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Validating a screening agar for linezolid-resistant enterococci.

Guido Werner1, Carola Fleige2, Ingo Klare2

  • 1Division Nosocomial Pathogens and Antibiotic Resistances, Department of Infectious Diseases, National Reference Centre for Staphylococci and Enterococci (NRC), Robert Koch Institute, Wernigerode Branch, Wernigerode, Germany. wernerg@rki.de.

BMC Infectious Diseases
|December 25, 2019
PubMed
Summary
This summary is machine-generated.

A new selective agar medium effectively screens for linezolid-resistant enterococci (LRE). This method aids in detecting multidrug-resistant Gram-positive bacteria, addressing a critical gap in clinical diagnostics.

Keywords:
Linezolid resistancecfr(B)optrApoxtA

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Area of Science:

  • Clinical Microbiology
  • Antimicrobial Resistance
  • Diagnostic Development

Background:

  • Linezolid is crucial for treating multidrug-resistant Gram-positive infections, including vancomycin-resistant enterococci (VRE).
  • Increasing linezolid resistance necessitates improved detection methods for linezolid-resistant enterococci (LRE).
  • Current diagnostic options lack a specific selective medium or genetic test for LRE.

Purpose of the Study:

  • To develop and validate a selective screening agar for the accurate detection of LRE.
  • To address the need for a reliable diagnostic tool recommended by German hospital hygiene guidelines.

Main Methods:

  • Combined a standard enterococcal screening agar with linezolid supplementation.
  • Evaluated various linezolid concentrations and incubation periods using reference and clinical strains.
  • Included LRE isolates with diverse resistance mechanisms (23S rDNA mutations, cfr(B), optrA, poxtA).
  • Validated the developed LRE screening agar with 400 clinical samples.

Main Results:

  • Enterococcosel® Agar supplemented with 2 mg/L linezolid and a 48-hour incubation period proved optimal.
  • The LRE screening agar demonstrated high performance with 96.6% sensitivity and 94.4% specificity.
  • Accurate identification of LRE strains was achieved.

Conclusions:

  • A practical and accurate selective screening agar for LRE detection has been successfully established.
  • This method provides a valuable tool for clinical laboratories to identify LRE isolates efficiently.