title: [Detection of vancomycin-resistant enterococci by a fully automated microbiology system, RAISUS].
abstract: A fully automated microbiology system, RAISUS recently developed (Nissui Pharmaceuticals Co., Ltd., Tokyo) was evaluated for identification of enterococci and for detection of vancomycin-resistant enterococci (VRE). When a total of 124 enterococcal isolates were tested, RAISUS correctly identified 122 (98.4%) isolates. Two isolates resulted in species-identifications disagreed with the reference but agreed as belonging to the genus of Enterococcus. When a total of fifty-seven VRE isolates confirmed to be positive for vanA and/or vanB genes were tested against vancomycin, the current RAISUS susceptibility program version 1.76 could detect 41 (71.9%) isolates of VRE as having > or = 32 microg/ml MIC for vancomycin, but one was intermediate (MIC, 8.0 microg/ml) and the remaining 15 vanB-type isolates were incorrectly interpreted as vancomycin-susceptible (MIC, < or = 4.0 microg/ml). The test program based on the algorism to determine bacterial growth in the presence of vancomycin was developed and evaluated. With this test program, all the VRE isolates positive for vanA and/or vanB genes were identified as being vancomycin-resistant or intermediate interpretation. However, eight of 19 clinical isolates of E. casseliflavus and E. gallinarum intrinsically possessing vanC gene were determined as being < or = 4.0 microg/ml MIC for vancomycin. With the influence of program revision, RAISUS became to incubate the test plate longer than with the current program, but 50% of enterococcal isolates including vancomycin-resistant and vancomycin-susceptible isolates were determined within 5 hour-incubations and 90% were within 9 to 10 hour-incubations. With these results, we can conclude that the revised test program for enterococcal isolates could rapidly and correctly identify vancomycin-resistance, and will be applicable to the routine susceptibility test in clinical laboratories.
authors.affiliation: Clinical Laboratories, University Hospital of the Ryukyus, Nishihara, Nakagami-Okinawa 903-0215, Japan. isamu@jim.u-ryukyu.ac.jp
authors.forename: Isamu
authors.initials: I
authors.lastname: Nakasone
authors.forename: Nobuhisa
authors.initials: N
authors.lastname: Yamane
authors.forename: Sayuri
authors.initials: S
authors.lastname: Onaga
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Mishina
authors.forename: Naoki
authors.initials: N
authors.lastname: Nishiyama
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Endo
authors.forename: Kenji
authors.initials: K
authors.lastname: Iwawaki
mesh_terms: D001431:Bacteriological Techniques / Q000295:instrumentation / Q000379:methods*; D016983:Enterococcus / Q000187:drug effects / Q000302:isolation & purification*; D014640:Vancomycin / Q000494:pharmacology*; D020713:Vancomycin Resistance
chemical_list: D014640:Vancomycin