Antimicrobial Susceptibility Testing for Enterococci.

Area of Science:

• Clinical Microbiology
• Infectious Diseases
• Antimicrobial Resistance

Background:

• Enterococci are significant nosocomial pathogens known for extensive antimicrobial resistance.
• Multidrug-resistant enterococci (MDR E.) present a serious global health challenge due to limited treatment options.
• The emergence of resistance to novel agents necessitates accurate antimicrobial susceptibility testing (AST) for effective patient management.

Purpose of the Study:

• To review and compare manual and automated AST methods for Enterococcus faecium and Enterococcus faecalis.
• To identify challenges and limitations in current AST for enterococci.
• To provide recommendations for clinical laboratories and discuss future innovations in enterococcal AST.

Main Methods:

• Review of existing literature on manual and automated AST methods for enterococci.
• Evaluation of AST performance and clinical utility for various antimicrobial classes including beta-lactams, aminoglycosides, vancomycin, lipoglycopeptides, oxazolidinones, tetracycline derivatives, and daptomycin.
• Identification of specific issues and knowledge gaps in enterococcal AST.

Main Results:

• Overview of the advantages and disadvantages of various AST methods for key antimicrobial agents.
• Highlighting unique challenges in AST performance and clinical utility for enterococci.
• Identification of areas requiring improvement in current AST protocols.

Conclusions:

• Accurate and feasible AST is crucial for guiding treatment of deep-seated enterococcal infections.
• Addressing identified gaps in enterococcal AST is essential for combating antimicrobial resistance.
• Future innovations in AST are needed to overcome current limitations and improve patient outcomes.