Evaluation of errors during susceptibility reporting of glycopeptide antibiotics for enterococcal isolates on sole basis of widely used disk diffusion test


Submitted: 20 August 2022
Accepted: 14 December 2022
Published: 22 December 2022
Abstract Views: 497
PDF: 110
HTML: 38
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

In resource limited settings, very often susceptibility reports glycopeptide antibiotics are released only on the basis of disk diffusion test. Determination of MIC by either E-strips or microbroth dilution tests can be of paramount importance in checking the errors that may have incurred with the singular use of disk diffusion tests. Distribution of errors in Vancomycin and Teicoplanin susceptibility reporting by disk diffusion test was evaluated in comparison with MIC determination with reference method of E-strip. A total of 40 isolates of Enterococcus species were obtained during the study period. In vancomycin susceptibility reporting, very major errors, major errors and minor errors were observed in 33.3%, 5.4% and 5% instances respectively. For teicoplanin, major errors were observed in 5.3% of instances. E test can be used in conjunction with disk diffusion where resources are limited. We have observed that by using a combination of both disk diffusion and MIC determination by E-strip methods for glycopeptide antibiotics, a majority of reporting errors can be addressed.


Murray BE. The life and times of the Enterococcus. Clin Microbiol Rev 1990;3:46-65. DOI: https://doi.org/10.1128/CMR.3.1.46

Geraci JE, Wilson WR. Vancomycin therapy for infective endocarditis. Rev Infect Dis 1981;3:S250-8. DOI: https://doi.org/10.1093/clinids/3.Supplement_2.S250

Gump DW. Vancomycin for treatment of bacterial meningitis. Rev Infect Dis 1981;3:S289-92. DOI: https://doi.org/10.1093/clinids/3.Supplement_2.S289

Kirby WM. Vancomycin therapy in severe staphylococcal infections. Rev Infect Dis 1981;3:S236-9. DOI: https://doi.org/10.1093/clinids/3.Supplement_2.S236

Leclercq R, Derlot E, Duval J, Courvalin P. Plasmid-mediated resistance to vancomycin and teicoplanin in Enterococcus faecium. New Engl J Med 1988;319:157-61. DOI: https://doi.org/10.1056/NEJM198807213190307

Uttley AH, George RC, Naidoo J, et al. High-level vancomycin-resistant enterococci causing hospital infections. Epidemiol Infect 1989;103:173-81.

Williamson R, Al-Obeid S, Shlaes JH, et al. Inducible resistance to vancomycin in Enterococcus faecium D366. J Infect Dis 1989;159:1095-104. DOI: https://doi.org/10.1093/infdis/159.6.1095

Hirt H, Hall JW, Larson E, Gorr SU. A D-enantiomer of the antimicrobial peptide GL13K evades antimicrobial resistance in the Gram positive bacteria Enterococcus faecalis and Streptococcus gordonii. PLoS One 2018;13:e0194900. DOI: https://doi.org/10.1371/journal.pone.0194900

Uttley AC. Vancomycin-resistant enterococci. Lancet 1988;2:57-8. DOI: https://doi.org/10.1016/S0140-6736(88)91037-9

Uttley AH, George RC, Naidoo J, et al. High-level vancomycin-resistant enterococci causing hospital infections. Epidemiol Infect 1989;103:173-81. DOI: https://doi.org/10.1017/S0950268800030478

Bhatt P, Sahni AK, Praharaj AK, et al. Detection of glycopeptide resistance genes in enterococci by multiplex PCR. Med J Armed Forces India 2015;71:43-7. DOI: https://doi.org/10.1016/j.mjafi.2014.03.005

Huang MB, Baker CN, Banerjee SH, Tenover F. Accuracy of the E test for determining antimicrobial susceptibilities of staphylococci, enterococci, Campylobacter jejuni, and gram-negative bacteria resistant to antimicrobial agents. J Clin Microbiol 1992;30:3243-8. DOI: https://doi.org/10.1128/jcm.30.12.3243-3248.1992

Clinical and Laboratory Standards Institute. Performance standard for antimicrobial susceptibility testing, 22nd ed. Wayne, USA: CLSI; 2022.

Tenover FC, Williams PP, Stocker S, et al. Accuracy of six antimicrobial susceptibility methods for testing linezolid against staphylococci and enterococci. J Clin Microbiol 2007;45:2917-22. DOI: https://doi.org/10.1128/JCM.00913-07

Angadi K, Jadhav S, Misra RN, et al. Incidence and antimicrobial susceptibility of enterococcal infections in tertiary care hospital. Intl J Microbiol Res 2018;10:1135–8. DOI: https://doi.org/10.9735/0975-5276.10.4.1135-1138

Gupta V, Singla N, Behl P, et al. Antimicrobial susceptibility pattern of vancomycin resistant enterococci to newer antimicrobial agents. Indian J Med Res 2015;141:483. DOI: https://doi.org/10.4103/0971-5916.159309

Mathew SK. A profile of vancomycin-resistant enterococcal infections and a comparison of resistance detection methods. Indian J Microbiol Res 2018;5:408–14. DOI: https://doi.org/10.18231/2394-5478.2018.0085

Rai S, Niranjan DK, Kaur T, et al. Detection of the classical G2576U mutation in linezolid resistant Staphylococcus aureus along with isolation of linezolid resistant Enterococcus faecium from a patient on short-term linezolid therapy: First report from India. Indian J Med Microbiol 2015;33:21–4. DOI: https://doi.org/10.4103/0255-0857.148371

Khalili H, Soltani R, Negahban S, et al. Reliability of disk diffusion test results for the antimicrobial susceptibility testing of nosocomial gram-positive microorganisms: is E-test method better? Iranian J Pharmaceut Res 2012;11:559.

Tenover FC, Swenson JM, O'Hara CM, Stocker SA. Ability of commercial and reference antimicrobial susceptibility testing methods to detect vancomycin resistance in enterococci. J Clin Microbiol 1995;33:1524-7. DOI: https://doi.org/10.1128/jcm.33.6.1524-1527.1995

Saini, V., Goyal, N., Singh, N. P., & Goswami, M. (2022). Evaluation of errors during susceptibility reporting of glycopeptide antibiotics for enterococcal isolates on sole basis of widely used disk diffusion test. Healthcare in Low-Resource Settings, 10(1). https://doi.org/10.4081/hls.2022.10806

Downloads

Download data is not yet available.

Citations