptible Enterococcus in a Tertiary Hospital in Northwest China
title_full Clinical Characteristics and Drug Resistance Mechanisms of Linezolid-Non-Susceptible Enterococcus in a Tertiary Hospital in Northwest China
title_fullStr Clinical Characteristics and Drug Resistance Mechanisms of Linezolid-Non-Susceptible Enterococcus in a Tertiary Hospital in Northwest China
title_full_unstemmed Clinical Characteristics and Drug Resistance Mechanisms of Linezolid-Non-Susceptible Enterococcus in a Tertiary Hospital in Northwest China
title_short Clinical Characteristics and Drug Resistance Mechanisms of Linezolid-Non-Susceptible Enterococcus in a Tertiary Hospital in Northwest China
title_sort clinical characteristics and drug resistance mechanisms of linezolid non susceptible enterococcus in a tertiary hospital in northwest china
topic linezolid-nonsusceptible enterococcus
pcr
mlst
st16
optra
url https://www.dovepress.com/clinical-characteristics-and-drug-resistance-mechanisms-of-linezolid-n-peer-reviewed-fulltext-article-IDR
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