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VOLUME 13 | ISSUE 3
Anderson are resistant to linezolid; the clinical significance of this rate of 5.5% in 2009. Patients with linezolid-resistant S. epidermidis
finding was unknown. The objective of Dr. Folan’s study was to tended to have worse short-term clinical outcomes as defined by
assess short-term clinical outcomes in adult leukemia patients with the investigators’ composite endpoint compared to those with
linezolid-resistant S. epidermidis bloodstream infections treated linezolid-sensitive organisms (60.7% versus 34.7%, p = 0.022). No
empirically with linezolid. This retrospective, single-center cohort differences existed between groups based on the individual compo-
study included patients ≥18 years old with a primary diagnosis nents of the composite endpoint, with the exception of persistent
of leukemia who had at least one blood culture positive for S. bacteremia (36.4% versus 8.2%, p = 0.009). In addition, linezolid
epidermidis between June 2013 and July 2015 and for whom resistance was associated with a significantly longer median time
linezolid therapy was initiated within 1 day of the first positive to discharge. The study demonstrated that patients with a linezol-
blood culture. id-resistant S. epidermidis bloodstream infection treated empir-
ically with linezolid had significantly worse short-term clinical
The primary endpoint was a composite of short-term outcomes outcomes, primarily because of persistent bacteremia, as compared
on day 3 including persistent fever (> 38° C), persistent S. epider- to patients with linezolid-susceptible isolates. Long-term morbid-
midis bacteremia, intensive care unit admission, and death from ity is being assessed, and the results from Dr. Folan’s study will be
any cause. Secondary endpoints evaluated were individual compo- used to discuss comprehensive treatment for leukemia patients
nents of the primary outcome, time to blood culture clearance, and with febrile neutropenia and gram positive bacteremia in light of
time to hospital discharge from initial positive culture (within 10 the current resistance rates and antimicrobial usage trends at the
days). These outcomes were compared between patients with linezol- institution.
id-resistant isolates versus those with linezolid-susceptible strains.
Of the 82 patients included in the study, 33 (40%) had a linezolid-
resistant isolate, a substantial increase from the institution-specific
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