Retrospective analysis of hospital-acquired linezolid-nonsusceptible enterococci infection in Chongqing, China, 2011-2014

• Published in: American journal of infection control 2015-12, Vol.43 (12), p.e101-e106
• Main Authors: Jia, Xiaojiong, MS, Ma, Weijia, MS, Xu, Xiuyu, MD, Yang, Shuangshuang, MS, Zhang, Liping, MD, PhD
• Format: Article
• Language: English
• Subjects: Adult; Aged; Anti-Bacterial Agents - pharmacology; Case-Control Studies; China - epidemiology; Cross Infection - epidemiology; Cross Infection - microbiology; Drug Resistance, Bacterial; Enterococci; Enterococcus - drug effects; Enterococcus - isolation & purification; Epidemiology; Female; Gram-Positive Bacterial Infections - epidemiology; Gram-Positive Bacterial Infections - microbiology; Hospitals, Teaching; Humans; Infection Control; Infections; Infectious Disease; Linezolid - pharmacology; Linezolid nonsusceptible; Male; Middle Aged; Retrospective Studies; Risk Factors
• ISSN: 0196-6553; 1527-3296
• DOI: 10.1016/j.ajic.2015.07.027

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. Conclusion Timely control efforts and appropriate antibiotic stewardship programs are necessary to effectively reduce the burden of LNSE infections among high-risk patients.