title: Emergence of cfr-harbouring coagulase-negative staphylococci among patients receiving linezolid therapy in two hospitals in China.
abstract: This study reports on the emergence of cfr-harbouring coagulase-negative staphylococci (CoNS) among patients who received linezolid therapy in two hospitals in Hangzhou, China. The mechanisms of resistance and transmission were analysed for these resistant isolates. Eight Staphylococcus capitis isolates, one Staphylococcus epidermidis isolate and one Staphylococcus hominis isolate, obtained from patients who had received linezolid therapy in two hospitals in Hangzhou, China, were confirmed as linezolid resistant, with MICs ranging from 8 to >256 mg l(-1). The linezolid usage data of the ten patients before isolation of the linezolid-resistant CoNS were collected. PFGE analysis showed that the eight S. capitis isolates from the two hospitals belonged to the same clone. Nine of the linezolid-resistant CoNS isolates carried the cfr gene, which was located on plasmids of a similar size. A 5.3 kb fragment containing the cfr gene, revealing 99 % identity to the sequence of the cfr-harbouring plasmid pSS-01 reported previously, was determined by PCR mapping for all cfr-positive isolates, and the cfr gene was flanked by two copies of IS256-like elements. Thus, these results document the emergence of linezolid-resistant CoNS isolates carrying the cfr gene in Hangzhou, China. Effective nosocomial infection control strategies and the judicious use of antibiotics will be required to prevent further spread of this resistance mechanism.
authors: Department of Clinical Laboratory, the First Affiliated Hospital, Zhejiang Chinese Medical University, 59 Youdian Road, Hangzhou, Zhejiang 310006, PR China.
authors: Xue-Jing
authors: XJ
authors: Yang
authors: Department of Infectious Diseases, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, 3 Qingchun Road, Hangzhou, Zhejiang 310016, PR China.
authors: Yan
authors: Y
authors: Chen
authors: State Key Laboratory for Diagnosis and Treatment of Infectious Disease, the First Affiliated Hospital, College of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, Zhejiang 310003, PR China.
authors: Qing
authors: Q
authors: Yang
authors: State Key Laboratory for Diagnosis and Treatment of Infectious Disease, the First Affiliated Hospital, College of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, Zhejiang 310003, PR China.
authors: Ting-Ting
authors: TT
authors: Qu
authors: Department of Infectious Diseases, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, 3 Qingchun Road, Hangzhou, Zhejiang 310016, PR China.
authors: Li-Lin
authors: LL
authors: Liu
authors: Department of Infectious Diseases, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, 3 Qingchun Road, Hangzhou, Zhejiang 310016, PR China.
authors: Hai-Ping
authors: HP
authors: Wang
authors: Department of Infectious Diseases, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, 3 Qingchun Road, Hangzhou, Zhejiang 310016, PR China.
authors: Yun-Song
authors: YS
authors: Yu
mesh_terms: D000081:Acetamides / Q000494:pharmacology*; D000368:Aged; D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000494:pharmacology*; D001426:Bacterial Proteins / Q000235:genetics* / Q000378:metabolism; D002681:China; D003030:Coagulase / Q000378:metabolism*; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics*; D006801:Humans; D000069349:Linezolid; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D008969:Molecular Sequence Data; D023303:Oxazolidinones / Q000494:pharmacology*; D010957:Plasmids / Q000235:genetics; D017422:Sequence Analysis, DNA; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000382:microbiology; D013210:Staphylococcus / Q000145:classification / Q000187:drug effects* / Q000201:enzymology / Q000302:isolation & purification; D013212:Staphylococcus epidermidis / Q000145:classification / Q000187:drug effects / Q000201:enzymology / Q000302:isolation & purification; D041181:Staphylococcus hominis / Q000145:classification / Q000187:drug effects / Q000201:enzymology / Q000302:isolation & purification
chemical_list: D000081:Acetamides; D000890:Anti-Infective Agents; D001426:Bacterial Proteins; D003030:Coagulase; D023303:Oxazolidinones; D000069349:Linezolid