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首页> 外文期刊>Journal of Clinical Microbiology >Factors influencing the vitek gram-positive susceptibility system's detection of vanB-encoded vancomycin resistance among enterococci.
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Factors influencing the vitek gram-positive susceptibility system's detection of vanB-encoded vancomycin resistance among enterococci.

机译：影响vitek革兰氏阳性药敏系统检测肠球菌中vanB编码的万古霉素耐药性的因素。

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Studies were conducted to identify factors contributing to the inability of the Vitek Gram-Positive Susceptibility system (GPS; bioMerieux, Vitek, Inc., Hazelwood, Mo.) to reliably detect vanB-mediated vancomycin resistance among enterococci. To some extent the accuracy of the GPS depended on a particular strain's level of resistance, as all isolates for which vancomycin MICs were > or = 128 mu g/ml were readily detected but detection of resistance expressed by several strains for which MICs were < or = 64 mu g/ml was sporadic. Factors besides the level of resistance were studied in two vanB strains. For one strain (Enterococcus faecium U8304), the ability of GPS to detect resistance was accurate and consistent, while for the other (Enterococcus faecalis V583), GPS results were inconsistent and unreliable. Using these isolates, we established that growth medium had the most notable effect on the detection of resistance. In the absence of vancomycin, Vitek GPS broth supported growth comparable to that obtained with brain heart infusion broth for both E. faecium U8304 and E. faecalis V583. However, in the presence of vancomycin the growth patterns changed dramatically so that neither VanB strain grew well in Vitek broth, and growth of V583 was barely detectable after 8 h of incubation. In contrast, good growth of both strains was observed in brain heart infusion broth supplemented with vancomycin. Additionally, the same medium effect was observed with other inducibly resistant VanB strains. In conclusion, although Vitek broth can support good enterococcal growth, this medium does not sufficiently support expression of vancomycin resistance by certain strains to allow them to be detected by the Vitek automated system. Furthermore, this observation establishes that the type of growth medium used can substantially influence the expression of vancomycin resistance and indicates that medium-based strategies should be explored for the enhancement of resistance detection among commercial systems.
机译：进行了研究以确定导致Vitek革兰氏阳性药敏系统（GPS; bioMerieux，Vitek，Inc.，Hazelwood，MO）无法可靠地检测肠球菌中vanB介导的万古霉素耐药性的因素。在某种程度上，GPS的准确性取决于特定菌株的抗性水平，因为万古霉素MIC>或= 128μg / ml的所有分离株都可以轻松检测到，但由MIC≤<或= 64μg / ml是零星的。在两个vanB菌株中研究了除抗性水平以外的因素。对于一种菌株（粪肠球菌U8304），GPS检测抗性的能力是准确且一致的，而对于另一种菌株（粪肠球菌V583），GPS结果是不一致且不可靠的。使用这些分离株，我们确定生长培养基对抗药性的检测最显着。在不存在万古霉素的情况下，Vitek GPS肉汤支持的生长可与粪肠球菌U8304和粪肠球菌V583的脑心灌注肉汤相比。然而，在存在万古霉素的情况下，生长方式发生了巨大变化，因此VanB菌株均无法在Vitek肉汤中生长良好，并且在孵育8小时后几乎无法检测到V583的生长。相反，在补充万古霉素的脑心浸液中观察到两种菌株均生长良好。另外，用其他诱导抗性VanB菌株观察到相同的培养基作用。总之，尽管Vitek肉汤可以支持良好的肠球菌生长，但是这种培养基不能充分支持某些菌株对万古霉素耐药性的表达，从而无法通过Vitek自动化系统进行检测。此外，该观察结果表明，所用生长培养基的类型可实质上影响万古霉素耐药性的表达，并表明应探索基于培养基的策略以增强商业系统中的耐药性检测。

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