ArticleJournal of clinical microbiology2014
Performance of the EUCAST disk diffusion method, the CLSI agar screen method, and the Vitek 2 automated antimicrobial susceptibility testing system for detection of clinical isolates of Enterococci with low- and medium-level VanB-type vancomycin resistance: a multicenter study.
Article in Journal of clinical microbiology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.
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Who cites it
25 citing papers in PubMed, 47 citations in OpenAlex.
- One Health Insights intoInternational journal of molecular sciences · 2026Article
- Rapid prediction of vancomycin-resistantFrontiers in microbiology · 2026Article
- In vitro phytochemical and biological evaluation of hydroethanolic extract of Anchomanes difformis In Togo.Scientific reports · 2025Article
- Draft genomes of multidrug-resistantMicrobiology resource announcements · 2025Article
- Transposon-directed insertion-site sequencing (TraDIS) analysis ofMicrobiology spectrum · 2025Article
- A novel thermostable lytic phage vB_EF_Enf3_CCASU-2024-3 against clinical Enterococcus faecium and Enterococcus faecalis.AMB Express · 2025Article
- Automated molecular detection of the vancomycin resistance genes vanA and vanB using the geneLEAD VIII platform.Access microbiology · 2025Article
- Molecular Epidemiology and Characterization of Multidrug-Resistant MRSA ST398 and ST239 in Himachal Pradesh, India.Infection and drug resistance · 2023Article
- Antimicrobial Susceptibility Testing for Enterococci.Journal of clinical microbiology · 2022Review
- A Simple and Rapid Low-Cost Procedure for Detection of Vancomycin-Resistance Genes in Enterococci Reveals an Outbreak of Vancomycin-VariableDiagnostics (Basel, Switzerland) · 2022Article
- Phenotypic and genotypic detection methods for antimicrobial resistance in ESKAPE pathogens (Review).Experimental and therapeutic medicine · 2022Review
- Evolution and antimicrobial resistance of enterococci isolated from Pecorino and goat cheese manufactured on-farm in an area facing constraints as per EU Regulation 1305/2013 in Umbria, Italy.Italian journal of food safety · 2022Article
- In vitro dissolution testing models of ocular implants for posterior segment drug delivery.Drug delivery and translational research · 2022Review
- Enterococcus faecium: from microbiological insights to practical recommendations for infection control and diagnostics.Antimicrobial resistance and infection control · 2020Review
- Comparison of VITEK® 2, three different gradient strip tests and broth microdilution for detecting vanB-positive Enterococcus faecium isolates with low vancomycin MICs.The Journal of antimicrobial chemotherapy · 2019Article
- Dissemination and genetic analysis of the stealthy vanB gene clusters of Enterococcus faecium clinical isolates in Japan.BMC microbiology · 2018Article
- Rapid disc diffusion antibiotic susceptibility testing for Pseudomonas aeruginosa, Acinetobacter baumannii and Enterococcus spp.The Journal of antimicrobial chemotherapy · 2018Article
- Continuous increase of vancomycin resistance in enterococci causing nosocomial infections in Germany - 10 years of surveillance.Antimicrobial resistance and infection control · 2018Article
- Evaluation of the novel artus C. difficile QS-RGQ, VanR QS-RGQ and MRSA/SA QS-RGQ assays for the laboratory diagnosis of Clostridium difficile infection (CDI), and for vancomycin-resistant enterococci (VRE) and methicillin-resistant Staphylococcus aureus (MRSA) screening.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2017Article
- Diagnostic Evasion of Highly-Resistant Microorganisms: A Critical Factor in Nosocomial Outbreaks.Frontiers in microbiology · 2017Article
Corrections and comments
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Authors and funding
9 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Different antimicrobial susceptibility testing methods to detect low-level vancomycin resistance in enterococci were evaluated in a Scandinavian multicenter study (n=28). A phenotypically and genotypically well-characterized diverse collection of Enterococcus faecalis (n=12) and Enterococcus faecium (n=18) strains with and without nonsusceptibility to vancomycin was examined blindly in Danish (n=5), Norwegian (n=13), and Swedish (n=10) laboratories using the EUCAST disk diffusion method (n=28) and the CLSI agar screen (n=18) or the Vitek 2 system (bioMérieux) (n=5). The EUCAST disk diffusion method (very major error [VME] rate, 7.0%; sensitivity, 0.93; major error [ME] rate, 2.4%; specificity, 0.98) and CLSI agar screen (VME rate, 6.6%; sensitivity, 0.93; ME rate, 5.6%; specificity, 0.94) performed significantly better (P=0.02) than the Vitek 2 system (VME rate, 13%; sensitivity, 0.87; ME rate, 0%; specificity, 1). The performance of the EUCAST disk diffusion method was challenged by differences in vancomycin inhibition zone sizes as well as the experience of the personnel in interpreting fuzzy zone edges as an indication of vancomycin resistance. Laboratories using Oxoid agar (P<0.0001) or Merck Mueller-Hinton (MH) agar (P=0.027) for the disk diffusion assay performed significantly better than did laboratories using BBL MH II medium. Laboratories using Difco brain heart infusion (BHI) agar for the CLSI agar screen performed significantly better (P=0.017) than did those using Oxoid BHI agar. In conclusion, both the EUCAST disk diffusion and CLSI agar screening methods performed acceptably (sensitivity, 0.93; specificity, 0.94 to 0.98) in the detection of VanB-type vancomycin-resistant enterococci with low-level resistance. Importantly, use of the CLSI agar screen requires careful monitoring of the vancomycin concentration in the plates. Moreover, disk diffusion methodology requires that personnel be trained in interpreting zone edges.
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