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Andrea T. Feßler, Noelia Calvo, Nieves Gutiérrez, Juan Luis Muñoz Bellido, Miguel Fajardo, Eugenio Garduño, Stefan Monecke, Ralf Ehricht, Kristina Kadlec, Stefan Schwarz, Cfr-mediated linezolid resistance in methicillin-resistant Staphylococcus aureus and Staphylococcus haemolyticus associated with clinical infections in humans: two case reports, Journal of Antimicrobial Chemotherapy, Volume 69, Issue 1, January 2014, Pages 268–270, https://doi.org/10.1093/jac/dkt331
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Sir,
Linezolid is a last-resort antimicrobial agent in human medicine approved for the control of serious infections caused by Gram-positive pathogens. Transferable linezolid resistance is based on the multiresistance gene cfr.1 Although originally found in staphylococci, this gene has meanwhile been reported in various Gram-positive and even Gram-negative bacteria.2 The emergence of the multiresistance gene cfr in staphylococci is of global concern.3 Here we report the detection of the cfr gene in a methicillin-resistant Staphylococcus aureus and a methicillin-resistant Staphylococcus haemolyticus strain from two clinical cases of septic shock identified in the same hospital in Spain.
Case 1
A middle-aged patient with no known underlying medical conditions was admitted to the hospital with a fever of 39°C, tachycardia, hypotension and oliguria. The abdominopelvic CT scan showed a peri-rectal and peri-anal liquid collection, which spread to the pre-sacrum and gluteal region, with air content and air–fluid levels in the peri-anal region.