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Annals of Clinical & Laboratory Science 37:260-262 (2007)
© 2007 Association of Clinical Scientists

Comparison of the MicroScan System and the Agar Dilution Assay for Quinupristin/Dalfopristin Susceptibility of Enterococcus faecium

Yang-Ree Kim1, Sang-Il Kim2, Ji-Ahn Hur3, Youn-Jeong Kim2, Seong-Heon Wie3, Yeon-Joon Park4 and Moon-Won Kang2
1 Department of Internal Medicine, Uijeongbu St. Mary’s Hospital, Uijeongbu, Korea; 2 Department of Internal Medicine, Kangnam St. Mary’s Hospital, Seoul, Korea; 3 Department of Internal Medicine, St. Vincent’s Hospital, Suwon, Korea; and 4 Department of Laboratory Medicine, Kangnam St. Mary’s Hospital, Seoul, Korea. All are affiliated with the College of Medicine of The Catholic University of Korea, Seoul, Korea

Address correspondence to Yeon-Joon Park, M.D., Department of Laboratory Medicine, The Catholic University of Korea, Kangnam St. Mary’s Hospital, 505 Banpo-dong, Seocho-ku, Seoul, 137-701, South Korea; tel 82 2 590 1604; fax 82 2 592 4190; e-mail yjpk{at}catholic.ac.kr.

We compared the results of Quinupristin/Dalfopristin (Q/D) susceptibility tests by the Positive Combo Panel (Type 11) of the MicroScan Walk Away 96 analyzer (Dade Behring, Inc.) with those obtained by the reference agar dilution method. From September 2003 to August 2004, a total of 410 E. faecium isolates were obtained from clinical samples. Of these, 65 (15.9%) strains were non-susceptible, and 345 (84.1%) strains were susceptible to Q/D. We collected consecutively 65 Q/D non-susceptible E. faecium isolates (42 resistant, 23 intermediate), and randomly selected 32 Q/D susceptible E. faecium isolates using the MicroScan system. The minimal inhibitory concentrations (MICs) of Q/D, vancomycin, and teicoplanin were determined by the agar dilution method according to CLSI guidelines. The agreement rates between the two methods were 100% for Q/D-susceptible strains, 85.7% for Q/D-resistant strains, and 26.1% for Q/D-intermediate strains of E. faecium. The major error rate (S->R) was 11.9%, and the minor error rate (S->I) was 13.0%. No very major errors were found. We conclude that for MicroScan ‘non-susceptible’ test results for Q/D, it is necessary to confirm the result using a reference method. The Q/D-resistance rate was higher in glycopeptide-susceptible (78.0% for vancomycin, 82.0% for teicoplanin) than glycopeptide-resistant E. faecium (22.0% for vancomycin, 16.0% for teicoplanin). Further studies are needed to determine whether Q/D use in hospitals or virginiamycin use in animals, or other factors, are responsible for the high rates of glycopeptide-susceptible and Q/D-resistant E. faecium strains in Korea.

Keywords: quinupristin/dalfopristin, Enterococcus faecium, antimicrobial susceptibility testing






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