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[Detection methods for drug-resistant bacteria in routine examination--VRE]
S Kawakami1, Y Miyazawa, Y Ono
1Department of Central Laboratory, Teikyo University School of Medicine.
Rinsho Byori. the Japanese Journal of Clinical Pathology
|May 11, 2000
Summary
Accurately test vancomycin susceptibility in enterococci by incubating plates for 24 hours and checking for growth. Differentiate acquired vancomycin resistance (vanA/vanB) from intrinsic resistance (vanC) using MIC and phenotypic tests.
Area of Science:
- Clinical microbiology
- Antimicrobial resistance
- Bacterial genetics
Context:
- Enterococci infections pose a significant challenge due to rising antimicrobial resistance.
- Accurate susceptibility testing is crucial for guiding vancomycin therapy.
- Distinguishing between acquired and intrinsic vancomycin resistance mechanisms is essential for effective treatment.
Purpose:
- To outline standardized methods for vancomycin susceptibility testing in enterococci.
- To differentiate between acquired vancomycin resistance (vanA, vanB) and intrinsic resistance (vanC).
- To guide the selection of appropriate antimicrobial agents for enterococcal infections.
Summary:
- Vancomycin susceptibility testing in enterococci requires a 24-hour incubation period with examination under transmitted light.
- The presence of haze or growth within the zone of inhibition signifies resistance.
- Vancomycin MIC, motility, and pigment production tests help distinguish species with acquired resistance (vanA/vanB) from those with intrinsic resistance (vanC), such as E. gallinarum and E. casseliflavus.
Impact:
- Improved accuracy in vancomycin susceptibility testing for enterococci.
- Enhanced ability to identify specific resistance mechanisms (vanA, vanB, vanC).
- Facilitates appropriate treatment selection, potentially reducing the spread of vancomycin-resistant enterococci.