Delmas J, Robin F, Romaszko J-P, Baraduc R, Lesens O, Sirot J, Bonnet R
Service de bactériologie, faculté de médecine, CHU Clermont-Ferrand, 28 place H.-Dunant, 63001 Clermont-Ferrand, France.
Pathol Biol (Paris). 2005 Oct-Nov;53(8-9):485-9. doi: 10.1016/j.patbio.2005.06.013. Epub 2005 Aug 3.
Screening for Vancomycin Resistant Enterococci (VRE) is recommended for preventing nosocomial infections with VRE. The aim of this study was to assess the performance of VCA3 agar (bioMérieux) in VRE isolation from fecal specimens. 220 specimens were cultured on VCA3 agar, which contains vancomycin and in parallel, on CAP agar (Oxoid), which is vancomycin-free. 36 vancomycin resistant enterococci were isolated: 24 isolates of Enterococcus faecium expressed a high-level resistance to vancomycin and 12 isolates of E. gallinarum/casseliflavus exhibited resistance at low-level. The sensitivity of VCA3 appeared greater than that of CAP for VRE isolation: 92% (22/24) vs 79% (19/24) for E. faecium (NS, P>0.05) ; 83% (10/12) vs 50% (6/12) for E. gallinarum/casselliflavus (NS, P>0.05). As expected, initial cultures of multiple gram positive organisms were far more frequent on CAP agar than on VCA3 agar. The isolation rate of vancomycin susceptible gram positive strains was impressively lower on VCA3 medium than on CAP medium. VCA3 agar avoided therefore additional subcultures, useless identification and susceptibility tests. In conclusion, VCA3 medium could be useful for the direct, rapid and selective isolation of VRE from fecal specimens.
推荐对耐万古霉素肠球菌(VRE)进行筛查以预防VRE引起的医院感染。本研究的目的是评估VCA3琼脂(生物梅里埃公司)从粪便标本中分离VRE的性能。220份标本分别在含万古霉素的VCA3琼脂和不含万古霉素的CAP琼脂(奥克托公司)上进行培养。共分离出36株耐万古霉素肠球菌:24株粪肠球菌对万古霉素表现出高水平耐药,12株鹑鸡肠球菌/格氏肠球菌表现出低水平耐药。VCA3琼脂对VRE分离的敏感性似乎高于CAP琼脂:粪肠球菌的敏感性分别为92%(22/24)和79%(19/24)(无统计学差异,P>0.05);鹑鸡肠球菌/格氏肠球菌的敏感性分别为83%(10/12)和50%(6/12)(无统计学差异,P>0.05)。正如预期的那样,CAP琼脂上多种革兰氏阳性菌的初始培养比VCA3琼脂上更为常见。VCA3培养基上万古霉素敏感革兰氏阳性菌株的分离率明显低于CAP培养基。因此,VCA3琼脂避免了额外的传代培养、无用的鉴定和药敏试验。总之,VCA3培养基可用于直接、快速和选择性地从粪便标本中分离VRE。