title: Cluster of linezolid-resistant Enterococcus faecium ST117 in Norwegian hospitals.
abstract: A linezolid-resistant, vancomycin-susceptible Enterococcus faecium strain was isolated from 3 patients who had not received linezolid. The first patient was hospitalized in the same hospitals and wards as the 2 following patients. The E. faecium isolates were resistant to linezolid (minimum inhibitory concentration 8-32 mg/l), ampicillin, and high levels of gentamicin. Resistance to linezolid was associated with a G2576T mutation in 23S rDNA. The cfr linezolid resistance gene was not detected. The 3 isolates showed identical DNA fingerprints by pulsed-field gel electrophoresis, belonged to ST117, and harboured virulence genes esp, hyl, acm, efaAfm, srgA, ecbA, scm, pilA, pilB, and pstD typically associated with high-risk E. faecium genotypes. The linezolid-resistant E. faecium high-risk clone caused bacteraemia in the first 2 cancer patients and survived in the hospital environment for more than a year before appearing in the urethral catheter of the third patient.
authors.affiliation: From the Reference Centre for Detection of Antimicrobial Resistance, Department of Microbiology and Infection Control, University Hospital of North-Norway , Tromsø
authors.forename: Kristin
authors.initials: K
authors.lastname: Hegstad
authors.forename: Jørn-Åge
authors.initials: JÅ
authors.lastname: Longva
authors.forename: Reidar
authors.initials: R
authors.lastname: Hide
authors.forename: Bettina
authors.initials: B
authors.lastname: Aasnæs
authors.forename: Tracy M
authors.initials: TM
authors.lastname: Lunde
authors.forename: Gunnar Skov
authors.initials: GS
authors.lastname: Simonsen
mesh_terms: D000081:Acetamides / Q000494:pharmacology*; D000328:Adult; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D004269:DNA, Bacterial / Q000737:chemistry / Q000235:genetics; D004275:DNA, Ribosomal / Q000737:chemistry / Q000235:genetics; D024881:Drug Resistance, Bacterial; D016521:Electrophoresis, Gel, Pulsed-Field; D016984:Enterococcus faecium / Q000145:classification* / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification*; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology* / Q000382:microbiology; D006761:Hospitals; D006801:Humans; D000069349:Linezolid; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D058889:Molecular Typing; D009664:Norway / Q000453:epidemiology; D023303:Oxazolidinones / Q000494:pharmacology*; D017354:Point Mutation; D012338:RNA, Ribosomal, 23S / Q000235:genetics; D017422:Sequence Analysis, DNA; D037521:Virulence Factors / Q000235:genetics
chemical_list: D000081:Acetamides; D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial; D004275:DNA, Ribosomal; D023303:Oxazolidinones; D012338:RNA, Ribosomal, 23S; D037521:Virulence Factors; D000069349:Linezolid
keywords: Enterococcus faecium; Linezolid resistance; ST117; Scandinavia; cluster