Practical approach to the identification of clinically relevant Enterococcus species

Enterococci have become important nosocomial pathogens, with Enterococcus f aecalis and then Enterococcus faecium predominating. Because of the emergen ce of glycopeptide (vancomycin and teicoplanin) resistance in enterococci, laboratories have been required to screen for resistance strains and to ide ntify them to the species level. This has resulted in the need for accurate identification of species less commonly associated with clinical infection s, such as Enterococcus casseliflavus and Enterococcus gallinarum, which ar e inherently resistant to the glycopeptides. Studies evaluating commonly us ed commercial identification systems, have found error rates for enterococc al species identification of 2-21% for E. faecalis, 5-9% for E. faecium, an d 14-79% for other species. Reporting errors may have adverse effects on th e management of clinical infections, as well as in the control of multidrug -resistant strain outbreaks. The purpose of this document is to present a s implified appuoach to the identification of Enterococcus species that uses a combination of rapid, readily available, and inexpensive tests. (C) 1999 Elsevier Science Inc.