Aims: Linezolid is regarded as last-resort therapy for the treatment of vancomycin-resistant enterococci (VRE).The emergence of linezolid non-susceptible enterococci (LNSE) secondary to linezolid-resistance genes acquisition is a worldwide concern.This study aimed to determine the prevalence of LNSE, the genes associated with it, and the clinical characteristics of patients with LNSE.Methodology and results: A total of 1,350 enterococcal isolates from various clinical samples were obtained between February 2021 and February 2022.All viable, non-duplicated isolates that exhibited linezolid minimum inhibitory concentrations (MICs) 3 g/mL were investigated by polymerase chain reaction (PCR) and sequencing for the presence of cfr, cfr(B), cfr(D), optrA, and poxtA genes.The clinical characteristics of patients with LNSE infection or colonization were retrieved from the patients' records.Forty-one (3.04%) of the tested isolates were linezolid nonsusceptible, of which only 27 isolates were subjected to PCR due to non-viability or missing clinical records.The optrA gene was identified in 14/27 (51.9%) isolates, harboured by Enterococcus faecalis.The cfr, cfr(B), cfr(D) and poxtA genes were not detected.Eighteen (66.7%) patients had been treated with antibiotics other than linezolid before LNSE isolation.Other possible risk factors were recent corticosteroid therapy, co-morbidities, prior abdominal surgery, and previous hospitalization. Conclusion, significance and impact of study:The emergence of optrA-mediated LNSE in a Malaysian tertiary care hospital is concerning, necessitating adequate infection control measures and surveillance due to the potential for gene transfer between Enterococcus species.
Ali et al. (Sun,) studied this question.