To report a case of Staphylococcus epidermidis infection of a hip prosthesis successfully treated with oral linezolid.
CASE SUMMARY:
A 46-year-old woman developed methicillin-resistant S. epidermidis (MRSE) infection of her prosthetic hip. She received oral linezolid 600 mg twice daily for one month; after that time, the biological inflammatory markers returned to normal.
DISCUSSION:
One of the most serious complications of arthroplasty is joint prosthesis infection. It is mainly caused by gram-positive bacteria, in particular those of the genus staphylococcus. The increasing prevalence of gram-positive cocci that are resistant to antimicrobial agents has complicated the treatment of serious infections.
CONCLUSIONS:
Oral linezolid appears to be an effective and well-tolerated treatment option for hip prosthesis infections due to MRSE.
HanssenADRandJA. An instructional course lecture. The American Academy of Orthopaedic Surgeons. Evaluation and treatment of infection at the site of a total hip or knee arthroplasty. J Bone Joint Surg Am1998; 80: 910–22.
2.
BrauseBD. Infections with prostheses in bones and joints. In: MandellGLBennettJEDolinR, eds. Principles and practice of infectious diseases. 5th ed.Philadelphia: Churchill Livingstone, 2000: 1196–200.
3.
MaderJTWangJCalhounJH. Antibiotic therapy for musculoskeletal infections. J Bone Joint Surg Am2001; 83: 1878–90.
4.
JacquelineCBatardEPerezLBoutoilleDHamelACaillonJ, In vivo efficacy of continuous infusion versus intermittent dosing of line-zolid compared to vancomycin in a methicillin-resistant Staphylococcus aureus rabbit endocarditis model. Antimicrob Agents Chemother2002; 46: 3706–11.
5.
RybakMJCappellettyDMMoldovanTAeschlimannJRKaatzGW. Comparative in vitro activities and postantibiotic effects of the oxazolidinone compounds eperezolid (PNU-100592) and linezolid (PNU-100766) versus vancomycin against Staphylococcus aureus, coagulase-negative staphylococci, Enterococcus faecalis, and Enterococcus faecium. Antimicrob Agents Chemother1998; 42: 721–4.
6.
Package insert. Zyvoxid (linezolid). Kalamazoo, MI: Pharmacia and Upjohn, 2001.
MelzerMGoldsmithDGransdenW. Successful treatment of vertebral osteomyelitis with linezolid in a patient receiving hemodialysis and with persistent methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus bacteremias. Clin Infect Dis2000; 31: 208–9.
9.
MoisePAForrestABirminghamMCSchentagJJ. The efficacy and safety of linezolid as treatment for Staphylococcus aureus infections in compassionate use patients who are intolerant of, or who have failed to respond to, vancomycin. J Antimicrob Chemother2002; 50: 1017–26.
10.
BassettiMDi BiagioACenderelloGDel BonoVPalermoACrucianiM, Linezolid treatment of prosthetic hip infections due to methicillin-resistant Staphylococcus aureus (MRSA). J Infect2001; 43: 148–9.
11.
LoveringAMZhangJBannisterGCLankesterBJBrownJGNarendraG, Penetration of linezolid into bone, fat, muscle and haematoma of patients undergoing routine hip replacement. J Antimicrob Chemother2002; 50: 73–7.
12.
BetriuCRedondoMBoloixAGomezMCulebrasEPicazoJJ. Comparative activity of linezolid and other new agents against methicillin-resistant Staphylococcus aureus and teicoplanin-intermediate coagulase-negative staphylococci. J Antimicrob Chemother2001; 48: 911–3.
13.
CercenadoEGarcia-GaroteFBouzaE. In vitro activity of linezolid against multiply resistant gram-positive clinical isolates. J Antimicrob Chemother2001; 47: 77–81.
14.
AntonySJDiaz-VasquezEStrattonC. Clinical experience with linezolid in the treatment of resistant gram-positive infections. J Natl Med Assoc2001; 93: 386–91.
15.
Jover-SaenzAGaiteFBRibellesAGPorcel-PerezJMGarrido-CalvoS. Linezolid treatment of total prosthetic knee infection due to methicillin-resistant Staphylococcus epidermidis. J Infect2003; 47: 87–8.
