Liofilchem(®) Chromatic VRE and vancomycin MIC Test Strip detected glycopeptide resistance in a vanB neonatal Enterococcus faecium isolate showing alternate vancomycin susceptibility and resistance with bioMérieux Vitek2

A 1-month old neonate urine sample yielded vanB Enterococcus faecium; nevertheless, the isolate alternatively showed susceptibility and resistance to vancomycin with bioMérieux Vitek2 (cards AST592, AST632, AST586), while glycopeptide resistance was detected by Liofilchem(®) vancomycin MIC Test Stri...

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Bibliographic Details
Published in:International journal of clinical and experimental pathology 2014-01, Vol.7 (9), p.6274-6277
Main Authors: Savini, Vincenzo, Marrollo, Roberta, Coclite, Eleonora, Fusilli, Paola, D'Incecco, Carmine, Fazii, Paolo, Gherardi, Giovanni
Format: Article
Language:English
Subjects:
Automation, Laboratory
Bacterial Proteins - genetics
Brief Communication
Disk Diffusion Antimicrobial Tests
Drug Resistance, Multiple, Bacterial - genetics
Enterococcus faecium - drug effects
Enterococcus faecium - genetics
Enterococcus faecium - isolation & purification
Genotype
Gram-Positive Bacterial Infections - diagnosis
Gram-Positive Bacterial Infections - drug therapy
Gram-Positive Bacterial Infections - microbiology
Humans
Infant, Newborn
Male
Microbial Sensitivity Tests - instrumentation
Predictive Value of Tests
Reagent Strips
Reproducibility of Results
Urinary Tract Infections - diagnosis
Urinary Tract Infections - drug therapy
Urinary Tract Infections - microbiology
Urine - microbiology
Vancomycin Resistance - genetics
Vancomycin-Resistant Enterococci - drug effects
Vancomycin-Resistant Enterococci - genetics
Vancomycin-Resistant Enterococci - isolation & purification
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Summary:A 1-month old neonate urine sample yielded vanB Enterococcus faecium; nevertheless, the isolate alternatively showed susceptibility and resistance to vancomycin with bioMérieux Vitek2 (cards AST592, AST632, AST586), while glycopeptide resistance was detected by Liofilchem(®) vancomycin MIC Test Strip and disc along with the Chromatic VRE chromogenic medium. This communication emphasizes that, as vanB gene may be heterogeneously expressed within a given Enterococcus population, glycopeptide resistance may be missed when using automated systems for antibiotic susceptibility testing. We suggest therefore that vancomycin in vitro activity be studied on all clinical isolates through agar methods, including use of chromogenic media.
ISSN:1936-2625