Clinical, Bacteriological, and Genetic Characterization of Bone and Joint Infections Involving Linezolid-Resistant Staphylococcus epidermidis: a Retrospective Multicenter Study in French Reference Centers
François Coustillères, Victor Renault, Stéphane Corvec, Céline Dupieux, Patrícia Martins-Simões, Marie Frédérique Lartigue, Chloé Plouzeau-Jayle, Didier Tandé, Claudie Lamoureux, Carole Lemarié, Rachel Chenouard, Frédéric Laurent, Adrien Lemaignen, Pascale Bémer, Marin Caubrière, Carole Lemarié, Rachel Chenouard, Amandine Vildy, Séverine Ansart, Luc Quaesaet, Éric Stindel, Didier Tandé, Claudie Lamoureux, Anaïs Grèves, David Boutoille, Raphaël Lecomte, Colin Deschanvres, Christophe Nich, Vincent Crenn, Pascale Bémer, Stéphane Corvec, Louise Ruffier d’Epenoux, C. Bourigault, Barbara Troussier, Barbara Plantard, F. Cazenave‐Roblot, G. Le Moal, P. Priès, Chloé Plouzeau-Jayle, Céline Thomas, C. Arvieux, M. Baldeyrou, Harold Common, Vincent Cattoir, Anne Méheut, Louis Bernard, Adrien Lemaignen, Marion Lacasse, Philippe Rosset, Louis‐Romée Le Nail, Marie-Frédérique Lartigue, Isabelle Laplaige
Abstract
The manuscript describes the emergence of clonal linezolid-resistant strains of Staphylococcus epidermidis (LR-MDRSE) isolated from patients presenting with bone and joint infections. Incidence of LR-MDRSE increased over the study period. All strains were highly resistant to oxazolidinones, gentamicin, clindamycin, ofloxacin, rifampicin, ceftaroline, and ceftobiprole, but were susceptible to cyclins, daptomycin, and dalbavancin. Susceptibility to delafloxacin was bimodal. The main mutation conferring linezolid resistance was the 23S rRNA G2576T mutation. All strains belonged to the sequence type ST2 or its clonal complex, and phylogenetic analysis showed emergence of five populations corresponding geographically to the centers. LR-MDRSE bone and joint infections seem to be accompanied by an overall poor prognosis related to comorbidities and therapeutic issues. Identifying patients at risk for LR-MDRSE acquisition and proposing alternatives to systematic postoperative linezolid use become essential, with a preference for parenteral drugs such as lipopeptids or lipoglycopeptids.