First study on detection of cryptic resistance to linezolid among clinical isolates of methicillin resistant Staphylococcus aureus from India |
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| Authors: | Ayushi Tayal Narendra Pal Singh Sumit Rai Kavita Gupta Arun Gupta Aditya Nath Agarwal Rituparna Saha Iqbal Rajinder Kaur |
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| Affiliation: | 1. Department of Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India;2. Department of Renal Transplant Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India;3. Department of Parasitology, Postgraduate Institute of Medical Education and Research, Chandigarh, India;1. Department of Microbiology, Pondicherry Institute of Medical Sciences, Kalapet, Puducherry - 605014, India;2. Department of Nephrology, Sri Naryani Hospital and Research Centre, Vellore - 632255, India;3. Department of Nephrology, JIPMER, Pondicherry - 605006, India;4. Department of Microbiology, The Madras Medical Mission, 4-A, Dr, Mogappair, Chennai - 600037, Tamil Nadu, India;5. Department of Nephrology, The Madras Medical Mission, 4-A, Dr, Mogappair, Chennai - 600037, Tamil Nadu, India;1. Department of Microbiology, P D Hinduja Hospital, Mumbai, 400016, India;2. Apollo Cancer Institute, 320 Anna Salai, Chennai 600035, India;3. Department of Microbiology, Apollo Hospital, Hyderabad, Telangana, 500033, India;1. Department of Clinical Laboratory, Liaocheng People''s Hospital, No. 67, Dongchangxi Road, Dongchangfu District, Liaocheng 252000, Shandong Province, People''s Republic of China;2. Department Hepatobiliary Surgery, Liaocheng People''s Hospital, No. 67, Dongchangxi Road, Dongchangfu District, Liaocheng 252000, Shandong Province, People''s Republic of China;3. Department Pediatrics, Liaocheng People''s Hospital, No. 67, Dongchangxi Road, Dongchangfu District, Liaocheng 252000, Shandong Province, People''s Republic of China;1. Infectious Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran;2. Cellular and Molecular Research Center, Yasuj University of Medical Sciences, Yasuj, Iran;3. Department of Parasitology, School of Medicine, Yasuj University of Medical Sciences, Yasuj, Iran;4. Mahidol Oxford Tropical Medicine Research Unit, Bangkok, Thailand;5. Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK;6. Department of Parasitology and Mycology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran;1. Infectious Diseases Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran;2. Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran;3. Student Research Committee and Department of Microbiology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran |
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| Abstract: | PurposeLinezolid is an oral antibiotic which is widely used for serious infections caused by Methicillin Resistant Staphylococcus aureus (MRSA). With emergence of vancomycin MIC creep among clinical strains of MRSA, it is essential to know the possible emergence of subclinical resistance against linezolid as well. With this background, we aimed to detect evident (phenotypic) and cryptic (hidden or genotypic) linezolid resistance among MRSA isolates.Methods250 clinical isolates of MRSA were collected and their susceptibility patterns were determined. Every third MRSA isolate was subjected to PCR for domain V of the 23S rRNA for the mutation hotspot in the 746bp segment which harbors the classical mutation for linezolid resistance. Restriction Fragment Length Polymorphism was done to confirm presence of the G2576U mutation.ResultsSix isolates (2.4%) were phenotypically resistant to linezolid. Among these six LRSA isolates, 5 demonstrated the G2576U mutation by PCR – RFLP. Cryptic resistance to Linezolid was identified in two isolates among linezolid susceptible isolates.ConclusionsIn the present study, hidden resistance to linezolid was observed in linezolid susceptible clinical isolates. Emergence of resistance against over-the-counter drugs like linezolid is major challenge. Identification of cryptic resistance among patients implies impending resistance to linezolid. Judicious use of antimicrobials, application of strict infection control practices and prescription audit needs to be made mandatory to preserve such drugs. |
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| Keywords: | Linezolid resistance Classical G2576U mutation Cryptic resistance MRSA |
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