{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T13:42:48Z","timestamp":1784554968038,"version":"3.55.0"},"reference-count":29,"publisher":"American Society for Microbiology","issue":"1","license":[{"start":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T00:00:00Z","timestamp":1767657600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T00:00:00Z","timestamp":1767657600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["5T32AI155391-05"],"award-info":[{"award-number":["5T32AI155391-05"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["ASM Case Rep"],"published-print":{"date-parts":[[2026,1,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:sec>\n                      <jats:title>Background<\/jats:title>\n                      <jats:p>\n                        Vancomycin-resistant\n                        <jats:italic toggle=\"yes\">Enterococcus faecium<\/jats:italic>\n                        (VRE) is a major cause of healthcare-associated infections, especially in immunocompromised hosts. Linezolid is a key therapeutic agent due to its oral bioavailability and activity against resistant Gram-positive bacteria. While rare in U.S. pediatric patients, linezolid resistance can severely limit treatment options.\n                      <\/jats:p>\n                    <\/jats:sec>\n                    <jats:sec>\n                      <jats:title>Case Summary<\/jats:title>\n                      <jats:p>We describe a 16-year-old female with high-risk B-cell acute lymphoblastic leukemia whose hospitalization was complicated by urinary tract infection with VRE. Serial isolates tested on multiple antimicrobial susceptibility testing platforms yielded discordant results for linezolid susceptibility. Minimum inhibitory concentrations to linezolid and chloramphenicol increased together, suggesting potential ribosomal-target-mediated resistance. She ultimately required daptomycin therapy for linezolid-resistant VRE urinary tract infection treatment.<\/jats:p>\n                    <\/jats:sec>\n                    <jats:sec>\n                      <jats:title>Conclusion<\/jats:title>\n                      <jats:p>\n                        This case underscores the diagnostic challenges in detecting emerging linezolid resistance in\n                        <jats:italic toggle=\"yes\">E. faecium<\/jats:italic>\n                        , particularly in immunocompromised patients. Accurate, timely susceptibility testing and improved access to confirmatory or molecular diagnostics are essential to guide therapy for VRE where linezolid remains one of the few viable therapeutic options.\n                      <\/jats:p>\n                    <\/jats:sec>\n                  <\/jats:sec>","DOI":"10.1128\/asmcr.00085-25","type":"journal-article","created":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T13:12:21Z","timestamp":1761138741000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":1,"title":["Linezolid-resistant and vancomycin-resistant\n                    <i>Enterococcus faecium<\/i>\n                    urinary isolate in a pediatric B-ALL patient"],"prefix":"10.1128","volume":"2","author":[{"given":"Emma","family":"Seevak","sequence":"first","affiliation":[{"name":"Harvard Medical School","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanvi S.","family":"Sharma","sequence":"additional","affiliation":[{"name":"Harvard Medical School","place":["Boston, USA"]},{"name":"Department of Infectious Diseases, Boston Children\u2019s Hospital","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8744-8136","authenticated-orcid":true,"given":"Alaric W.","family":"D'Souza","sequence":"additional","affiliation":[{"name":"Harvard Medical School","place":["Boston, USA"]},{"name":"Department of Infectious Diseases, Boston Children\u2019s Hospital","place":["Boston, USA"]},{"name":"Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_4_2_2","unstructured":"Centers for Disease Control and Prevention (U.S.). 2019. Antibiotic resistance threats in the United States 2019. 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