TY - JOUR
T1 - The clinical impact of linezolid susceptibility reporting in patients with vancomycin-resistant enterococci
AU - Scheetz, Marc H.
AU - Qi, Chao
AU - Noskin, Gary A.
AU - Warren, John R.
AU - Postelnick, Michael J.
AU - Malczynski, Michael
AU - Huang, Jie
AU - Zembower, Teresa R.
N1 - Funding Information:
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.
PY - 2006/12
Y1 - 2006/12
N2 - 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.
AB - 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.
KW - Antimicrobial resistance
KW - Linezolid
KW - Susceptibility testing
KW - Vancomycin-resistant enterococci
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U2 - 10.1016/j.diagmicrobio.2006.06.018
DO - 10.1016/j.diagmicrobio.2006.06.018
M3 - Article
C2 - 16930924
AN - SCOPUS:33845288401
VL - 56
SP - 407
EP - 413
JO - Diagnostic Microbiology and Infectious Disease
JF - Diagnostic Microbiology and Infectious Disease
SN - 0732-8893
IS - 4
ER -
