title: Investigation of mechanism and molecular epidemiology of linezolid-resistant Enterococcus faecalis in China.
abstract: Enterococcus is a major cause of important nosocomial infections. Linezolid, the first member of an entirely new class of antibiotics (oxazolidinones), is effective against serious infections caused by Enterococcus. However, resistance to linezolid has been discovered throughout the world rapidly. From 2011 to 2013, nine linezolid-resistant E. faecalis isolates were collected and the possible mechanisms of linezolid resistance, including mutations in domain V of 23S rRNA genes and in ribosomal proteins L3 and L4, and the multiresistance gene cfr, were investigated. Furthermore, an epidemiological survey of the nine linezolid-resistant E. faecalis isolates was performed by pulsed field gel electrophoresis (PFGE), multilocus sequence typing (MLST) and DiversiLab. The three methods were compared to evaluate their merits and demerits, respectively. We failed to find the resistance mechanisms that have been revealed in recent years by PCR and sequencing analysis in the linezolid-resistant E. faecalis. Epidemiological investigation suggested that a small-scale outbreak of linezolid-resistant E. faecalis emerged in neurosurgery ICU from March to May of 2013. DiversiLab was a reliable typing tool and a suitable alternative to PFGE because it was as discriminatory as PFGE and better than MLST.
authors.affiliation: Department of Clinical Laboratory, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Lipeng
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Clinical Laboratory, Chongqing Zhongshan Hospital, Chongqing, China.
authors.forename: Yunyan
authors.initials: Y
authors.lastname: He
authors.affiliation: Department of Clinical Laboratory, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China. Electronic address: xiayun12cn@aliyun.com.
authors.forename: Yun
authors.initials: Y
authors.lastname: Xia
authors.affiliation: Department of Clinical Laboratory, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Huijuan
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Clinical Laboratory, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Shumei
authors.initials: S
authors.lastname: Liang
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002681:China / Q000453:epidemiology; D003428:Cross Infection; D024881:Drug Resistance, Bacterial / Q000235:genetics; D016521:Electrophoresis, Gel, Pulsed-Field; D013293:Enterococcus faecalis / Q000145:classification / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D005798:Genes, Bacterial; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology* / Q000382:microbiology*; D006801:Humans; D000069349:Linezolid / Q000494:pharmacology*; D008826:Microbial Sensitivity Tests; D058885:Multilocus Sequence Typing; D009154:Mutation
chemical_list: D000900:Anti-Bacterial Agents; D000069349:Linezolid
keywords: DiversiLab; Enterococcus faecalis; Linezolid; Multilocus sequence typing; Pulsed field gel electrophoresis; Resistance