Retrospective analysis of hospital-acquired linezolid-nonsusceptible enterococci infection in Chongqing, China, 2011-2014

Am J Infect Control. 2015 Dec 1;43(12):e101-6. doi: 10.1016/j.ajic.2015.07.027. Epub 2015 Aug 25.

Abstract

Background: Linezolid-nonsusceptible enterococci (LNSE) is an increasingly emerging multidrug-resistant pathogen, and the caused nosocomial infections are difficult to manage. However, data on the host-related risk factors and clinical outcomes for LNSE infection are poorly characterized.

Methods: A retrospective case-case-control study of risk factors and clinical outcomes of hospitalized patients with LNSE infection during the period 2011-2014 was conducted in a teaching hospital in Chongqing, China. Case patients with LNSE and those with linezolid-susceptible enterococci (LSE) and controls with no enterococcal infection were compared at a ratio of 1:1:4. Two parallel multivariate logistic regression models were used to evaluate independent predictors for acquiring LNSE and LSE, respectively.

Results: Forty-four LNSE cases, 44 LSE cases, and 176 uninfected controls were analyzed. Multivariable analysis indicated that transferring from another hospital (odds ratio [OR], 3.57; 95% confidence interval [CI], 1.58-8.09), peripheral vascular disease (OR, 4.36; 95% CI, 1.64-11.60), and exposure to cephalosporins (OR, 4.24; 95% CI, 1.85-9.71) were unique independent predictors for acquiring LNSE. Gallbladder disease (OR, 3.64; 95% CI, 1.36-9.74) was independently associated with LSE acquisition. Polymicrobial infection was the only factor identified in both LNSE and LSE groups compared with controls; however, no statistical significance was observed in in-hospital mortality.

Conclusion: Timely control efforts and appropriate antibiotic stewardship programs are necessary to effectively reduce the burden of LNSE infections among high-risk patients.

Keywords: Enterococci; Epidemiology; Infections; Linezolid nonsusceptible.

MeSH terms

  • Adult
  • Aged
  • Anti-Bacterial Agents / pharmacology*
  • Case-Control Studies
  • China / epidemiology
  • Cross Infection / epidemiology*
  • Cross Infection / microbiology
  • Drug Resistance, Bacterial*
  • Enterococcus / drug effects*
  • Enterococcus / isolation & purification*
  • Female
  • Gram-Positive Bacterial Infections / epidemiology*
  • Gram-Positive Bacterial Infections / microbiology
  • Hospitals, Teaching
  • Humans
  • Linezolid / pharmacology*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Risk Factors

Substances

  • Anti-Bacterial Agents
  • Linezolid