title: 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.
abstract: 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.
authors.affiliation: Clinical Microbiology and Virology, Spirito Santo Hospital Pescara (Pe), Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Savini
authors.affiliation: Clinical Microbiology and Virology, Spirito Santo Hospital Pescara (Pe), Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Marrollo
authors.affiliation: Neonatal Intensive Care Unit and Neonatal Pathology, Spirito Santo Hospital Pescara (PE), Italy.
authors.forename: Eleonora
authors.initials: E
authors.lastname: Coclite
authors.affiliation: Neonatal Intensive Care Unit and Neonatal Pathology, Spirito Santo Hospital Pescara (PE), Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Fusilli
authors.affiliation: Neonatal Intensive Care Unit and Neonatal Pathology, Spirito Santo Hospital Pescara (PE), Italy.
authors.forename: Carmine
authors.initials: C
authors.lastname: D'Incecco
authors.affiliation: Clinical Microbiology and Virology, Spirito Santo Hospital Pescara (Pe), Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Fazii
authors.affiliation: Integrated Research Centre, University Campus Biomedico Rome (RM), Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Gherardi
mesh_terms: D057205:Automation, Laboratory; D001426:Bacterial Proteins / Q000235:genetics*; D052978:Disk Diffusion Antimicrobial Tests; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics*; D016984:Enterococcus faecium / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification; D005838:Genotype; D016908:Gram-Positive Bacterial Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008826:Microbial Sensitivity Tests / Q000295:instrumentation*; D011237:Predictive Value of Tests; D011934:Reagent Strips; D015203:Reproducibility of Results; D014552:Urinary Tract Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D014556:Urine / Q000382:microbiology; D020713:Vancomycin Resistance / Q000235:genetics*; D065507:Vancomycin-Resistant Enterococci / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification
chemical_list: D001426:Bacterial Proteins; D011934:Reagent Strips; C079913:VanB protein, Enterococcus
keywords: Enterococcus faecium; glycopeptide; neonate; newborn; vanB; vancomycin