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   Table of Contents     
LETTER TO EDITOR  
Year : 2017  |  Volume : 9  |  Issue : 1  |  Page : 31
Linezolid-resistant Enterococcus (LRE) faecium from blood culture of an adult burns patient: First report of LRE from Mumbai


Department of Microbiology, L.T.M. Medical College, Mumbai, Maharashtra, India

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Date of Web Publication13-Feb-2017
 

How to cite this article:
Baveja SM, De AS, Talwadekar SL, Vasave RA. Linezolid-resistant Enterococcus (LRE) faecium from blood culture of an adult burns patient: First report of LRE from Mumbai. J Global Infect Dis 2017;9:31

How to cite this URL:
Baveja SM, De AS, Talwadekar SL, Vasave RA. Linezolid-resistant Enterococcus (LRE) faecium from blood culture of an adult burns patient: First report of LRE from Mumbai. J Global Infect Dis [serial online] 2017 [cited 2017 Jun 23];9:31. Available from: http://www.jgid.org/text.asp?2017/9/1/31/192963


Sir,

Linezolid is an oxazolidone antibiotic used for treating infections due to Gram-positive cocci. There have been reports of emerging linezolid resistance in complicated enterococcal infections.[1] The first report of nosocomial transmission of linezolid-resistant Enterococcus (LRE) faecium was from Mayo Clinic, USA.[2] We reported the first documented case of LRE from Mumbai.

A 36-year-old male was admitted to a tertiary care hospital in Mumbai with history of electric burns. Extensive debridement of both upper and lower limbs was done. He was started on injection meropenem and metronidazole. After 10 days of admission, the patient developed intermittent spikes of fever, and his blood was sent for culture. The blood culture grew E. faecium, resistant to both vancomycin and linezolid. Minimum inhibitory concentration (MIC) of vancomycin was >32 µg/ml and linezolid MIC >8 µg/ml. It also exhibited high-level aminoglycoside resistance.

The first and only reported case of LRE faecium from India was from Kolkata in 2015, with no history of prior linezolid medication.[3] LRE has been reported even without prior exposure, and asymptomatic colonization has also been documented.[4] A nosocomial transmission of LRE may be a possibility in our patient.

Resistance to linezolid is a matter of grave concern. Indiscriminate use of linezolid and its availability as an oral preparation may contribute to the development of resistance. Rational use of linezolid and avoiding long-term therapy with linezolid should be the objective of every treating physician. Sincere efforts are also needed for specific infection control measures for LRE.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
   References Top

1.
Scheetz MH, Knechtel SA, Malczynski M, Postelnick MJ, Qi C. Increasing incidence of linezolid-intermediate or -resistant, vancomycin-resistant Enterococcus faecium strains parallels increasing linezolid consumption. Antimicrob Agents Chemother 2008;52:2256-9.  Back to cited text no. 1
    
2.
Gonzales RD, Schreckenberger PC, Graham MB, Kelkar S, DenBesten K, Quinn JP. Infections due to vancomycin-resistant Enterococcus faecium resistant to linezolid. Lancet 2001;357:1179.  Back to cited text no. 2
    
3.
Kumar S, Bandyoapdhyay M, Chatterjee M, Mukhopadhyay P, Poddar S, Banerjee P. The first linezolid-resistant Enterococcus faecium in India: High level resistance in a patient with no previous antibiotic exposure. Avicenna J Med 2014;4:13-6.  Back to cited text no. 3
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4.
Rahim S, Pillai SK, Gold HS, Venkataraman L, Inglima K, Press RA. Linezolid-resistant, vancomycin-resistant Enterococcus faecium infection in patients without prior exposure to linezolid. Clin Infect Dis 2003;36:E146-8.  Back to cited text no. 4
    

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Correspondence Address:
Anuradha S De
Department of Microbiology, L.T.M. Medical College, Mumbai, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-777X.192963

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2008 Journal of Global Infectious Diseases | Published by Wolters Kluwer - Medknow
Online since 10th December, 2008