Linezolid-Resistant VREF Identified Reuters Health April 16, 2001 Westport, Ct (Reuters Health) April 16 - Vancomycin-resistant Enterococcus faecium (VREF) appears capable of developing resistance to the new synthetic oxazolidinione antibiotic linezolid, according to a report published in the April 14th issue of the Lancet. Dr. John P. Quinn, from the University of Illinois College of Medicine, in Chicago, and colleagues describe five patients who were treated with linezolid for VREF. One patient had VREF bacteremia due to an aortic graft infection that occurred after aneurysm repair. After linezolid treatment for 3 weeks, VREF that was intermediately resistant to linezolid was isolated. The antibiotic regimen was changed to quinupristin-dalfopristin and doxycycline, but the patient died 9 weeks later of uncertain causes. The remaining four patients were transplant recipients who received linezolid for at least 4 weeks after VREF was isolate. Linezolid-resistant VREF was subsequently isolated in all cases and one patient who was changed to quinupristin-dalfopristin died after developing multiorgan failure. The researchers report that 2.2% of patients treated with linezolid for VREF at their centers developed linezolid-resistant organisms. "We encourage clinicians using linezolid for VRE infections to measure susceptibility of all isolates at the start of therapy," the authors emphasize. "Attention to proper dosing and prompt removal of infected devices, when feasible, could limit emergence of resistance." Back to Main Index Page