Wednesday February 15, 2006
Linezolid-resistant enterococcus (LRE!)
This study was presented at Infectious Disease Society of America meeting 2005 from Dr. Devasia. Fifteen patients in a 500-bed teaching hospital were diagnosed with Linezolid(Zyvox)-resistant enterococcus during 13 months of study. In a comparison of these patients with 60 control patients with Linezolid-sensitive enterococcus, the resistant cases had a significantly higher mortality rate - 40% vs 7%. Interestingly, 8 LRE patients were vancomycin sensitive enterococcus but what make it thought-provoking, 8 cases out of 15 had no prior exposure to Linezolid. As expected, length of stay was way higher (35 days vs 11 days) but scary part is - median age of patients was only 54 years (vs 65 years for control).
Are younger patients more prone to LRE even without prior exposure? Are we up for another battle against microbes?. Atleast one thing is sure, its time for very judicious use of Linezolid.
To note, similar related report was published about 4 years ago in NEJM.
References: Click to get abstract/article (secondpopup override first popup)
1. Abstracts Infectious Disease Society of America Meeting 2005 - Scroll down to page 238 (abstract # 1079) - may take little time to download due to big pdf file.
2. Nosocomial Spread of Linezolid-Resistant, Vancomycin-Resistant Enterococcus faecium - NEJM, March 14, 2002 Volume 346:867-869