Incidence, management and outcomes of the first cfr-mediated linezolid-resistant Staphylococcus epidermidis outbreak in a tertiary referral centre in the Republic of Ireland.

Hdl Handle:
http://hdl.handle.net/10147/583470
Title:
Incidence, management and outcomes of the first cfr-mediated linezolid-resistant Staphylococcus epidermidis outbreak in a tertiary referral centre in the Republic of Ireland.
Authors:
O'Connor, C; Powell, J; Finnegan, C; O'Gorman, A; Barrett, S; Hopkins, K L; Pichon, B; Hill, R; Power, L; Woodford, N; Coffey, J C; Kearns, A; O'Connell, N H; Dunne, C P
Citation:
Incidence, management and outcomes of the first cfr-mediated linezolid-resistant Staphylococcus epidermidis outbreak in a tertiary referral centre in the Republic of Ireland. 2015, 90 (4):316-21 J. Hosp. Infect.
Publisher:
The Journal of hospital infection
Journal:
The Journal of hospital infection
Issue Date:
Aug-2015
URI:
http://hdl.handle.net/10147/583470
DOI:
10.1016/j.jhin.2014.12.013
PubMed ID:
25648941
Abstract:
To report the first Irish outbreak of cfr-mediated linezolid-resistant Staphylococcus epidermidis.; Linezolid-resistant S. epidermidis isolated at University Hospital Limerick from four blood cultures, one wound and four screening swabs (from nine patients) between April and June 2013 were characterized by pulsed-field gel electrophoresis (PFGE), multi-locus sequence typing (MLST) and staphylococcal cassette chromosome (SCCmec) typing. Antibiotic susceptibilities were determined according to the guidelines of the British Society for Antimicrobial Chemotherapy. The outbreak was controlled through prohibiting prescription and use of linezolid, adherence to infection prevention and control practices, enhanced environmental cleaning, isolation of affected patients, and hospital-wide education programmes.; PFGE showed that all nine isolates represented a single clonal strain. MLST showed that they belonged to ST2, and SCCmec typing showed that they encoded a variant of SCCmecIII. All nine isolates were cfr positive, and eight isolates were positive for the G2576T 23S rRNA mutation commonly associated with linezolid resistance. Isolates exhibited multiple antibiotic resistances (i.e. linezolid, gentamicin, methicillin, clindamycin, ciprofloxacin, fusidic acid and rifampicin). The adopted infection prevention intervention was effective, and the outbreak was limited to the affected intensive care unit.; This is the first documented outbreak of cfr-mediated linezolid-resistant S. epidermidis in the Republic of Ireland. Despite this, and due to existing outbreak management protocols, the responsible micro-organism and source were identified efficiently. However, it became apparent that staff knowledge of antimicrobial susceptibilities and appropriate hygiene practices were suboptimal at the time of the outbreak, and that educational interventions (and re-inforcement) are necessary to avoid occurrence of antimicrobial resistance and outbreaks such as reported here.
Item Type:
Article
Language:
en
Description:
To report the first Irish outbreak of cfr-mediated linezolid-resistant Staphylococcus epidermidis
Keywords:
COMMUNICABLE DISEASE; INFECTION CONTROL
ISSN:
1532-2939

Full metadata record

DC FieldValue Language
dc.contributor.authorO'Connor, Cen
dc.contributor.authorPowell, Jen
dc.contributor.authorFinnegan, Cen
dc.contributor.authorO'Gorman, Aen
dc.contributor.authorBarrett, Sen
dc.contributor.authorHopkins, K Len
dc.contributor.authorPichon, Ben
dc.contributor.authorHill, Ren
dc.contributor.authorPower, Len
dc.contributor.authorWoodford, Nen
dc.contributor.authorCoffey, J Cen
dc.contributor.authorKearns, Aen
dc.contributor.authorO'Connell, N Hen
dc.contributor.authorDunne, C Pen
dc.date.accessioned2015-12-09T12:36:55Zen
dc.date.available2015-12-09T12:36:55Zen
dc.date.issued2015-08en
dc.identifier.citationIncidence, management and outcomes of the first cfr-mediated linezolid-resistant Staphylococcus epidermidis outbreak in a tertiary referral centre in the Republic of Ireland. 2015, 90 (4):316-21 J. Hosp. Infect.en
dc.identifier.issn1532-2939en
dc.identifier.pmid25648941en
dc.identifier.doi10.1016/j.jhin.2014.12.013en
dc.identifier.urihttp://hdl.handle.net/10147/583470en
dc.descriptionTo report the first Irish outbreak of cfr-mediated linezolid-resistant Staphylococcus epidermidisen
dc.description.abstractTo report the first Irish outbreak of cfr-mediated linezolid-resistant Staphylococcus epidermidis.en
dc.description.abstractLinezolid-resistant S. epidermidis isolated at University Hospital Limerick from four blood cultures, one wound and four screening swabs (from nine patients) between April and June 2013 were characterized by pulsed-field gel electrophoresis (PFGE), multi-locus sequence typing (MLST) and staphylococcal cassette chromosome (SCCmec) typing. Antibiotic susceptibilities were determined according to the guidelines of the British Society for Antimicrobial Chemotherapy. The outbreak was controlled through prohibiting prescription and use of linezolid, adherence to infection prevention and control practices, enhanced environmental cleaning, isolation of affected patients, and hospital-wide education programmes.en
dc.description.abstractPFGE showed that all nine isolates represented a single clonal strain. MLST showed that they belonged to ST2, and SCCmec typing showed that they encoded a variant of SCCmecIII. All nine isolates were cfr positive, and eight isolates were positive for the G2576T 23S rRNA mutation commonly associated with linezolid resistance. Isolates exhibited multiple antibiotic resistances (i.e. linezolid, gentamicin, methicillin, clindamycin, ciprofloxacin, fusidic acid and rifampicin). The adopted infection prevention intervention was effective, and the outbreak was limited to the affected intensive care unit.en
dc.description.abstractThis is the first documented outbreak of cfr-mediated linezolid-resistant S. epidermidis in the Republic of Ireland. Despite this, and due to existing outbreak management protocols, the responsible micro-organism and source were identified efficiently. However, it became apparent that staff knowledge of antimicrobial susceptibilities and appropriate hygiene practices were suboptimal at the time of the outbreak, and that educational interventions (and re-inforcement) are necessary to avoid occurrence of antimicrobial resistance and outbreaks such as reported here.en
dc.language.isoenen
dc.publisherThe Journal of hospital infectionen
dc.rightsArchived with thanks to The Journal of hospital infectionen
dc.subjectCOMMUNICABLE DISEASEen
dc.subjectINFECTION CONTROLen
dc.titleIncidence, management and outcomes of the first cfr-mediated linezolid-resistant Staphylococcus epidermidis outbreak in a tertiary referral centre in the Republic of Ireland.en
dc.typeArticleen
dc.identifier.journalThe Journal of hospital infectionen

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