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Background <p>Antimicrobial resistance is a major global public health challenge. Vancomycin-resistant <i>Enterococcus faecium</i> (VR-<i>Efm</i>) is a significant cause of healthcare-associated infections. To investigate the incidence density of VR-<i>Efm</i> and methicillin-resistant <i>Staphylococcus aureus</i> (MRSA), and to analyze their correlation with vancomycin and linezolid antimicrobial consumption (defined daily doses per 1,000 patient-days), thereby providing evidence for developing effective infection prevention and antimicrobial stewardship strategies.</p> Methods <p>A retrospective analysis was conducted to investigate the epidemiology of VR-<i>Efm</i> and MRSA from 2019 to the first and second quarters of 2025 (2025 Q1-Q2) in a tertiary care hospital in China. Correlation analyses were performed to assess the relationships between VR-<i>Efm</i> and MRSA incidence density and the consumption of vancomycin and linezolid, respectively.</p> Results <p>The vancomycin resistance rate among <i>Enterococcus faecium</i> isolates showed an upward trend, increasing from 1.6% in 2019 to 23.1% in 2025 Q1-Q2. Linezolid resistance was first identified during 2025 Q1–Q2, with a resistance rate of 1.9%. A significant positive correlation was observed between linezolid consumption and the incidence density of VR-<i>Efm</i> (ρ = 0.779, <i>n</i> = 7, <i>p</i> = 0.039). However, no significant association was found between vancomycin consumption and VR-<i>Efm</i> incidence density (ρ = -0.022, <i>n</i> = 7, <i>p</i> = 0.963). No significant correlation was found between MRSA incidence density and the consumption of vancomycin (ρ = -0.490, <i>n</i> = 7, <i>p</i> = 0.265) or linezolid (ρ = -0.190, <i>n</i> = 7, <i>p</i> = 0.683).</p> Conclusions <p>The increasing vancomycin resistance rate of <i>Enterococcus faecium</i>, along with the emergence of linezolid-resistant strains, warrants heightened attention and strategic action. Strengthened hospital infection control measures targeting VR-<i>Efm</i> are urgently needed, along with the rational use of linezolid as a key strategy to mitigate antimicrobial selection pressure.</p>

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Trends in vancomycin-resistant Enterococcus faecium and methicillin-resistant Staphylococcus aureus and their association with vancomycin / linezolid consumption in a tertiary hospital in China

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月19日

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  • Zihuan Li,
  • Tian Wang,
  • Baohong Liu,
  • Cuiqiong Fan,
  • Maorui Lin,
  • Ya Zou,
  • Guanwen Lin

摘要

Background

Antimicrobial resistance is a major global public health challenge. Vancomycin-resistant Enterococcus faecium (VR-Efm) is a significant cause of healthcare-associated infections. To investigate the incidence density of VR-Efm and methicillin-resistant Staphylococcus aureus (MRSA), and to analyze their correlation with vancomycin and linezolid antimicrobial consumption (defined daily doses per 1,000 patient-days), thereby providing evidence for developing effective infection prevention and antimicrobial stewardship strategies.

Methods

A retrospective analysis was conducted to investigate the epidemiology of VR-Efm and MRSA from 2019 to the first and second quarters of 2025 (2025 Q1-Q2) in a tertiary care hospital in China. Correlation analyses were performed to assess the relationships between VR-Efm and MRSA incidence density and the consumption of vancomycin and linezolid, respectively.

Results

The vancomycin resistance rate among Enterococcus faecium isolates showed an upward trend, increasing from 1.6% in 2019 to 23.1% in 2025 Q1-Q2. Linezolid resistance was first identified during 2025 Q1–Q2, with a resistance rate of 1.9%. A significant positive correlation was observed between linezolid consumption and the incidence density of VR-Efm (ρ = 0.779, n = 7, p = 0.039). However, no significant association was found between vancomycin consumption and VR-Efm incidence density (ρ = -0.022, n = 7, p = 0.963). No significant correlation was found between MRSA incidence density and the consumption of vancomycin (ρ = -0.490, n = 7, p = 0.265) or linezolid (ρ = -0.190, n = 7, p = 0.683).

Conclusions

The increasing vancomycin resistance rate of Enterococcus faecium, along with the emergence of linezolid-resistant strains, warrants heightened attention and strategic action. Strengthened hospital infection control measures targeting VR-Efm are urgently needed, along with the rational use of linezolid as a key strategy to mitigate antimicrobial selection pressure.