Detection of glycopeptide-resistant enterococci in routine diagnostic faeces specimens

Taylor, Mark E.; Oppenheim, B.A.; Chadwick, P R; Weston, Debbie; Palepou, M.-F. I.; Woodford, Neil; Bellis, M. A

doi:10.1053/jhin.1999.0630

Cited by 17 publications

(12 citation statements)

References 49 publications

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“…This may be due to both the highly selective nature of the BEA VAN agar as well as the anticipated complexities of van expression in the bacterial host. A number of studies have found that the inclusion of a VAN broth enrichment step provides sensitivity superior to that achieved by direct agar culture (5,7,11,22). In spite of this, broth VRE selective media are not readily available from commercial suppliers.…”

Section: Discussionmentioning

confidence: 99%

“…Other studies have found that the gut flora of study populations harbored various ratios of vanA and vanB E. faecium and/or E. faecalis strains, all of which were notably different from our population of predominantly vanA E. faecium (68%). The ratios of van type and enterococcal species (i.e., E. faecium or E. faecalis) which harbor these genetic determinants thus appear to be unique for a given population (1,5,22,25).…”

Section: Discussionmentioning

confidence: 99%

“…However, there is a continued need for an improved culture method of VRE detection (i) for the collection of viable isolates necessary for epidemiological and antimicrobial susceptibility studies and (ii) by those clinical microbiology laboratories that do not have access to nucleic acid amplification technology (8,12,17,18). VAN broth enrichment has been shown to be superior to direct plating on VAN-containing media for VRE isolation, but VAN broth is not generally commercially available, and the in-house manufacturing of VAN selective broth is beyond the capability of many clinical microbiology laboratories (5,7,11,22). Because of these problems associated with the use of VAN broth, commercially produced VRE selective differential agars containing VAN at concentrations of 6 to 8 g/ml (e.g., bile esculin azide [BEA] agar with VAN) are often used.…”

mentioning

confidence: 99%

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Convenient Selective Differential Broth for Isolation of Vancomycin-Resistant Enterococcus from Fecal Material

Novicki¹,

Schapiro

Ulness³

et al. 2004

J Clin Microbiol

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Studies have shown that vancomycin broth enrichment is superior to direct plating for the detection of vancomycin-resistant enterococcus (VRE), but vancomycin selective broth is not generally commercially available. We developed an easy-to-prepare VRE selective differential broth and compared it to direct plating on bile esculin azide (BEA) agar for the isolation of VRE from fecal samples. A total of 528 consecutive rectal swabs and stools were inoculated onto BEA agar and into BEA broth with vancomycin at a concentration of 15 g/ml (BEA VAN 15g/ml broth). After 1 to 2 days of incubation, broths were subcultured to BEA VAN 6g/ml agar. Bile esculin-positive colonies from the direct and broth subculture plates were evaluated for the presence of VRE by standard microbiological techniques. Addition of the broth enrichment step led to the detection of significantly more VRE isolates than did direct plating alone (28 versus 18 VRE isolates, respectively). In all, 30 VRE strains were isolated from 29 cultures, all of which were Enterococcus faecium. MICs of vancomycin ranged from 32 g/ml (n ‫؍‬ 2) to > 256 g/ml (n ‫؍‬ 28). Twenty-two VRE isolates were available for further testing: sixteen exhibited a VanA phenotype and six were of the VanB phenotype. van genotypes were in agreement with phenotypes for all VRE isolates except one, which could not be genotyped. The broth method also resulted in significantly fewer bile esculin-positive, non-VRE isolates requiring further workup. We have thus developed an easily prepared vancomycin selective differential broth that is significantly more sensitive and specific in the detection of VRE than is direct fecal plating to BEA agar.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Convenient Selective Differential Broth for Isolation of Vancomycin-Resistant Enterococcus from Fecal Material

Novicki¹,

Schapiro

Ulness³

et al. 2004

J Clin Microbiol

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“…Reported VRE colonization rates among hospitalized patients vary widely, ranging from 1.5% to 32%, while the prevalence of VRE among non-hospitalized patients is 1-3.5%, usually involving non-epidemic isolates 11,14,[20][21][22] . Futardo et al 7) reported that the incidence of VRE in neurosurgical department was from 2% to 6%.…”

Section: Incidence Of Vre Infection In Neurosurgical Practicementioning

confidence: 99%

Incidence and Risk Factors of Infection Caused by Vancomycin-Resistant Enterococcus Colonization in Neurosurgical Intensive Care Unit Patients

et al. 2009

J Korean Neurosurg Soc

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Objective : This study was aimed to identify the incidence and risk factors of vancomycin-resistant enterococcus (VRE) colonization in neurosurgical practice of field, with particular attention to intensive care unit (ICU). Methods : This retrospective study was carried out on the Neurosurgical ICU (NICU), during the period from January. 2005 to December. 2007, in 414 consecutive patients who had been admitted to the NICU. Demographics and known risk factors were retrieved and assessed by statistical methods. Results : A total of 52 patients had VRE colonization among 414 patients enrolled, with an overall prevalence rate of 6.1%. E. faecium was the most frequently isolated pathogen, and 92.3 % of all VRE were isolated from urine specimen. Active infection was noticed only in 2 patients with bacteremia and meningitis. Relative antibiotic agents were third-generation cephalosporin in 40%, and vancomycin in 23%, and multiple antibiotic usages were also identified in 13% of all cases. Multivariate analyses showed Glasgow coma scale (GCS) score less than 8, placement of Foley catheter longer than 2 weeks, ICU stay over 2 weeks and presence of nearby VRE-positive patients had a significantly independent association with VRE infection. Conclusion : When managing the high-risk patients being prone to be infected VRE in the NICU, extreme caution should be paid upon. Because prevention and outbreak control is of ultimate importance, clinicians should be alert the possibility of impending colonization and infection by all means available. The most crucial interventions are careful hand washing, strict glove handling, meticulous and active screening, and complete segregation.

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“…In the United Kingdom, this cluster is found in approximately 15% of glycopeptideresistant enterococci from hospitalized patients (8), although proportions as high as 64 and 90% have been reported in some hospitals (9,11). Three subtypes, based on nucleotide variability, have been designated vanB1, vanB2, and vanB3 (2, 10), respectively, and have been found within different transposons (3).…”

mentioning

confidence: 99%

Prevalence of the vanB2 Gene Cluster in VanB Glycopeptide-Resistant Enterococci in the United Kingdom and the Republic of Ireland and Its Association with a Tn 5382 -Like Element

McGregor¹,

Nolan²,

Young³

et al. 2001

Antimicrob Agents Chemother

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Detection of glycopeptide-resistant enterococci in routine diagnostic faeces specimens

Cited by 17 publications

References 49 publications

Convenient Selective Differential Broth for Isolation of Vancomycin-Resistant Enterococcus from Fecal Material

Convenient Selective Differential Broth for Isolation of Vancomycin-Resistant Enterococcus from Fecal Material

Incidence and Risk Factors of Infection Caused by Vancomycin-Resistant Enterococcus Colonization in Neurosurgical Intensive Care Unit Patients

Prevalence of the vanB2 Gene Cluster in VanB Glycopeptide-Resistant Enterococci in the United Kingdom and the Republic of Ireland and Its Association with a Tn 5382 -Like Element

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