2191. Characteristics of Tedizolid Non-susceptible Enterococcal Clinical Isolates
Session: Poster Abstract Session: HAI: MRSA, MSSA, and Other Gram Positives
Saturday, October 7, 2017
Room: Poster Hall CD
Posters
  • Poster 1- TRE_IDWEEK_2017-66904.pdf (337.5 kB)
  • Background: Tedizolid is a novel oxazolidinone antibiotic with activity across a broad range of gram-positive pathogens. The aim of this study was to describe the characteristics of tedizolid (TZD) resistant enterococcal clinical isolates.

    Methods: Tedizolid resistant isolates were recovered from patients at Westchester Medical Center, NY from 2012 to 2016. In vitrosusceptibility of tedizolid isolates was performed by broth microdilution using the Sensititre™ panel in accordance with the guidelines of the Clinical and Laboratory Standards Institute. The sequence type (ST) of enterococci was determined based on multilocus sequence typing (MLST) data derived from assembled next-generation sequencing.

    Results: During the study period, we identified 8 clinical isolates which were resistant to Tedizolid. Clinical characteristics, genomic, treatment and outcome data are summarized in table 1. 7/8 isolates were E. faecium belonging to a unique ST736 which predominates in our hospital. 7/8 isolates showed G2567T mutation of 23S rRNA. Only one patient had prior reciept of Linezolid. None of the patients had recieved Tedizolid in past.

    Date

    Site

    Sequence type

    Prior Linezolid use

    MIC mg/L

    Treatment

    Outcome

    LIN

    TZD

    DAP

    VAN

    62/F

    2012

    Urine

    736

    No

    8

    1

    16

    1

    NA

    -

    59/F

    2013

    Peritoneum

    736

    Yes

    8

    2

    6

    >16

    DAP x 14 d

    Cure

    61/F

    2013

    Blood

    NA

    No

    >8

    2

    4

    2

    Tigecycline x 4 d + Doxycycline x 10 d

    Cure

    80/M

    2015

    Urine

    736

    No

    16

    1

    2

    >16

    DAP x 7 d

    Cure

    47/F

    2015

    Urine

    736

    No

    8

    1

    4

    >16

    DAP x 21 d

    Cure

    72/F

    2015

    Urine

    736

    No

    8

    1

    8

    >16

    NA

    -

    75/M

    2015

    Urine

    736

    No

    8

    2

    4

    >16

    NA

    -

    60/F

    2016

    Peritoneum

    736

    No

    16

    2

    3

    >16

    DAP x 21 d

    Cure

    Conclusion: There is de-novo emergence of Tedizolid resistant enterococcal isolates. This along with higher incidence daptomycin non-susceptibility in our institution is of significant concern. This highlights the need for further improvement in infection control practices and newer options for the treatment of enterococcal infections.

    Abhay Dhand, M.D, Transplant Infectious Diseases, Westchester Medical Center, Valhalla, NY, Leslie Lee, PharmD, Westchester Medical Center, Valhalla, NY, Stephen Lobo, MD, Medicine, Westchester Medical Center/New York Medical College, Valhalla, NY and Guiqing Wang, MD/PhD, Pathology and Clinical Laboratories, Westchester Medical Center, Valhalla, NY

    Disclosures:

    A. Dhand, Merck, Pfizer, Allergan: Speaker's Bureau , Speaker honorarium
    Astellas: Consultant , Consulting fee

    L. Lee, None

    S. Lobo, None

    G. Wang, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 4th with the exception of research findings presented at the IDWeek press conferences.