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Comparison of eight methods to detect vancomycin resistance in enterococci
H P Endtz1, N Van Den Braak, A Van Belkum
1Erasmus University Medical Center Rotterdam, The Netherlands. ENDTZ@BACL.AZR.NL
Journal of Clinical Microbiology
|February 18, 1998
Summary
This study evaluated eight methods for detecting vancomycin-resistant enterococci (VRE). E-test and agar screen methods accurately identified all VRE strains, including vanC VRE.
Area of Science:
- Microbiology
- Clinical Diagnostics
- Antimicrobial Resistance
Background:
- Vancomycin-resistant enterococci (VRE) pose a significant threat due to limited treatment options.
- Accurate and timely detection of VRE is crucial for infection control and patient management.
Purpose of the Study:
- To assess the diagnostic accuracy of eight common susceptibility testing methods for VRE.
- To identify methods capable of detecting diverse VRE genotypes, including vanA, vanB, vanC1, and vanC2.
Main Methods:
- Evaluation of eight susceptibility test methods: agar dilution, disk diffusion, E-test, agar screen plate, Vitek GPS-TA, Vitek GPS-101, MicroScan overnight, and MicroScan rapid panels.
- Testing involved genetically unrelated VRE isolates: 50 vanA, 15 vanB, 50 vanC1, and 30 vanC2.
- Comparison of detection rates across different VRE genotypes for each method.
Main Results:
- All tested methods detected vanA VRE.
- Vitek GPS-TA and MicroScan rapid panels showed lower sensitivity for vanB VRE (47% and 53%).
- The Vitek GPS-101 demonstrated improved detection of vanB VRE.
- E-test and agar screen plate were the only methods that detected all VRE strains, including vanC1 and vanC2 VRE.
Conclusions:
- E-test and agar screen plate methods offer superior accuracy for detecting a broad range of VRE genotypes.
- Certain automated systems (Vitek GPS-TA, MicroScan rapid) require improvement for reliable vanB VRE detection.
- Accurate VRE susceptibility testing is critical for effective clinical decision-making and infection control strategies.