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Journal of Microbes and Infection, September 2009, Vol. 4, No. 3 Advances in mechanisms of bacterial resistance to linezolid and
related detection methods

1. No. 263 Hospital of Chinese People s Liberation Army, Beijing 101149, China; 2. Dalian Medical University, Abstract: Linezolid is an antibacterial belonging to the oxazolidinone class of antibiotics. The importance of linezolid
as an antibiotic is related to its activity against a number of clinically significant Gram-positive cocci, including
multidrug-resistant staphylococci and vancomycin-resistant enterococci. Although bacterial resistance to linezolid is not a major issue at present, its development in clinical isolates should be paid more attention. In this article, the mechanisms of bacterial resistance to linezolid, and related detection methods were reviewed. We showed that bacterial resistance is mediated by a single-nucleotide mutation and the production of methyltransferase, however, other potential mechanisms have not yet been determined. The detection methods for linezolid resistance include microbiological and molecular biological methods, some of which would benefit from technological improvements.
Key words: Linezolid; Resistance; Oxazolidinone; Bacteria
( methicillin-resistant Staphylococcus aureus, MRSA) ( vancomycin-resistant enterococci, Corresponding author: XIA Meng-Y an, E-mail: Yixmy@ 126. com Journal of Microbes and Infection, September 2009, Vol. 4, No. 3 ( chloramphenicol-florfenicol resistance, Journal of Microbes and Infection, September 2009, Vol. 4, No. 3 [ 1] Mutnick AH, Enne V, Jones RN. Linezolid resistance since 2001: Sentry antimicrobial surveillance program [ J] . Ann Pharmacother, 2003, 37( 6) : 769-774 dependence of emergence of resistance to linezolid in Enterococcus faecalis in vivo[ J] . J Infect Dis, 2007, 195 [ 3] Potoski BA, Adams J, Clarke L, et al. Epidemiological Staphylococci[ J] . Clin Infect Dis, 2006, 43( 3) : 165-171 [ 4] Hillemann D, R sch-Gerdes S, Richter E.
selected linezolid-resistant Mycobacterium mutants [ J] .
Antimicrob Agents Chemother, 2008, 52( 2) : 800-801 [ 5] Ruggero KA, Schroeder LK, Schreckenberger PC, et al.
Nosocomial superinfections due to linezolid-resistant Enterococcus faecalis: evidence for a gene dosage effect Journal of Microbes and Infection, September 2009, Vol. 4, No. 3 on linezolid MICs[ J] . Diagn Microbiol Infect Dis, 2003, against Staphylococci and Enterrococci [ J ] .
[ 6] Tsiodras S, Gold HS, Sakoulas G, et al.
[ 11] Marshall SH, Donskey CJ, Hutton-Thomas R, et al.
resistance in a clinical isolate of Staphylococcus aureus Gene dosage and linezolid resistance in Enterococcus [ J] . Lancet, 2001, 358( 9277) : 207-208 faecium and Enterococcus faecalis[ J] . Antimicrob Agents Chemother, 2002, 46( 10) : 3334-3336.
resistance in sequential Staphylococcus aureus isolated [ 12] Qi C, Zheng X, Obtas A, et al. Comparision of testing associated with a T2500A mutation in the 23S rRNA methods for detection of decreased linezolid susceptibility gene and loss of a single copy of rRNA [ J] . J Infect due to G2576T mutation of the 23S rRNA gene in Enterococcus faecium and Enterococcus faecalis[ J] . J [ 8] Arias CA, Vallejo M, Reyes J, et al. Clinical and microbiological aspects of linezolid resistance mediated by the cfr gene encoding a 23S rRNA methyltransferase [ J] . J Clin Microbiol, 2008, 46( 3) : 892-896 Enterococcus spp. by fluorescence in situ hybridization [ 9] Elvira R, Sabine RG, Doris H. First linezolid-resistant [ J] . J Clin Microbiol, 2007, 45( 10) : 3421-3423 clinical isolates of Mycobacterium tuberculosis [ J ] .
[ 14] Werner G, Strornmenger B, Klare I, et al. Molecular Antimicrobial Agents Chemother, 2007, 51 ( 4 ) : 1534- detection of linezolid resistance in Enterococcus faecium and Enterococcus faecalis by use of 5 nuclease real-time [ 10] Fred CT, Portia PW, Sheila S, et al. Accuracy of six PCR compared to a modified classical approach[ J] . J antimicrobial susceptibility methods for testing linezolid Clin Microbiol, 2004, 42( 11) : 5327-5331 : http: / / www. ncbi. nlm. gov /Genbank /

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Th is order was filed under Su prem e C ourtRu le 23 and may not be cited as precedentby any p arty e xce pt in t h e limitedcircumstances allowed under Rule 23(e )(1). _________________________________________________________________JUSTICE POPE delivered the judgment of the court. Presiding Justice Knecht and Justice Steigmann(1) Stipulation was not tantamount to a guilty plearequiring that

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