The clinical impact of linezolid susceptibility reporting in patients with vancomycin-resistant enterococci

Marc H. Scheetz*, Chao Qi, Gary A Noskin, John R. Warren, Michael J. Postelnick, Michael Malczynski, Jie Huang, Teresa R Zembower

*Corresponding author for this work

Research output: Contribution to journalArticle

8 Scopus citations

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 languageEnglish (US)
Pages (from-to)407-413
Number of pages7
JournalDiagnostic Microbiology and Infectious Disease
Volume56
Issue number4
DOIs
StatePublished - Dec 1 2006

Keywords

  • Antimicrobial resistance
  • Linezolid
  • Susceptibility testing
  • Vancomycin-resistant enterococci

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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