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Clinical outbreak of LRSA reported in Spain
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An outbreak in Spain among 12 patients in an intensive care unit has been described as linezolid-resistant Staphylococcus aureus, according to recently released findings.
Miguel Sanchez Garcia, MD, PhD, and colleagues from the Hospital Clinicio San Carlos and Universidad Complutense conducted a study of critically ill patients who were colonized or infected with linezolid-resistant Staphylococcus aureus (LRSA).
The researchers screened the environment and the hands of health care workers and noted that between April 13 and June 26, 2008, 12 patients were diagnosed with LRSA. Half of the patients experienced ventilator-associated pneumonia and one-quarter of the patients developed bacteremia due to LRSA. Linezolid resistance was linked to the Cfr gene in all of the patients.
Garcia and colleagues determined that the potential hospital staff carriers and environmental factors did not cause LRSA in 11 of 12 patients. The researchers said the widespread use of linezolid was responsible for the outbreak. They added that the successful early control of the outbreak was due to the institution of more rigorous infection-control measures and the reduction of the use of linezolid.
Methicillin-resistant Staphylococcus aureus has become prevalent in the Hospital Clinicio San Carlos in Madrid, with a mean cumulative incidence of seven of every 1,000 patients admitted reporting MRSA, according to study researchers. However, options for treating severe cases of MRSA are limited. Linezolid is often used in critical care because of its antimicrobial spectrum, favorable short-term safety profile, pharmacokinetics/pharmacodynamics and effectiveness.
However, the widespread use of linezolid in hospitals rapidly decreased from 202 defined daily doses in 2008 to 25 defined daily doses in July 2008. Furthermore, between July 2008 and April 2010, there have not been any new cases identified in the weekly surveillance cultures or diagnostic samples, the researchers said.
Sánchez García M. JAMA. 2010; 303:2260-2264.