Linezolid-and vancomycin-resistant enterococcus faecium in solid organ transplant recipients: Infection control and antimicrobial stewardship using whole genome sequencing

Vista sencilla de ítem
dc.contributor.authorAbbo, Lilian
dc.contributor.authorShukla, Bhavarth S.
dc.contributor.authorGiles, Amber
dc.contributor.authorAragon, Laura
dc.contributor.authorJimenez, Adriana
dc.contributor.authorCamargo, Jose F.
dc.contributor.authorSimkins, Jacques
dc.contributor.authorSposato, Kathleen
dc.contributor.authorTran, Truc T.
dc.contributor.authorDiaz, Lorena
dc.contributor.authorReyes, Jinnethe
dc.contributor.authorRios, Rafael
dc.contributor.authorCarvajal Ortiz, Lina Paola
dc.contributor.authorCardozo, Javier
dc.contributor.authorRuiz, Maribel
dc.contributor.authorRosello, Gemma
dc.contributor.authorPerez Cardona, Armando
dc.contributor.authorMartinez, Octavio
dc.contributor.authorGuerra, Giselle
dc.contributor.authorBeduschi, Thiago
dc.contributor.authorVianna, Rodrigo
dc.contributor.authorArias, Cesar A.
dc.contributor.orcidCarvajal Ortiz, Lina Paola [0000-0001-8301-8836]
dc.date.accessioned2020-05-13T20:53:53Z
dc.date.available2020-05-13T20:53:53Z
dc.date.issued2019
dc.description.abstractenglishBackground Vancomycin-resistant enterococci are an important cause of healthcare-associated infections and are inherently resistant to many commonly used antibiotics. Linezolid is the only drug currently approved by the US Food and Drug Administration to treat vancomycin-resistant enterococci; however, resistance to this antibiotic appears to be increasing. Although outbreaks of linezolid- and vancomycin-resistant Enterococcus faecium (LR-VRE) in solid organ transplant recipients remain uncommon, they represent a major challenge for infection control and hospital epidemiology. Methods We describe a cluster of 4 LR-VRE infections among a group of liver and multivisceral transplant recipients in a single intensive care unit. Failure of treatment with linezolid in 2 cases led to a review of standard clinical laboratory methods for susceptibility determination. Testing by alternative methods including whole genome sequencing (WGS) and a comprehensive outbreak investigation including sampling of staff members and surfaces was performed. Results Review of laboratory testing methods revealed a limitation in the VITEK 2 system with regard to reporting resistance to linezolid. Linezolid resistance in all cases was confirmed by E-test method. The use of WGS identified a resistant subpopulation with the G2376C mutation in the 23S ribosomal RNA. Sampling of staff members’ dominant hands as well as sampling of surfaces in the unit identified no contaminated sources for transmission. Conclusions This cluster of LR-VRE in transplant recipients highlights the possible shortcomings of standard microbiology laboratory methods and underscores the importance of WGS to identify resistance mechanisms that can inform patient care, as well as infection control and antibiotic stewardship measures.eng
dc.format.mimetypeapplication/pdf
dc.identifier.doihttps://doi.org/10.1093/cid/ciy903
dc.identifier.issn1537-6591
dc.identifier.urihttps://hdl.handle.net/20.500.12495/2721
dc.language.isoeng
dc.publisherOxford University Pressspa
dc.publisher.journalClinical Infectious Diseasesspa
dc.relation.ispartofseriesClinical Infectious Diseases, 1537-6591, Vol 69, Num 2, 2019, pag 259–265spa
dc.relation.urihttps://academic.oup.com/cid/article-abstract/69/2/259/5136442?redirectedFrom=fulltext
dc.rights.creativecommons2019
dc.rights.localAcceso cerradospa
dc.subject.decsLinezolidspa
dc.subject.decsTrasplante de órganosspa
dc.subject.decsInfeccionesspa
dc.subject.keywordsLinezolid resistancespa
dc.subject.keywordsE faeciumspa
dc.subject.keywordsOrgan transplantspa
dc.subject.keywordsInfection controlspa
dc.subject.keywordsWhole genome sequencingspa
dc.titleLinezolid-and vancomycin-resistant enterococcus faecium in solid organ transplant recipients: Infection control and antimicrobial stewardship using whole genome sequencingspa
dc.title.translatedLinezolid-and vancomycin-resistant enterococcus faecium in solid organ transplant recipients: Infection control and antimicrobial stewardship using whole genome sequencingspa
dc.typearticlespa
dc.type.hasversioninfo:eu-repo/semantics/publishedVersion
dc.type.localartículospa

Archivos

Colecciones

Artículos