Users Online: 7528
Home Print this page Email this page
Home About us Editorial board Search Browse articles Submit article Ahead of Print Instructions Subscribe Contacts Special issues Login 

Previous article Browse articles Next article 
Adv Biomed Res 2023,  12:205

Detection of Genes Related to Linezolid Resistance (poxtA, cfr, and optrA) in Clinical Isolates of Enterococcus spp. from Humans: A First Report from Iran

Department of Bacteriology and Virology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Date of Submission25-Feb-2023
Date of Decision02-May-2023
Date of Acceptance10-May-2023
Date of Web Publication31-Jul-2023

Correspondence Address:
Farkhondeh Poursina
Department of Bacteriology and Virology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Postal Code: 8174673461
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/abr.abr_74_23

Rights and Permissions

Background: Enterococci may develop resistance to linezolid through chromosomal mutations that involve specific linezolid resistance genes, such as cfr, optrA, and poxtA. The objective of this study was to evaluate the antibiotic susceptibility of enterococcal isolates and identify cfr, optrA, and poxtA genes in MDR isolates.
Materials and Methods: Enterococcal isolates were collected from various clinical specimens at Al-Zahra, Amin, and Khorshid Hospitals in Isfahan. The Enterococcus isolates were identified as belonging to the E. faecalis and E. faecium species by using specific gene (D alanine D alanine ligase ddl) sets in PCR. To detect cfr, optrA, and poxtA genes among the species, a multiplex-PCR assay was performed.
Results: Out of 175 isolates, E. faecalis predominated 129/175 (73.7%). Furthermore, the prevalence of vancomycin-resistant Enterococci (VRE) and linezolid-resistant Enterococci (LRE) was 29.7% and 4%, respectively. The overall prevalence of MDR was 91.1%, 68.9%, and 66.6% of E. faecium, E. faecalis, and other Enterococcus spp., respectively. Interestingly, the frequency of optrA (71.4%) in E. faecium and poxtA and crf (42.8%) in E. faecalis were detected among LRE species. A statistically significant relationship (P < 0.05) was found between the presence of the three genes and the occurrence of LRE.
Conclusion: This is the first study to report the detection of linezolid resistance genes (cfr, optrA, and poxtA) in clinical Enterococcus spp. isolates from Iran, conducted at Isfahan University of Medical Sciences hospitals. The emergence of enterococcal strains that resist linezolid is concerning as it can lead to the spread of resistant strains among patients, resulting in treatment failure.

Keywords: Enterococcus, drug resistance, humans, linezolid

How to cite this article:
Torabi M, Faghri J, Poursina F. Detection of Genes Related to Linezolid Resistance (poxtA, cfr, and optrA) in Clinical Isolates of Enterococcus spp. from Humans: A First Report from Iran. Adv Biomed Res 2023;12:205

How to cite this URL:
Torabi M, Faghri J, Poursina F. Detection of Genes Related to Linezolid Resistance (poxtA, cfr, and optrA) in Clinical Isolates of Enterococcus spp. from Humans: A First Report from Iran. Adv Biomed Res [serial online] 2023 [cited 2023 Sep 28];12:205. Available from:

  Introduction Top

Linezolid is commonly reserved as a final option for treating severe infections caused by multidrug-resistant (MDR) gram-positive organisms, including vancomycin-resistant Enterococcus spp. (VRE), methicillin-resistant Staphylococcus spp., and Streptococcus pneumoniae.[1],[2],[3] While the majority of gram-positive cocci remain susceptible to linezolid, resistant Enterococci isolates have been reported across the globe.[3],[4] Bacteria can develop resistance to linezolid through either chromosomal mutations or the uptake of mobile genetic elements that harbor certain linezolid-resistance genes, such as cfr, optrA, and poxtA.[5],[6],[7],[8]

The cfr gene, which codes for an rRNA methyltransferase, was initially identified on the plasmid pSCFS1 of Staphylococcus sciuri and has since been detected in a range of gram-positive and gram-negative bacteria from different sources.[9],[10] The cfr gene confers resistance to a group of antibiotics known as PhLOPSA, which includes phenicols, lincosamides, pleuromutilins, streptogramin A, and oxazolidinones. In addition, clinical enterococcal isolates have been shown to exhibit cfr gene variations [cfr(B) and cfr(D)].[11],[12],[13] However, the role of cfr-like genes in reducing linezolid susceptibility in Enterococci is still debated. OptrA is an ATP-binding cassette F (ABC-F) protein that gives resistance to phenicols and oxazolidinones. The optrA gene was initially identified among Enterococcus faecalis (Efa) and Enterococcus faecium (Efm) isolates from both animals and humans in China.[14],[15],[16] poxtA is a recently discovered gene that provides resistance to oxazolidinones, phenicols, and tetracycline. It was initially identified in a clinical strain of methicillin-resistant Staphylococcus aureus. This gene, like optrA, encodes antibiotic resistance (ARE) ABC-F protein; however, it only shares 32 percent of optrA's amino acid sequence. poxtA is also found in efa and efm, and it is frequently found in a composite transposon.[16],[17]

Due to this emerging problem, an accurate and thorough assessment of the rate and magnitude of linezolid resistance between clinical isolates is required.[18],[19],[20],[21] The objective of this study was to evaluate the antibiotic susceptibility patterns of clinical MDR Enterococcus isolates in several teaching hospitals affiliated with Isfahan University of Medical Sciences and to investigate the emergence of linezolid resistance as well as the prevalence of cfr, optrA, and poxtA genes in these isolates.

  Materials and Methods Top

Clinical samples

Between May 2020 and December 2021, a total of 175 Enterococcal isolates were collected from various clinical specimens, including urine, blood, body fluids, wounds, and catheters, at three hospitals located in Isfahan, a central province in Iran. The hospitals included Al-Zahra, Amin, and Khorshid. The isolates were confirmed as non-duplicate strains to ensure that each isolate was unique and representative of a different infection episode.

Enterococcus species identification

For bacterial identification, standard biochemical tests were utilized, including assessments of catalase activity, growth in 6.5% sodium chloride, bile esculin hydrolysis, and pyrrolidinyl aminopeptidase activity.[22] The ddl gene was detected using polymerase chain reaction (PCR) to confirm the Enterococcus species.[23]

Antibiotic susceptibility testing

As described in the Clinical and Laboratory Standards Institute Guidelines (CLSI-2022), all isolates of enterococci were tested for antimicrobial agents (PadtanTEB Co., IR) in Muller-Hinton agar (IBRESCO Co., IR) using Kirby-Bauer disk diffusion methods: ampicillin (AMP, 10 μg), vancomycin (VAN, 30 μg), teicoplanin (TEC, 30 μg), ciprofloxacin (CIP, 5 μg), nitrofurantoin (NIT, 300 μg), chloramphenicol (CHL, 30 μg), gentamicin (GEN, 120 μg), rifampin (RIF, 5 μg), erythromycin (ERY, 15 μg), teicoplanin (TEC, 30 μg), linezolid (LZD, 30 μg) and fosfomycin (FOS, 200 μg). E. faecalis ATCC 29,212 was used as the control strain. A brain-heart infusion (BHI) screening agar with vancomycin (6 mg/mL) was used to retest bacteria that showed intermediate or resistant responses to vancomycin disk in Kirby-Bauer.[22] After that, WHONET 2021 software ( was utilized to determine the MDR of each strain.[24]

PCR detection

To confirm the two species E. faecalis and E. faecium, amplification of ddl gene was performed.[23] For the detection of cfr, optrA, and poxtA genes, a multiplex-PCR method as described by K. Bender et al.[25] was employed in this study. The expected fragment sizes for optrA, poxtA, and cfr were 422 bp, 533 bp, and 746 bp, respectively.

Sequencing of PCR products

The PCR products of samples that showed bands for the mentioned ranges (for optrA, the expected fragment size was 422 bp, for poxtA it was 533 bp, and for cfr it was 746 bp) was sequenced and checked with a database PubMLST (, and then these positive genes were used as control of gene amplification.

Statistical analysis

The statistical analyses for this study were conducted using SPSS v26 software. A P value less than 0.05 was considered significant. The data were analyzed using both Chi-square and Fisher's exact tests to determine statistical significance.

  Results Top

Identification of Enterococcal isolates

To identify the Enterococcal isolates, both phenotypic and PCR methods were employed for E. faecalis and E. faecium with a high level of agreement. Out of 175 clinical Enterococcal isolates, the majority (73.7%) were identified as E. faecalis, while 19.4% were identified as E. faecium. The remaining 6.8% of the isolates were classified as other species of Enterococcus.

Antimicrobial susceptibility results

A summary of the ARE profiles found among all isolates using the disk diffusion method can be found in [Table 1].
Table 1: Antibiotics resistance profile

Click here to view

According to our data, the Enterococcal isolates exhibited varying levels of ARE. Erythromycin had the highest rate of resistance at 84.6%, while Fosfomycin had the lowest rate at 0.6%. The prevalence of vancomycin-resistant Enterococci was 29.7%, and 52/175 (29.7%) and 7/175 (4%)., Further details regarding the resistance patterns of different Enterococcus species are provided in [Table 1]. MDR was observed in a significant number of Enterococcal isolates. Specifically, the prevalence of MDR was found to be 91.1% (31/34) in E. faecium, 68.9% (89/129) in E. faecalis, and 66.6% (8/12) in other Enterococcus species, respectively. This indicates that these bacteria have developed resistance to multiple antibiotics.

Prevalence of optrA, cfr, and poxtA genes among Enterococcus strains

The prevalence of optrA, cfr, and poxtA genes among the total MDR isolates was 5.4% (7/128), 3.1% (4/128), and 2.3% (3/128), respectively. There was no significantly correlation between the prevalence of resistance genes (optrA, cfr, and poxtA) and MDR isolates (P > 0.05) [Table 2].
Table 2: Prevalence of MDR strains and optrA, cfr, and poxtA genes

Click here to view

Among the Enterococcal isolates that we tested, we identified several strains that contained multiple ARE genes. Specifically, two isolates (1 E. faecalis and 1 E. faecium) were found to harbor all three resistance genes (optrA, cfr, and poxtA), while two other isolates (1 E. faecalis and 1 E. faecium) carried two resistance genes (optrA and poxtA). Additionally, three strains (2 E. faecalis and 1 E. faecium) carried a single resistance gene (optrA), and one strain (other species of Enterococcus) was found to harbor a single resistance gene (cfr).

  Discussion Top

Linezolid, which is one of the final options for treating MDR gram-positive pathogens, stands out due to its distinctive mechanism of action and relatively low global resistance rates.[9] Additionally, it boasts a near-perfect bioavailability when taken orally and has an excellent safety record. Unfortunately, the combination of these factors has led to excessive and widespread use of linezolid, ultimately resulting in the development of resistance to this antibiotic.[9],[26]

Our study's findings corroborate previous Iranian research that identified E. faecalis as the predominant clinical Enterococcus species. Additionally, our results support the notion that E. faecium exhibits greater multidrug ARE compared to other Enterococcus species.[22],[23],[27],[28],[29],[30]

Despite the lack of a reliable report on the prevalence of LRE in Iran, our findings indicate that MDR strains had a 4.5% rate of LRE, while intermediate strains had a rate of 3.9%. In contrast, Jahansepas et al.[22] reported 8.7% prevalence of LRE in their study conducted in northern Iran. Contrary to our study, no LRE strain was shown in published studies from south-western Iran in 2017.[31],[32] It seems that the differences in the prevalence of resistance is related to the geographical and the treatment strategy in different areas.

As far as we know, this is the initial report on the occurrence of cfr, optrA, and poxtA linezolid resistance genes in human clinical Enterococcus spp. isolates in Iran. Our study revealed a high prevalence of the optrA and poxtA genes in LREs. We observed a significant association (P < 0.05) between the presence of these genes and resistance to linezolid. These results suggest that optrA and poxtA may play a key role in the development of linezolid resistance in Enterococci and highlight the need for continued surveillance and investigation into the mechanisms underlying ARE in these bacteria. Another study conducted in Pakistan and the USA also reported high prevalence rates of poxtA and optrA among LREs.[33] Similarly, Zaira Moure et al.[34] from Spain reported an optrA frequency of 85.2% among LREs. In various studies, the relationship of these genes with LRE strains has been reported.[5],[6],[7],[8]

According to our research, a significant proportion of LREs had multiple ARE genes. Specifically, in some LREs (28.5%) was detected all three genes (optrA, cfr, and poxtA) at the same time, while others (28.5%) had two genes (optrA and poxtA) simultaneously. Additionally, in a large portion of LREs (42.8%), there was only optrA gene. Interestingly, these results are very similar to those found in a study conducted by Zaira Moure et al.[34] in Spain.

While the prevalence of LRE strains may be relatively low, the identification of even a single isolate carrying the optrA, poxtA, or cfr resistance genes in Enterococcus spp. is a cause for concern. Such findings underscore the potential for these genes to spread across clinical and nonclinical settings, as well as among different species. Therefore, continued surveillance and implementation of effective infection control measures are crucial in preventing the dissemination of antibiotic-resistant Enterococci.[35],[36],[37],[38]

As a conclusion, the prevalence of antibiotic resistance is a growing concern worldwide, and Enterococci strains among Iranian patients are no exception. These strains have been found to carry and spread resistance genes, such as optrA, poxtA, and cfr, leading to the emergence of last-resort ARE strains. To address this issue, active surveillance is recommended. This includes identifying the different epidemiological contexts in which linezolid resistance develops, evaluating ARE in Enterococcus spp., and implementing antibiotic stewardship of linezolid to prevent the spread of resistance. Additionally, it is important to study the prevalence of these resistance genes in other bacterial strains and environments to better understand the scope of this issue. Implementation of effective infection control measures is essential in combating the spread of ARE and preserving the efficacy of our current treatments. By taking such measures, we can work toward mitigating the impact of ARE and ensuring that effective treatments remain available for patients in need.


Medical University of Isfahan, Iran.

Financial support and sponsorship

The study was granted by the Medical University of Isfahan, Iran (Council of Medical Science, grant No. 399097).

Conflicts of interest

There are no conflicts of interest.

  References Top

Côrtes MF, André C, Martins Simões P, Corvec S, Caillon J, Tristan A, et al. Persistence of a multidrug-resistant worldwide-disseminated methicillin-resistant Staphylococcus epidermidis clone harbouring the cfr linezolid resistance gene in a French hospital with evidence of interspecies transfer to several Staphylococcus aureus lineages. J Antimicrob Chemother 2022;77:1838-46.  Back to cited text no. 1
Dembicka KM, Powell J, O'Connell NH, Hennessy N, Brennan G, Dunne CP. Prevalence of linezolid-resistant organisms among patients admitted to a tertiary hospital for critical care or dialysis. Ir J Med Sci 2022;191:1745-50.  Back to cited text no. 2
Sadowy E. Linezolid resistance genes and genetic elements enhancing their dissemination in enterococci and streptococci. Plasmid 2018;99:89-98.  Back to cited text no. 3
Ma X, Zhang F, Bai B, Lin Z, Xu G, Chen Z, et al. Linezolid resistance in enterococcus faecalis associated with urinary tract infections of patients in a tertiary hospitals in China: Resistance mechanisms, virulence, and risk factors. Front Public Health 2021;9:570650.  Back to cited text no. 4
Egan S, Corcoran S, McDermott H, Fitzpatrick M, Hoyne A, McCormack O, et al. Hospital outbreak of linezolid-resistant and vancomycin-resistant ST80 Enterococcus faecium harbouring an optrA-encoding conjugative plasmid investigated by whole-genome sequencing. J Hosp Infect 2020;105:726-35.  Back to cited text no. 5
Shang Y, Li D, Shan X, Schwarz S, Zhang SM, Chen YX, et al. Analysis of two pheromone-responsive conjugative multiresistance plasmids carrying the novel mobile optrA locus from Enterococcus faecalis. Infect Drug Resist 2019;12:2355.  Back to cited text no. 6
Zou J, Tang Z, Yan J, Liu H, Chen Y, Zhang D, et al. Dissemination of Linezolid Resistance Through Sex Pheromone Plasmid Transfer in Enterococcus faecalis. Front Microbiol 2020;11:1185.  Back to cited text no. 7
Freitas AR, Tedim AP, Duarte B, Elghaieb H, Abbassi MS, Hassen A, et al. Linezolid-resistant (Tn 6246: fexB-poxtA) enterococcus faecium strains colonizing humans and bovines on different continents: Similarity without epidemiological link. J Antimicrob Chemother 2020;75:2416-23.  Back to cited text no. 8
Chen Q, Yin D, Li P, Guo Y, Ming D, Lin Y, et al. First report Cfr and OptrA co-harboring linezolid-resistant Enterococcus faecalis in China. Infect Drug Resist 2020;13:3919–22.  Back to cited text no. 9
Brenciani A, Morroni G, Vincenzi C, Manso E, Mingoia M, Giovanetti E, et al. Detection in Italy of two clinical Enterococcus faecium isolates carrying both the oxazolidinone and phenicol resistance gene optrA and a silent multiresistance gene cfr. J Antimicrob Chemother 2016;71:1118-9.  Back to cited text no. 10
Guerin F, Sassi M, Dejoies L, Zouari A, Schutz S, Potrel S, et al. Molecular and functional analysis of the novel cfr(D) linezolid resistance gene identified in Enterococcus faecium. J Antimicrob Chemother 2020;75:1699-703.  Back to cited text no. 11
Kuroda M, Sekizuka T, Matsui H, Suzuki K, Seki H, Saito M, et al. Complete genome sequence and characterization of linezolid-resistant enterococcus faecalis clinical isolate KUB3006 carrying a cfr(B)-transposon on its chromosome and optrA-plasmid. Front Microbiol 2018;9:2576.  Back to cited text no. 12
Deshpande LM, Ashcraft DS, Kahn HP, Pankey G, Jones RN, Farrell DJ, et al. Detection of a new cfr-like gene, cfr(B), in Enterococcus faecium isolates recovered from human specimens in the United States as part of the SENTRY Antimicrobial Surveillance Program. Antimicrob Agents Chemother 2015;59:6256-61.  Back to cited text no. 13
Sharkey LK, Edwards TA, O'Neill AJ. ABC-F proteins mediate antibiotic resistance through ribosomal protection. mBio 2016;7:e01975.  Back to cited text no. 14
Wang Y, Lv Y, Cai J, Schwarz S, Cui L, Hu Z, et al. A novel gene, optrA, that confers transferable resistance to oxazolidinones and phenicols and its presence in Enterococcus faecalis and Enterococcus faecium of human and animal origin. J Antimicrob Chemother 2015;70:2182-90.  Back to cited text no. 15
Ruiz-Ripa L, Feßler AT, Hanke D, Eichhorn I, Azcona-Gutiérrez JM, Pérez-Moreno MO, et al. Mechanisms of linezolid resistance among enterococci of clinical origin in spain—detection of optrA-and cfr(D)-carrying e. faecalis. Microorganisms 2020;8:1155.  Back to cited text no. 16
Antonelli A, D'Andrea MM, Brenciani A, Galeotti CL, Morroni G, Pollini S, et al. Characterization of poxtA, a novel phenicol–oxazolidinone–tetracycline resistance gene from an MRSA of clinical origin. J Antimicrob Chemother 2018;73:1763-9.  Back to cited text no. 17
Mendes RE, Deshpande L, Streit JM, Sader HS, Castanheira M, Hogan PA, et al. ZAAPS programme results for 2016: An activity and spectrum analysis of linezolid using clinical isolates from medical centres in 42 countries. J Antimicrob Chemother 2018;73:1880-7.  Back to cited text no. 18
Cui L, Wang Y, Lv Y, Wang S, Song Y, Li Y, et al. Nationwide surveillance of novel oxazolidinone resistance gene optrA in enterococcus isolates in China from 2004 to 2014. Antimicrob Agents Chemother 2016;60:7490-3.  Back to cited text no. 19
Deshpande LM, Castanheira M, Flamm RK, Mendes RE. Evolving oxazolidinone resistance mechanisms in a worldwide collection of enterococcal clinical isolates: Results from the SENTRY antimicrobial surveillance program. J Antimicrob Chemother 2018;73:2314-22.  Back to cited text no. 20
Sassi M, Guérin F, Zouari A, Beyrouthy R, Auzou M, Fines-Guyon M, et al. Emergence of optrA-mediated linezolid resistance in enterococci from France, 2006–16. J Antimicrob Chemother 2019;74:1469-72.  Back to cited text no. 21
Jahansepas A, Sharifi Y, Aghazadeh M, Ahangarzadeh Rezaee M. Comparative analysis of enterococcus faecalis and enterococcus faecium strains isolated from clinical samples and traditional cheese types in the Northwest of Iran: Antimicrobial susceptibility and virulence traits. Arch Microbiol 2020;202:765-72.  Back to cited text no. 22
Ghaziasgar F, Poursina F, Hassanzadeh A. Virulence factors, biofilm formation and antibiotic resistance pattern in Enterococcus faecalis and Enterococcus faecium isolated from clinical and commensal human samples in Isfahan, Iran. Ann Ig 2019;31:156-64.  Back to cited text no. 23
O'Brien T, Stelling J. WHONET: An information system for monitoring antimicrobial resistance. Emerg Infect Dis 1995;1:66.  Back to cited text no. 24
Bender JK, Fleige C, Klare I, Werner G. Development of a multiplex-PCR to simultaneously detect acquired linezolid resistance genes cfr, optrA and poxtA in enterococci of clinical origin. J Microbiol Methods 2019;160:101-3.  Back to cited text no. 25
Lei CW, Chen X, Liu S-Y, Li T-Y, Chen Y, Wang H-N. Clonal spread and horizontal transfer mediate dissemination of phenicol-oxazolidinone-tetracycline resistance gene poxtA in enterococci isolates from a swine farm in China. Vet Microbiol 2021;262:109219.  Back to cited text no. 26
Dehghani T, Karmostaji A, Alizade H. Virulence genes and antibiotic susceptibility of enterococcus spp. in Bandar Abbas City, Iran. Infect Epidemiol Microbiol 2022;8.:129-137.  Back to cited text no. 27
Kalantari H, Hajizade A, Issazadeh K, Faezi Ghasemi M. A study on the prevalence of vancomycin-resistant enterococci and their antibiotic resistance pattern in recreational waters in Guilan Province, Iran. Iran J Microbiol 2022;16:251-8.  Back to cited text no. 28
Hasanpour F, Neyestani Z, Arzanlou M, Moradi-Asl E, Sahebkar A, Khademi F. Vancomycin-resistant enterococci in Iran: A systematic review and meta-analysis of non-clinical studies. Gene Reports 2021;24:101265.  Back to cited text no. 29
Asadollahi P, Razavi S, Asadollahi K, Pourshafie M, Talebi M. Rise of antibiotic resistance in clinical enterococcal isolates during 2001–2016 in Iran: A review. New Microbes New Infect 2018;26:92-9.  Back to cited text no. 30
Heidari H, Hasanpour S, Ebrahim-Saraie HS, Motamedifar M. High incidence of virulence factors among clinical Enterococcus faecalis isolates in Southwestern Iran. Infect Chemother 2017;49:51-6.  Back to cited text no. 31
Houri H, Kazemian H, Ebrahim-Saraie HS, Taji A, Tayebi Z, Heidari H. Linezolid activity against clinical gram-positive cocci with advanced antimicrobial drug resistance in Iran. J Glob Antimicrob Resist 2017;10:200-3.  Back to cited text no. 32
Wardenburg KE, Potter RF, D'Souza AW, Hussain T, Wallace MA, Andleeb S, et al. Phenotypic and genotypic characterization of linezolid-resistant Enterococcus faecium from the USA and Pakistan. J Antimicrob Chemother 2019;74:3445-52.  Back to cited text no. 33
Moure Z, Lara N, Marin M, Sola-Campoy PJ, Bautista V, Gómez-Bertomeu F, et al. Interregional spread in Spain of linezolid-resistant Enterococcus spp. Isolates carrying the optrA and poxtA genes. Int J Antimicrob Agents 2020;55:105977.  Back to cited text no. 34
Almeida LM, Lebreton F, Gaca A, Bispo PM, Saavedra JT, Calumby RN, et al. Transferable resistance gene optrA in Enterococcus faecalis from swine in Brazil. Antimicrob Agents Chemother 2020;64:e00142-20.  Back to cited text no. 35
Zarzecka U, Zakrzewski AJ, Chajęcka-Wierzchowska W, Zadernowska A. Linezolid-resistant Enterococcus spp. isolates from foods of animal origin—The genetic basis of acquired resistance. Foods 2022;11:975.  Back to cited text no. 36
Turner AM, Lee JYH, Gorrie CL, Howden BP, Carter GP. Genomic insights into last-line antimicrobial resistance in multidrug-resistant staphylococcus and vancomycin-resistant enterococcus. Front Microbiol 2021;12:637656.  Back to cited text no. 37
Bi R, Qin T, Fan W, Ma P, Gu B. The emerging problem of linezolid-resistant enterococci. J Glob Antimicrob Resist 2018;13:11-9.  Back to cited text no. 38


  [Table 1], [Table 2]


Previous article  Next article
Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
Access Statistics
Email Alert *
Add to My List *
* Registration required (free)

  In this article
Materials and Me...
Article Tables

 Article Access Statistics
    PDF Downloaded70    
    Comments [Add]    

Recommend this journal