title: Proficiency of determination of vancomycin susceptibility in enterococci by clinical laboratories in Taiwan.
abstract: Eighty clinical microbiology laboratories in Taiwan were evaluated for proficiency in the determination of vancomycin susceptibility of enterococci. Each laboratory was given 1 vancomycin-sensitive isolate and 3 vancomycin-resistant enterococci (VRE) isolates to determine the levels of vancomycin resistance. Among a total of 240 tests performed, 153 (63.8%) correctly determined the levels of vancomycin resistance of the survey isolates. Seventy eight (98%) of the 80 laboratories accurately identified the high level of vancomycin resistant isolates [Enterococcus faecalis; minimum inhibitory concentration (MIC) >256 microg/mL]. Seventy two laboratories (90%) correctly determined the level of vancomycin resistance of another VRE with a vancomycin MIC of 64 microg/mL. Only 3 of the 80 laboratories correctly determined the intermediate-level vancomycin resistant isolates (Enterococcus casseliflavus; MIC = 8 microg/mL). Eight laboratories reported the vancomycin-susceptible isolate as being vancomycin-resistant or of intermediate susceptibility. This survey demonstrated that clinical microbiology laboratories in Taiwan are proficient in detecting high-level but not low-level VRE, suggesting a need to improve their proficiency in VRE detection.
authors.affiliation: Division of Clinical Pathology, Department of Pathology, Tri-Service General Hospital and National Defense Medical Center, Taipei, ROC. jjl@mail.ndmctsgh.edu.tw
authors.forename: Jang-Jih
authors.initials: JJ
authors.lastname: Lu
authors.forename: Shih-Yi
authors.initials: SY
authors.lastname: Lee
authors.forename: Cherng-Lih
authors.initials: CL
authors.lastname: Perng
mesh_terms: D016983:Enterococcus / Q000187:drug effects* / Q000302:isolation & purification*; D013293:Enterococcus faecalis / Q000187:drug effects / Q000302:isolation & purification; D016984:Enterococcus faecium / Q000187:drug effects / Q000302:isolation & purification; D006801:Humans; D007753:Laboratories / Q000592:standards / Q000706:statistics & numerical data; D008826:Microbial Sensitivity Tests / Q000592:standards / Q000706:statistics & numerical data; D013624:Taiwan; D020713:Vancomycin Resistance