Clinical and microbiologic characteristics of pediococci.

Over a 43-month period, 23 separate isolates of nonenterococcal alpha- and nonhemolytic streptococci were reported by our clinical microbiology laboratory to be resistant to vancomycin. This constituted 0.32% of nonenterococcal alpha- and nonhemolytic streptococci reported and 4.4% of such streptococci upon which susceptibility testing was performed. Of 13 isolates which were available for further study, all were highly resistant to vancomycin (MIC greater than or equal to 1,024 micrograms/ml), but none were actually streptococci. Three were clearly gram-positive rods by Gram stain and were found to be homofermentative lactobacilli. Two strains with elongated gram-positive cocci from colonies on agar showed small gram-positive rods when grown in thioglycolate broth and were physiologically identified as Lactobacillus confusus. Two isolates with lenticular gram-positive cocci appeared to be Leuconostoc mesenteroides subsp. mesenteroides. Six gram-positive isolates with round cells from growth on agar and from broth were arranged in tetrads in broth and closely resembled Pediococcus acidilactici. Twelve additional strains of pediococci that were not of human origin were also found to be highly resistant to vancomycin. These findings confirm published reports of clinical isolation of organisms resembling pediococci and suggest that clinically isolated, vancomycin-resistant bacteria which superficially resemble streptococci are probably other lactic acid bacteria.