Abstract
Enterococci are major, recalcitrant nosocomial pathogens with a wide repertoire of intrinsic and acquired resistance determinants and the potential of developing resistance to all clinically available antimicrobials. As such, multidrug-resistant enterococci are considered a serious public health threat. Due to limited treatment options and rapid emergence of resistance to all novel agents, the clinical microbiology laboratory plays a critical role in deploying accurate, reproducible, and feasible antimicrobial susceptibility testing methods to guide appropriate treatment of patients with deep-seated enterococcal infections. In this review, we provide an overview of the advantages and disadvantages of existing manual and automated methods that test susceptibility of Enterococcus faecium and Enterococcus faecalis to β-lactams, aminoglycosides, vancomycin, lipoglycopeptides, oxazolidinones, novel tetracycline-derivatives, and daptomycin. We also identify unique problems and gaps with the performance and clinical utility of antimicrobial susceptibility testing for enterococci, provide recommendations for clinical laboratories to circumvent select problems, and address potential future innovations that can bridge major gaps in susceptibility testing.
Original language | English (US) |
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Pages (from-to) | e0084321 |
Journal | Journal of Clinical Microbiology |
Volume | 60 |
Issue number | 9 |
DOIs | |
State | Published - Sep 21 2022 |
Keywords
- Enterococcus
- antibiotic resistance
- antimicrobial activity
- antimicrobial agents
- clinical methods
- diagnostics
- gram-positive bacteria
- hospital infections
- multidrug resistance
- susceptibility testing
- Oxazolidinones/therapeutic use
- Aminoglycosides/therapeutic use
- Humans
- Daptomycin
- Tetracycline/therapeutic use
- beta-Lactams
- Anti-Bacterial Agents/pharmacology
- Lipoglycopeptides
- Microbial Sensitivity Tests
- Vancomycin/therapeutic use
- Gram-Positive Bacterial Infections/drug therapy
ASJC Scopus subject areas
- Microbiology (medical)