Clinical and Microbiological Aspects of Linezolid Resistance Mediated by the cfr Gene Encoding a 23S rRNA Methyltransferase

The cfr (chloramphenicol-florfenicol resistance) gene encodes a 23S rRNA methyltransferase that confers resistance to linezolid. Detection of linezolid resistance was evaluated in the first cfr-carrying human hospital isolate of linezolid and methicillin-resistant Staphylococcus aureus (designated M...

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Bibliographic Details
Published in:Journal of Clinical Microbiology 2008-03, Vol.46 (3), p.892-896
Main Authors: Arias, Cesar A, Vallejo, Martha, Reyes, Jinnethe, Panesso, Diana, Moreno, Jaime, Castañeda, Elizabeth, Villegas, Maria V, Murray, Barbara E, Quinn, John P
Format: Article
Language:English
Subjects:
Acetamides - pharmacology
Anti-Bacterial Agents - pharmacology
Bacterial Proteins - genetics
Bacteriology
Biological and medical sciences
Chloramphenicol - pharmacology
Colombia - epidemiology
Contact Tracing
Cross Infection - epidemiology
Cross Infection - microbiology
Drug Resistance, Bacterial - genetics
Family Characteristics
Fatal Outcome
Female
Fundamental and applied biological sciences. Psychology
Genetics
Humans
Linezolid
Methicillin Resistance
Methyltransferases - genetics
Microbial Sensitivity Tests
Microbiology
Middle Aged
Oxazolidinones - pharmacology
RNA, Ribosomal, 23S - genetics
Staphylococcal Infections - epidemiology
Staphylococcal Infections - microbiology
Staphylococcus aureus
Staphylococcus aureus - classification
Staphylococcus aureus - drug effects
Staphylococcus aureus - genetics
Staphylococcus aureus - isolation & purification
Thiamphenicol - analogs & derivatives
Thiamphenicol - pharmacology
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Summary:The cfr (chloramphenicol-florfenicol resistance) gene encodes a 23S rRNA methyltransferase that confers resistance to linezolid. Detection of linezolid resistance was evaluated in the first cfr-carrying human hospital isolate of linezolid and methicillin-resistant Staphylococcus aureus (designated MRSA CM-05) by dilution and diffusion methods (including Etest). The presence of cfr was investigated in isolates of staphylococci colonizing the patient's household contacts and clinical isolates recovered from patients in the same unit where MRSA CM-05 was isolated. Additionally, 68 chloramphenicol-resistant Colombian MRSA isolates recovered from hospitals between 2001 and 2004 were screened for the presence of the cfr gene. In addition to erm(B), the erm(A) gene was also detected in CM-05. The isolate belonged to sequence type 5 and carried staphylococcal chromosomal cassette mec type I. We were unable to detect the cfr gene in any of the human staphylococci screened (either clinical or colonizing isolates). Agar and broth dilution methods detected linezolid resistance in CM-05. However, the Etest and disk diffusion methods failed to detect resistance after 24 h of incubation. Oxazolidinone resistance mediated by the cfr gene is rare, and acquisition by a human isolate appears to be a recent event in Colombia. The detection of cfr-mediated linezolid resistance might be compromised by the use of the disk diffusion or Etest method.
ISSN:0095-1137
1098-660X
1098-5530
DOI:10.1128/JCM.01886-07