The first linezolid-resistant Enterococcus faecium in India: High level resistance in a patient with no previous antibiotic exposure

Linezolid provides high rates of the clinical cure and microbiological success in complicated infections due to Enterococcus spp., including vancomycin-resistant Enterococcus faecium. However, the emergence of resistance during linezolid treatment has been reported for clinical strains of Enterococcus, which is alarming given the fact that, this leaves the clinician with very few treatment options. We report the first case of linezolid resistant Enterococcus faecium from India, which was isolated from the blood culture of a hypoglycemic encephalopathy patient. There have been previous reports of linezolid resistant enterococci from different parts of the world, with minimum inhibitory concentration (MIC) ranging from 16 to 64 μg/mL and most of them were associated with vancomycin resistance but the isolate reported over here had an MIC of 1024 μg/mL and interestingly was sensitive to vancomycin.