Universität zu Köln

Walker, Sarah, V, Wolke, Martina, Plum, Georg, Weber, Robert E., Werner, Guido and Hamprecht, Axel ORCID: 0000-0003-1449-5780 (2021). Failure of Vitek2 to reliably detect vanB-mediated vancomycin resistance in Enterococcus faecium. J. Antimicrob. Chemother., 76 (7). S. 1698 - 1703. OXFORD: OXFORD UNIV PRESS. ISSN 1460-2091

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Abstract

Objectives: The increasing prevalence of VRE necessitates their reliable detection, especially for Low-Level resistance mediated by vanB in Enterococcus faecium. In this prospective study we analysed if vanB-mediated vancomycin resistance can be reliably detected by Vitek2. Methods: One thousand, three hundred and forty-four enterococcal isolates from routine clinical specimens were tested by Vitek2 (bioMerieux, Nurtingen, Germany). Additionally, a bacterial suspension (with a turbidity equivalent to that of a 0.5 McFarland standard) was inoculated on chromlD VRE screening agar (bioMerieux) and incubated for 48 h. If vancomycin tested susceptible by Vitek2 but growth was detected on the screening agar, PCR for vanA/vanB was performed (GeneXpert vanA/B test, Cepheid, Frankfurt, Germany). For isolates that tested susceptible to vancomycin by Vitek2 but were vanA/B positive, MICs were determined before and after cultivation in broth with increasing concentrations of vancomycin. Results: One hundred and fifty-six out of 491 E. faecium were VRE and were predominantly vanB positive (81.0%). Of these, Vitek2 did not identify 14 as VRE (sensitivity 91.0%). By broth microdilution 9/14 isolates demonstrated high MICs (>= 32 mg/L) and 5/14 showed Low vancomycin MICs, which did not increase despite vancomycin exposure. Three of the 14 isolates demonstrated growth on chromlD VRE; after vancomycin exposure seven additional isolates were able to grow on chromlD VRE. Conclusions: Vitek2 fails to detect vanB-mediated vancomycin resistance consistently, especially, but not Limited to, Low-Level resistance. As this may Lead to treatment failure and further dissemination of vanB VRE, additional methods (e.g. culture on VRE screening agar or PCR) are necessary to reliably identify vanB-positive enterococci in clinical routine.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Walker, Sarah, V UNSPECIFIED UNSPECIFIED UNSPECIFIED Wolke, Martina UNSPECIFIED UNSPECIFIED UNSPECIFIED Plum, Georg UNSPECIFIED UNSPECIFIED UNSPECIFIED Weber, Robert E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Werner, Guido UNSPECIFIED UNSPECIFIED UNSPECIFIED Hamprecht, Axel UNSPECIFIED orcid.org/0000-0003-1449-5780 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-585255
DOI:	10.1093/jac/dkab101
Journal or Publication Title:	J. Antimicrob. Chemother.
Volume:	76
Number:	7
Page Range:	S. 1698 - 1703
Date:	2021
Publisher:	OXFORD UNIV PRESS
Place of Publication:	OXFORD
ISSN:	1460-2091
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language PERFORMANCE; RISE Multiple languages Infectious Diseases; Microbiology; Pharmacology & Pharmacy Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/58525