title: The emerging problem of linezolid-resistant Staphylococcus.
abstract: The oxazolidinone antibiotic linezolid has demonstrated potent antimicrobial activity against Gram-positive bacterial pathogens, including methicillin-resistant staphylococci. This article systematically reviews the published literature for reports of linezolid-resistant Staphylococcus (LRS) infections to identify epidemiological, microbiological and clinical features for these infections. Linezolid remains active against >98% of Staphylococcus, with resistance identified in 0.05% of Staphylococcus aureus and 1.4% of coagulase-negative Staphylococcus (CoNS). In all reported cases, patients were treated with linezolid prior to isolation of LRS, with mean times of 20.0 ± 47.0 months for S. aureus and 11.0 ± 8.0 days for CoNS. The most common mechanisms for linezolid resistance were mutation (G2576T) to the 23S rRNA (63.5% of LRSA and 60.2% of LRCoNS) or the presence of a transmissible cfr ribosomal methyltransferase (54.5% of LRSA and 15.9% of LRCoNS). The emergence of linezolid resistance in Staphylococcus poses significant challenges to the clinical treatment of infections caused by these organisms, and in particular CoNS.
authors.affiliation: Department of Laboratory Medicine,  First Affiliated Hospital of Nanjing Medical University, Nanjing 210029,  China.
authors.forename: Bing
authors.initials: B
authors.lastname: Gu
authors.forename: Theodoros
authors.initials: T
authors.lastname: Kelesidis
authors.forename: Sotirios
authors.initials: S
authors.lastname: Tsiodras
authors.forename: Janet
authors.initials: J
authors.lastname: Hindler
authors.forename: Romney M
authors.initials: RM
authors.lastname: Humphries
mesh_terms: D000081:Acetamides / Q000494:pharmacology* / Q000627:therapeutic use*; D000818:Animals; D000890:Anti-Infective Agents / Q000494:pharmacology / Q000627:therapeutic use; D024881:Drug Resistance, Bacterial / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D000069349:Linezolid; D023303:Oxazolidinones / Q000494:pharmacology* / Q000627:therapeutic use*; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D013210:Staphylococcus / Q000187:drug effects* / Q000472:pathogenicity
chemical_list: D000081:Acetamides; D000890:Anti-Infective Agents; D023303:Oxazolidinones; D000069349:Linezolid