Evaluation of the Velogene genomic assay for detection of vanA and vanB genes in vancomycin-resistant Enterococcus species

Effective communication of antimicrobial susceptibility data by pathologists to clinicians

As antimicrobial-resistant gram-positive and gram-negative bacterial infections continue to emerge over time, influenced by selective pressure, and the costs of treating these infections increase, the ability of microbiology laboratories to accurately detect drug resistant bacteria and communicate susceptibility test results effectively to clinicians in a timely manner is more important than ever. Ongoing cooperation and coordination of activities among clinical pathologists, technical personnel, pharmacy, clinical services, and infection control using up-to-date laboratory methodologies and interpretive criteria to develop laboratory reports that are transmitted efficiently through computerized communication systems for use within each particular institution are essential to provide optimum patient care, control resistance, and conserve resources.

Epidemiology and mechanisms of glycopeptide resistance in enterococci

PURPOSE OF REVIEW

This review updates epidemiologic trends and our understanding of glycopeptide resistance in enterococci.

RECENT FINDINGS

Colonization and infection rates with vancomycin resistant enterococci continue to increase throughout the world while factors contributing to this rise continue to be defined. While no interventions exist to eradicate colonization, infection control procedures are cost effective and decrease the prevalence of vancomycin resistant enterococcal colonization and infection. New molecular methods show great promise in strengthening our ability to detect colonization with these bacteria. Furthermore, our understanding of the origin of vancomycin resistant enterococci continues to grow. Paenibacillus species found in soil have been found to carry homologues of vanA-associated glycopeptide resistance genes found in enterococci. Also, additional evidence supports previous data that VanB-associated resistance may have been horizontally transferred from gastrointestinal tract bacteria to enterococci. Finally, glycopeptide resistance has been transferred to methicillin-resistant Staphylococcus aureus in clinical practice on several occasions.

SUMMARY

The prevalence of vancomycin resistant enterococci will likely continue to increase. Implementation of infection control strategies, in conjunction with deployment of advanced technologies for detection of vancomycin resistant enterococci, may curb this rise. The emergence of vancomycin resistant S. aureus is of concern.

Evaluation of ChromocultR enterococci agar for the isolation and selective enumeration of Enterococcus spp. in broilers

AIMS

To investigate the productivity and specificity of a new chromogenic enterococci selective medium (Chromocult enterococci agar) recently developed by Merck.

METHODS AND RESULTS

The study was carried out comparing Chromocult enterococci agar with MRS agar (Merck), a basal lactic acid bacteria medium in current use. A total of 216 faecal samples from poultry were collected and enterococci populations were counted. Likewise, 100 randomly selected strains were identified for each medium. The differences found between the two media were analysed and discussed.

CONCLUSIONS

A good sensitivity of 98% was obtained for Chromocult agar and all false-positive isolates obtained were identified as Leuconostoc spp. However significant differences (P<0.01) were obtained between the enterococci species isolation rates identified from these two media, suggesting the poor growth of some species in Chromocult enterococci agar. Viable counts of Enterococcus spp. obtained with MRS agar were significantly higher than those obtained with Chromocult enterococci agar.

SIGNIFICANCE AND IMPACT OF THE STUDY

The use of chromogenic media for microbiological analysis is increasing. Independent studies are important to evaluate newly developed chromogenic media.