Lu Jang-Jih, Lee Shih-Yi, Perng Cherng-Lih
Division of Clinical Pathology, Department of Pathology, Tri-Service General Hospital and National Defense Medical Center, Taipei, ROC.
J Microbiol Immunol Infect. 2004 Aug;37(4):242-5.
Eighty clinical microbiology laboratories in Taiwan were evaluated for proficiency in the determination of vancomycin susceptibility of enterococci. Each laboratory was given 1 vancomycin-sensitive isolate and 3 vancomycin-resistant enterococci (VRE) isolates to determine the levels of vancomycin resistance. Among a total of 240 tests performed, 153 (63.8%) correctly determined the levels of vancomycin resistance of the survey isolates. Seventy eight (98%) of the 80 laboratories accurately identified the high level of vancomycin resistant isolates [Enterococcus faecalis; minimum inhibitory concentration (MIC) >256 microg/mL]. Seventy two laboratories (90%) correctly determined the level of vancomycin resistance of another VRE with a vancomycin MIC of 64 microg/mL. Only 3 of the 80 laboratories correctly determined the intermediate-level vancomycin resistant isolates (Enterococcus casseliflavus; MIC = 8 microg/mL). Eight laboratories reported the vancomycin-susceptible isolate as being vancomycin-resistant or of intermediate susceptibility. This survey demonstrated that clinical microbiology laboratories in Taiwan are proficient in detecting high-level but not low-level VRE, suggesting a need to improve their proficiency in VRE detection.
