Abstract
A total of 374 clinical isolates of Enterococcus spp. were characterized to determine the species distribution and vancomycin resistance. The ability of the Vitek system (bioMerieux Inc, Hazelwood, St. Louis, Mo.) to identify enterococci to the species level and to recognize vancomycin resistance by using computer software version 7.1 was evaluated. Conventional methods were used for identification and agar dilution was used for susceptibility testing, the results of which were as follows (presented as number of vancomycin-resistant isolates/number of members of that species identified): 219/234 E. faecium, 9/112 E. faecalis, 2/3 E. mundtii, 0/1 E. durans, 0/1 E. hirae, 0/1 E. raffinosis, and 0/1 E. avium. Ten enterococci were in the vancomycin-intermediate category (six E. gallinarum, two E. casseliflavus, and one each of E. faecium and E. faecalis). The Vitek GPI card correctly identified 98% of E. faecium isolates, 99% of E. faecalis isolates, and only two isolates of other enterococcal species. The GPS-TA card was 98% sensitive and 95% specific for the detection of vancomycin resistance, generating a total of four very major (1.6%) and five minor errors (1.3%).
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- Arthur M., Molinas C., Depardieu F., Courvalin P. Characterization of Tn1546, a Tn3-related transposon conferring glycopeptide resistance by synthesis of depsipeptide peptidoglycan precursors in Enterococcus faecium BM4147. J Bacteriol. 1993 Jan;175(1):117–127. doi: 10.1128/jb.175.1.117-127.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Facklam R. R., Collins M. D. Identification of Enterococcus species isolated from human infections by a conventional test scheme. J Clin Microbiol. 1989 Apr;27(4):731–734. doi: 10.1128/jcm.27.4.731-734.1989. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Green M., Barbadora K., Michaels M. Recovery of vancomycin-resistant gram-positive cocci from pediatric liver transplant recipients. J Clin Microbiol. 1991 Nov;29(11):2503–2506. doi: 10.1128/jcm.29.11.2503-2506.1991. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Guiot H. F., Peetermans W. E., Sebens F. W. Isolation of vancomycin-resistant enterococci in haematologic patients. Eur J Clin Microbiol Infect Dis. 1991 Jan;10(1):32–34. doi: 10.1007/BF01967094. [DOI] [PubMed] [Google Scholar]
- Handwerger S., Pucci M. J., Kolokathis A. Vancomycin resistance is encoded on a pheromone response plasmid in Enterococcus faecium 228. Antimicrob Agents Chemother. 1990 Feb;34(2):358–360. doi: 10.1128/aac.34.2.358. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hayden M. K., Trenholme G. M., Schultz J. E., Sahm D. F. In vivo development of teicoplanin resistance in a VanB Enterococcus faecium isolate. J Infect Dis. 1993 May;167(5):1224–1227. doi: 10.1093/infdis/167.5.1224. [DOI] [PubMed] [Google Scholar]
- Johnson A. P., Uttley A. H., Woodford N., George R. C. Resistance to vancomycin and teicoplanin: an emerging clinical problem. Clin Microbiol Rev. 1990 Jul;3(3):280–291. doi: 10.1128/cmr.3.3.280. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Karanfil L. V., Murphy M., Josephson A., Gaynes R., Mandel L., Hill B. C., Swenson J. M. A cluster of vancomycin-resistant Enterococcus faecium in an intensive care unit. Infect Control Hosp Epidemiol. 1992 Apr;13(4):195–200. doi: 10.1086/646509. [DOI] [PubMed] [Google Scholar]
- Leclercq R., Dutka-Malen S., Brisson-Noël A., Molinas C., Derlot E., Arthur M., Duval J., Courvalin P. Resistance of enterococci to aminoglycosides and glycopeptides. Clin Infect Dis. 1992 Sep;15(3):495–501. doi: 10.1093/clind/15.3.495. [DOI] [PubMed] [Google Scholar]
- Leclercq R., Dutka-Malen S., Duval J., Courvalin P. Vancomycin resistance gene vanC is specific to Enterococcus gallinarum. Antimicrob Agents Chemother. 1992 Sep;36(9):2005–2008. doi: 10.1128/aac.36.9.2005. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Livornese L. L., Jr, Dias S., Samel C., Romanowski B., Taylor S., May P., Pitsakis P., Woods G., Kaye D., Levison M. E. Hospital-acquired infection with vancomycin-resistant Enterococcus faecium transmitted by electronic thermometers. Ann Intern Med. 1992 Jul 15;117(2):112–116. doi: 10.7326/0003-4819-117-2-112. [DOI] [PubMed] [Google Scholar]
- Pesce A., Debbia E. A., Toni M., Schito G. C. Antibiotic resistance of clinical isolates of Enterococcus in Italy. Clin Infect Dis. 1992 Sep;15(3):490–494. doi: 10.1093/clind/15.3.490. [DOI] [PubMed] [Google Scholar]
- Quintiliani R., Jr, Evers S., Courvalin P. The vanB gene confers various levels of self-transferable resistance to vancomycin in enterococci. J Infect Dis. 1993 May;167(5):1220–1223. doi: 10.1093/infdis/167.5.1220. [DOI] [PubMed] [Google Scholar]
- Rao G. G., Morris K. J., George R. C., Woodford N. Vancomycin-resistant enterococci in a district general hospital. Lancet. 1992 Dec 12;340(8833):1471–1472. [PubMed] [Google Scholar]
- Sahm D. F., Olsen L. In vitro detection of enterococcal vancomycin resistance. Antimicrob Agents Chemother. 1990 Sep;34(9):1846–1848. doi: 10.1128/aac.34.9.1846. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Vincent S., Knight R. G., Green M., Sahm D. F., Shlaes D. M. Vancomycin susceptibility and identification of motile enterococci. J Clin Microbiol. 1991 Oct;29(10):2335–2337. doi: 10.1128/jcm.29.10.2335-2337.1991. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Willey B. M., Kreiswirth B. N., Simor A. E., Willaims G., Scriver S. R., Phillips A., Low D. E. Detection of vancomycin resistance in Enterococcus species. J Clin Microbiol. 1992 Jul;30(7):1621–1624. doi: 10.1128/jcm.30.7.1621-1624.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]