Abstract
Linezolid is currently used to treat infections caused by multidrug-resistant Gram-positive cocci. Both linezolid-resistant S. aureus (LRSA) and coagulase-negative staphylococci (CoNS) strains have been collected worldwide. Two isolates carrying linezolid resistance genes were recovered from laryngological patients and characterized by determining their antimicrobial resistance patterns and using molecular methods such as spa typing, MLST, SCCmec typing, detection of virulence genes and ica operon expression, and analysis of antimicrobial resistance determinants. Both isolates were multidrug resistant, including resistance to methicillin. The S. aureus strain was identified as ST-398/t4474/SCCmec IVe, harboring adhesin, hemolysin genes, and the ica operon. The S. haemolyticus strain was identified as ST-42/mecA-positive and harbored hemolysin genes. Linezolid resistance in S. aureus strain was associated with the mutations in the ribosomal proteins L3 and L4, and in S. haemolyticus, resistance was associated with the presence of cfr gene. Moreover, S. aureus strain harbored optrA and poxtA genes. We identified the first case of staphylococci carrying linezolid resistance genes from patients with chronic sinusitis in Poland. Since both S. aureus and CoNS are the most common etiological factors in laryngological infections, monitoring of such infections combined with surveillance and infection prevention programs is important to decrease the number of linezolid-resistant staphylococcal strains.
Highlights
The first oxazolidinone antimicrobial approved in clinical practice, is currently used to treat infections caused by Gram-positive cocci, especially methicillin-resistant
The patient was referred for functional endoscopic sinus surgery (FESS)
The linezolid resistance can emerge in coagulase-negative staphylococci (CoNS) after only a few days of treatment and in S. aureus strains, it usually occurs after a long time after the treatment [18]
Summary
The first oxazolidinone antimicrobial approved in clinical practice, is currently used to treat infections caused by Gram-positive cocci, especially methicillin-resistantStaphylococcus aureus (MRSA) and vancomycin-resistant enterococci [1]. The first oxazolidinone antimicrobial approved in clinical practice, is currently used to treat infections caused by Gram-positive cocci, especially methicillin-resistant. The first linezolidresistant S. aureus (LRSA) strain was detected in 2001 [2]. S. aureus strains have been collected worldwide, but most of them are related to (i) severe diseases such as cystic fibrosis [3,4], (ii) ICU patients [5,6] or (iii) chronic infections with long-term linezolid treatments [7]. Have S. aureus linezolid-resistant strains been reported, but increasing linezolid resistance in coagulase-negative staphylococci (CoNS). The first linezolid-resistant S. haemolyticus (LRSH) strain was reported by Rodríguez-Aranda et al in 2009 [8].
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