title: Retrospective analysis of hospital-acquired linezolid-nonsusceptible enterococci infection in Chongqing, China, 2011-2014.
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.
  
  
  CONCLUSIONS
  Timely control efforts and appropriate antibiotic stewardship programs are necessary to effectively reduce the burden of LNSE infections among high-risk patients.
authors: Department of Laboratory Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
authors: Xiaojiong
authors: X
authors: Jia
authors: Department of Laboratory Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
authors: Weijia
authors: W
authors: Ma
authors: Department of Laboratory Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
authors: Xiuyu
authors: X
authors: Xu
authors: Department of Laboratory Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
authors: Shuangshuang
authors: S
authors: Yang
authors: Department of Laboratory Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China. Electronic address: 1309898173@qq.com.
authors: Liping
authors: L
authors: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D016022:Case-Control Studies; D002681:China / Q000453:epidemiology; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology; D024881:Drug Resistance, Bacterial; D016983:Enterococcus / Q000187:drug effects* / Q000302:isolation & purification*; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology* / Q000382:microbiology; D006784:Hospitals, Teaching; D006801:Humans; D000069349:Linezolid / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D000900:Anti-Bacterial Agents; D000069349:Linezolid
keywords: Enterococci; Epidemiology; Infections; Linezolid nonsusceptible