Coagulase-negative staphylococci (CNS) play a predominant role in nosocomial infections. Rapid, reliable identification of these organisms is essential for accurate diagnosis and prompt effective treatment of these infections. Quite recently, the VITEK 2 g-positive (gram-positive [GP]) identification card (bioMérieux) has been redesigned for greater accuracy in the identification of gram-positive cocci. We compared the BD Phoenix (Becton Dickinson) and VITEK 2 (bioMérieux) automated microbiology systems, using their respective update version cards, and the API ID32 STAPH test. The glyceraldehyde-3-phosphate dehydrogenase (gap) gene-based T-RFLP (terminal restriction fragment length polymorphism) method was used for verifying the results. In total, 86 clinical isolates of CNS and 27 reference strains were analyzed. The results show that for identification of CNS, the automated identification methods using the newest VITEK 2 and BD Phoenix identification cards are comparable. However, API ID32 STAPH revealed more correct results compared to both automated microbiology systems. Despite the increased performance of the phenotypic automated identification systems compared to the former versions, molecular methods, e.g., the gap-based T-RFLP method, still show superior accuracy in identifying Staphylococcus species other than Staphylococcus aureus.
So far, 40 species of the genus Staphylococcus have been identified (8).Staphylococcus aureus is the best known and has been frequently implicated in the etiology of a series of infections and intoxications in humans, whereas coagulase-negative staphylococci (CNS), representing the majority of the species, have been considered to be saprophytic or rarely pathogenic. Currently, several species of CNS are recognized as potential pathogens, mainly causing nosocomial infections, often involved in infections related to implanted medical devices such as intravenous catheters, prosthetic heart valves, and orthopedic implants. The species that most frequently cause diseases in humans are Staphylococcus epidermidis, Staphylococcus haemolyticus, and Staphylococcus saprophyticus. (6,12,17,20).
Other significant opportunistic pathogens include Staphylococcus hominis, Staphylococcus warneri, Staphylococcus capitis, Staphylococcus simulans, Staphylococcus cohnii, Staphylococcus xylosus, Staphylococcus saccharolyticus, and Staphylococcus lugdunensisIn this regard, comprehensive and accurate identification of the distinct Staphylococcus species is of great importance. A variety of methods have been proposed for identification schemes based on commercial tests and in relation to the publication of Kloos and Schleifer (15). Various automated identification and susceptibility test systems are currently on the market, among them VITEK 2 (bioMérieux, Marcy l'Etoile, France) and the BD Phoenix system (Becton Dickinson Diagnostic Systems, Sparks, MD.). Quite recently, the VITEK 2 gram-positive (GP) identification card (bioMérieux, Marcy l'Etoile, France) has been redesigned for increased accuracy...