Abstract
Linezolid remains a mainstay of therapy for vancomycin-resistant enterococci (VREs), but resistance has emerged. We describe a cohort of 20 patients with linezolid-intermediate or resistant VRE (LIRVRE) reported by Etest and disk diffusion testing, 18 of whom demonstrated linezolid susceptibility by agar dilution on further investigation. Patients with reported LIRVRE were matched based on culture site and enterococcal species to patients with linezolid-susceptible VRE (LSVRE) in a 1:3 ratio. Patients with reported LIRVRE developed more nosocomial infections (P = .04), had more central lines placed (P = .04), and underwent more computed tomography scans related to VRE infection (P = .02). Multivariate analysis revealed increased surgical procedures related to VRE infections (P = .008), increased linezolid use during hospital stay (P = .03), and delayed culture and susceptibility results compared with those with LSVRE (P = .006). Therefore, inaccurate detection and reporting of LIRVRE by disk diffusion and Etest is associated with increased patient morbidity and resource use.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 407-413 |
| Number of pages | 7 |
| Journal | Diagnostic Microbiology and Infectious Disease |
| Volume | 56 |
| Issue number | 4 |
| DOIs | |
| State | Published - Dec 2006 |
Funding
This study was funded by the Feinberg School of Medicine, Northwestern University, Chicago, IL. Funding for the materials used in the PCR identification was obtained from the Department of Pathology, School of Medicine, Northwestern University Feinberg.
Keywords
- Antimicrobial resistance
- Linezolid
- Susceptibility testing
- Vancomycin-resistant enterococci
ASJC Scopus subject areas
- Microbiology (medical)
- Infectious Diseases