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Multicenter evaluation of E faecalis PNA FISH for rapid identification and differentiation of E faecalis and other enterococci directly from positive blood culture bottles



Multicenter evaluation of E faecalis PNA FISH for rapid identification and differentiation of E faecalis and other enterococci directly from positive blood culture bottles



Abstracts of the General Meeting of the American Society for Microbiology 103: C-157



Background: Enterococci, especially E. faecalis and E. faecium, have emerged as important causes of nosocomial and community infections. Moreover, resistance to antimicrobials among enterococci has become increasingly prevalent and problematic. Because resistance to ampicillin and vancomycin in E. faecalis is relatively uncommon compared to resistance in E. faecium, the development of rapid tests allowing differentiation between these two enterococcal species is especially important for the institution of appropriate therapy and for resistance surveillance. E. faecalis PNA FISH is a new fluorescence in situ hybridization (FISH) method using PNA probes for identification and differentiation of E. faecalis and other enterococcal species, including E. faecium, directly from positive blood culture bottles with gram-positive cocci in pairs or chains (GPCPC). Methods: A total of 138 routine and 29 spiked blood cultures from four clinical microbiology laboratories and representing three commonly used blood culture systems (ESP, BacT Alert, BacTec) for which a Gram stain showed GPCPC were included in the study. Results were compared to species identification and/or antimicrobial susceptibility data from routine testing by standard methods following subculture and overnight incubation. Results: Direct identification by E. faecalis PNA FISH showed 95% agreement with routine identification. 84% of the negative results were due to streptococci. 0% and 9% of isolates from blood cultures identified as E. faecalis by E. faecalis PNA FISH were resistant to ampicillin and vancomycin, respectively, whereas 79% and 57% of the isolates from blood cultures identified as other enterococci by E. faecalis PNA FISH were resistant to ampicillin and vancomycin, respectively. Conclusion: E. faecalis PNA FISH performs well with commonly used continuously monitoring blood culture systems and provides important information for optimal antimicrobial therapy 1-2 days earlier than standard methods.

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