Prevalence and genetic characterization of linezolid resistance gene reservoirs in hospital sewage from Zhejiang Province, China

Hospital sewage in Zhejiang Province, China, is a significant source of pathogens and antimicrobial resistance genes. A study analyzed 420 Gram-positive isolates from 11 hospitals, revealing that each carried at least one linezolid resistance gene. Enterococci were the most common carriers, with a resistance rate of 77.8%. Phylogenetic analysis revealed a multispecies and polyclonal distribution of linezolid-resistant bacteria, with Enterococcus faecalis sequence types 16 and 179 spreading the most across different hospitals. The genetic environment of linezolid resistance genes in sewage was similar to animals, humans, or the environment.