Abstract
Introduction: Linezolid resistance among Staphylococcus aureus has emerged almost exclusively in those organisms with methicillin resistance (MRSA). To our knowledge, recovery of linezolid‐resistant (LR) methicillin‐susceptible S. aureus (MSSA) from humans has been described in only a single case. Case presentation: A 63‐year‐old Japanese man was referred for removal of an infected cardiac resynchronization device. He had received a 2‐week administration of linezolid approximately 6 months previously. LR MSSA (linezolid MIC = 8 μg ml−1) was recovered from purulent materials around the exposed generator and removed electrode leads, concurrently with linezolid‐susceptible (LS) MRSA and LS MSSA. The LR MSSA and LS MRSA demonstrated close genetic relatedness in a macrorestriction analysis and were categorized into the same molecular types (multilocus sequence type 239 and spa type t137), suggesting that they originated from an identical ancestor. The LR MSSA had a G2576T mutation in the 23S rRNA genes in two of five rrn operons. Conclusion: Linezolid resistance may occur not only among multidrug‐resistant Gram‐positive organisms but also in those for which a number of antibiotics are still effective.
Highlights
Linezolid resistance among Staphylococcus aureus has emerged almost exclusively in those organisms with methicillin resistance (MRSA)
The first oxazolidinone approved for clinical use, has often been used for treatment of infections caused by multidrug-resistant Gram-positive organisms, including methicillin-resistant Staphylococcus aureus (MRSA), methicillin-resistant coagulase-negative staphylococci and vancomycin-resistant enterococci (Diekema & Jones, 2001)
Most LR S. aureus strains have coexhibited methicillin resistance (Gu et al, 2013; Flamm et al, 2013a, b) and, to our knowledge, only a report from Spain has described the recovery of methicillin-susceptible S. aureus (MSSA) with linezolid resistance from humans (Quiles-Melero et al, 2012)
Summary
The first oxazolidinone approved for clinical use, has often been used for treatment of infections caused by multidrug-resistant Gram-positive organisms, including methicillin-resistant Staphylococcus aureus (MRSA), methicillin-resistant coagulase-negative staphylococci and vancomycin-resistant enterococci (Diekema & Jones, 2001). A 63-year-old Japanese man was referred for removal of an infected cardiac resynchronization device (CRD). He had been receiving haemodialysis caused by diabetic. At the operation for removal of the infected CRD, massive purulent matter was present around the generator. After removal of the infected CRD, the patient’s general condition rapidly improved. He was transferred to the referring hospital 7 days after the operation whilst administration of vancomycin was continued.
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