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PubMed1978

Antimicrobial susceptibility patterns of Streptococcus pneumoniae.

Fifty clinical isolates of Streptococcus pneumoniae received by the Streptococcus Laboratory of the Center for Disease Control from August 1976 through March 1977 and 50 pneumococcal strains retrieved from 13- to 16-year storage (originally isolated October 1961 through December 1964) were tested for susceptibility to 10 antimicrobial agents by disk-agar diffusion and agar dilution tests. No appreciable differences in susceptibility patterns were apparent between the two groups, and, except for one isolate, all were highly susceptible to every drug tested except gentamicin. This single isolate required higher drug concentrations to inhibit macroscopic growth and had corresponding decrements in zones of disk inhibition with penicillin, ampicillin, and cephalothin. An additional 43 pneumococci recently received from various areas of the United States and Canada were screened by a disk agar diffusion method for penicillin resistance. Four of these isolates had penicillin zone diameters <30 mm, and subsequent agar dilution test results showed that the penicillin minimum inhibitory concentrations were elevated with these organisms. Antimicrobial susceptibility patterns of pneumococci to antimicrobials other than penicillin and its analogs have not changed substantially in over a decade. However, due to the emergence of strains with decreased susceptibility to penicillin, the screening test for penicillin resistance in pneumococci, especially in isolates from spinal fluid and blood, could be clinically useful as an aid in selecting optimal therapy.

Cephalosporinase↗

PubMed1984

Variation in the abilities of automated, commercial, and reference methods to detect methicillin-resistant (heteroresistant) Staphylococcus aureus.

The abilities of commercial MIC, automated, and reference methods for in vitro detection of methicillin-resistant Staphylococcus aureus were determined on 49 strains from eight hospitals. Micro-Media, MicroScan, Sensititre, Sceptor, API Uniscept KB, Abbott MS-2, Vitek AMS, Autobac MTS, NCCLS disk diffusion, and broth microdilution antimicrobial susceptibility testing procedures were evaluated. All testing was performed by using manufacturers' or reference procedures, and results were determined at no later than 24 h of incubation at 35 degrees C. With NCCLS disk diffusion, all strains were resistant to oxacillin (1 microgram), 47 (96%) were resistant to methicillin (4 micrograms), and 48 (98%) were resistant to nafcillin (1 microgram). The percentages of strains resistant to methicillin (greater than 8 micrograms/ml) were 98% with API Uniscept KB, 86% with Sceptor, MicroScan, and Autobac MTS, 84% with Sensititre, 71% with Micro-Media, and 70% with NCCLS MIC. Abbott MS-2 detected 86% of strains resistant to methicillin (greater than 5 micrograms/ml). With oxacillin (greater than 2 micrograms/ml), 90% were detected with Vitek AMS and 70% were detected with NCCLS MIC. With nafcillin (greater than 2 micrograms), 82% were resistant with Micro-Media, 57% were resistant by NCCLS MIC, and 50% (three of six) were resistant by MicroScan. Two strains from one hospital and one strain from another gave susceptible results with all automated and commercial methods. All strains from three centers were detected by all methods. Variability also occurred among the systems with cephalothin, clindamycin, gentamicin, chloramphenicol, and trimethoprim sulfamethoxazole.

Methicillin↗

PubMed2004

High prevalence of multiple resistance to antibiotics in Salmonella serovars isolated from a poultry slaughterhouse in Spain.

Salmonellosis is a major foodborne infection in Spain, and strains that are resistant to a great variety of antibiotics have become a major public health concern. The aim of this study was to determine the level of antibiotic resistance in 133 Salmonella isolates obtained from a poultry slaughterhouse in Zaragoza (NE Spain). Antimicrobial resistance testing was performed by disk diffusion method using 19 antibiotics. Results were interpreted following the NCCLS criteria. Overall, the highest percentage of resistance was found to the following antimicrobial agents: sulfadiazine (96.2%), neomycin (53.4%), tetracycline (21.8%), and streptomycin (11.3%). All isolates were found to be resistant to one or more of the antibiotics tested. Multiple resistance was observed in 87 strains (65.4%). We found 23 different patterns of resistance in Salmonella Enteritidis. Resistance to sulfadiazine was the most common single resistance. The most frequent patterns of multiresistant strains were neomycin+sulfadiazine and neomycin+tetracycline+sulfadiazine. S. 4,5,12:b: showed the highest percentages of resistance to the tested drugs, with five different resistance patterns found. Ampicillin+chloramphenicol+streptomycin+sulphonamides+tetracycline (ACSSuT) resistance pattern, commonly associated with S. Typhimurium DT 104, was not detected in strains of the same phage type from broilers. The appearance of substantial multiresistance in foodborne Salmonella isolates suggests the need for more prudent use of antibiotics by farmers, veterinarians, and physicians.

Abattoirs↗

PubMed1993

Prevalence of self-medication with antibiotics among patients attending a clinic for treatment of sexually transmitted diseases.

To ascertain the prevalence of self-medication with antimicrobial agents among patients attending a clinic for treatment of sexually transmitted diseases (STDs), we administered a questionnaire to and collected a urine specimen for antimicrobial testing from 551 patients before treatment. We defined self-medication as an antimicrobial agent taken on the patient's own initiative by self-report during the week before the visit to the clinic or a positive urine assay for antimicrobial agents at the time of the clinic visit. We tested urine for the presence of antimicrobial agents by a disk diffusion method using Sarcina lutea as the test organism. A total of 75 (14%) of the 551 participants were self-medicators: 19 reported antimicrobial use and had a positive urine test, 27 reported antimicrobial use but had a negative urine test, and 29 denied antimicrobial use but had a positive urine test. Thus, 29 (60%) of the 48 patients with antimicrobial agents detected in their urine at the time of the clinic visit denied self-medication. Self-medicators acquired their antibiotics either from their medicine cabinet (44%) or from a family member or friend (56%). Self-medication was associated with self-report of prior use of unprescribed antimicrobial agents (P < .0001). We concluded that use of unprescribed antimicrobial agents (usually beta-lactam agents or tetracyclines) among STD clinic attendees in our study was common and that self-reporting was not a reliable method of screening for self-medicators.

Adult↗

PubMed1997

Resistance to second- and third-generation cephalosporins among Escherichia coli and Klebsiella species is rare in Finland.

OBJECTIVE: To investigate the antimicrobial resistance of Escherichia coli and Klebsiella spp. from pus, urine and respiratory specimens, with particular emphasis on the detection of third-generation cephalosporin resistance. METHODS: E. coli (698) and Klebsiella sp. (476) strains from pus, respiratory and urinary specimens from hospital patients were collected from 19 laboratories. Data about consumption of third-generation cephalosporins and cefuroxime were collected from 24 hospitals. Antimicrobial susceptibility was tested with disk diffusion in primary laboratories and by an agar dilution method. Extended-spectrum beta-lactamase (ESBL) production was studied with a double disk synergy test and an ESBL Etest. The beta-lactamase classes were characterized with polymerase chain reaction probes of the TEM and SHV beta-lactamase families and isoelectric focusing. RESULTS: Only 0.6% of E. coli and 2.3% of Klebsiella spp. strains were resistant or intermediately resistant to cefotaxime, ceftriaxone and/or ceftazidime. The ESBL producers detected comprised one E. coli harboring TEM-like genes and five Klebsiella pneumoniae strains, two of which harbored SHV-like genes, two TEM-like genes and one both. Although consumption of cefuroxime has increased in the years 1990-1994, from 3.48 to 5.84 defined daily doses/100 bed-days, and the consumption of third-generation cephalosporins from 1.25 to 1.94 defined daily doses/100 bed-days, cefuroxime resistance of E. coli was only 3%. CONCLUSION: Although the use of broad-spectrum cephalosporins has increased, resistance to second- and third-generation cephalosporins is still rare in Finland.

Journal Article↗

PubMed1995

Preliminary interpretive criteria for disk diffusion susceptibility testing of SCH 27899, a compound in the everninomicin class of antimicrobial agents.

As antimicrobial resistance among Gram-positive species becomes more common, alternative agents need to be developed for the therapy of serious infections. SCH 27899 is a compound from the everninomicin class of antimicrobial agents that possesses a potent Gram-positive spectrum. We evaluated three disk concentrations (0.25, 1, and 5 micrograms) of three SCH 27899 formulations including SCH 27899 base (SCHB), N-methylglucamine SCH 27899 (NMG-SCH), and NMG-SCH complexed with hydroxypropyl beta-cyclodextrin. Disk zone diameters were correlated with minimum inhibitory concentration for 209 aerobic, nonfastidious Gram-positive strains and selected Gram-negative bacilli to develop disk diffusion interpretive criteria. No significant differences in activity were noted among the three SCH 27899 preparations. Of the three disk concentrations, the correlation coefficient was greatest (r = 0.88) for the 5-micrograms SCHB disk test. For a tentative break point of < or = 2 micrograms SCHB/ml, preliminary disk interpretive criteria were: susceptible at > or = 12 mm, intermediate at 10-11 mm, and resistant at < or = 9 mm (absolute categorical agreement, 99.5%). Zones were small secondary to drug solubility and diffusion limitations. Using these criteria for the SCHB 5-micrograms disks, nearly all of the tested Gram-positive organisms were susceptible including methicillin-resistant staphylococci and vancomycin-resistant enterococci.

Aminoglycosides↗

PubMed1985

Comparative evaluation of a commercial microdilution method and a conventional disk diffusion method for determination of antibiograms of gram-positive cocci.

A commercial broth microdilution system for testing the antimicrobial susceptibility of gram-positive cocci was compared with the standardized disk agar-diffusion method by testing 254 clinical strains of staphylococci and streptococci using both methods. A total of 2,794 parallel determinations were made with 92.3% complete agreement between the 2 methods; of the discrepancies encountered, 3.0% were minor, 2.5% were major, and 2.1% were very major. The results indicate that the commercial microdilution system may provide a reliable quantitative method for antimicrobial susceptibility testing of clinical isolates from animals.

Anti-Bacterial Agents↗

PubMed2000

Use of the National Committee for Clinical Laboratory Standards guidelines for disk diffusion susceptibility testing in New York state laboratories.

Accurate antimicrobial susceptibility testing is vital for patient care and surveillance of emerging antimicrobial resistance. The National Committee for Clinical Laboratory Standards (NCCLS) outlines generally agreed upon guidelines for reliable and reproducible results. In January 1997 we surveyed 320 laboratories participating in the New York State Clinical Evaluation Program for General Bacteriology proficiency testing. Our survey addressed compliance with NCCLS susceptibility testing guidelines for bacterial species designated a problem (Staphylococcus aureus and Enterococcus species) or fastidious (Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria gonorrhoeae) organism. Specifically, we assessed compliance with guidelines for inoculum preparation, medium choice, number of disks per plate, and incubation conditions for disk diffusion tests. We also included length of incubation for S. aureus and Enterococcus species. We found overall compliance with the five characteristics listed above in 80 of 153 responding laboratories (50.6%) for S. aureus and 72 of 151 (47.7%) laboratories for Enterococcus species. The most common problem was an incubation time shortened to less than 24 h. Overall compliance with the first four characteristics was reported by 92 of 221 (41.6%) laboratories for S. pneumoniae, 49 of 163 (30.1%) laboratories for H. influenzae, and 11 of 77 (14.3%) laboratories for N. gonorrhoeae. Laboratories varied from NCCLS guidelines by placing an excess number of disks per plate. Laboratories also reported using alternative media for Enterococcus species, N. gonorrhoeae, and H. influenzae. This study demonstrates a need for education among clinical laboratories to increase compliance with NCCLS guidelines.

Anti-Bacterial Agents↗

PubMed2002

Trends in antibacterial susceptibility of mastitis pathogens during a seven-year period.

Milk samples collected from dairy cattle suspected of having mastitis were submitted to the Microbiology Laboratory of the Animal Health Diagnostic Laboratory, Michigan State University, for bacteriologic culture. A total of 2778 isolates, from the years 1994 to 2000, were isolated, identified, and subjected to in vitro antimicrobial susceptibility testing using the disk diffusion method, in accordance with National Committee on Clinical Laboratory Standards (NCCLS) standards. Isolates included in this study were Streptococcus uberis, Streptococcus dysgalactiae, Streptococcus agalactiae, Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, Serratia marcesens, and Pseudomonas aeruginosa. The proportion of bacterial isolates determined to be susceptible did not change during the 7-yr period for the majority of bacterial-antibacterial interactions tested. However, analysis for linear trend in proportions determined that there were increases in the proportion of S. aureus isolates that were susceptible to ampicillin, penicillin, and erythromycin. For Strep. uberis, increases in the proportion of susceptible isolates occurred for oxacillin, sulfa-trimethoprim, gentamicin, and pirlimycin, and a decrease in the proportion of susceptible isolates occurred with penicillin. For Strep. dysgalactiae, increases in the proportion of susceptible isolates occurred with erythromycin, gentamicin, sulfa-trimethoprim, and tetracycline. For Strep. agalactiae, increases in the proportion of susceptible isolates occurred with sulfa-trimethoprim. Among E. coli isolates, there was an increase in the proportion that were susceptible to ampicillin and cephalothin. Among K pneumoniae isolates, there was an increase in the proportion that were susceptible to ceftiofur. Overall, there was no indication of increased resistance of mastitis isolates to antibacterials that are commonly used in dairy cattle.

Animals↗

PubMed2000

Milkborne campylobacter infection in Hungary.

In April 1998, an annual 2-day animal farm sale was held in Hódmezóvásárhely, where 500 to 600 visitors consumed unpasteurized milk. The first signs of disease began 2 days after the end of the sale. Fifty-two people from a wide age range fell ill, primarily with inflammatory enteritis. These cases included 34 with Campylobacter positivity: 30 with Campylobacter jejuni and 4 with Campylobacter coli. Environmental samples (raw milk, udder swabs, and rectal swabs from 12 cows in the suspected herd) were tested 2 weeks after the first signs of the disease, and two rectal swabs were found to be positive for C. jejuni. Initially, the epidemic seemed to be sporadic and, accordingly, only 26 human and 2 animal Campylobacter isolates were reserved for randomly amplified polymorphic DNA analysis. This comparative analysis verified that fecally contaminated milk was the source of the outbreak. The DNA-banding patterns of 20 C. jejuni isolates (19 human and 1 animal) were identical. The antibiotic susceptibilities of the Campylobacter isolates were determined, and only six C. jejuni (human) isolates, one C. coli (human) isolate, and one C. jejuni (animal) isolate were resistant to tetracycline, both by disk diffusion and by E test (antimicrobial gradient strip for the quantitative determination of susceptibility or resistance of microorganisms). No plasmid was detected in these tetracycline-resistant isolates. The endotoxin production of Campylobacter isolates was examined via the cytopathogenic effect on the Vero cell line. This effect exhibited various degrees of positivity in 19 cases. Only two human C. jejuni isolates displayed + + + + positivity. Both isolates were from patients who had required antibiotic therapy and hospital care.

Animals↗

PubMed2005

Concentrations of Escherichia coli and genetic diversity and antibiotic resistance profiling of Salmonella isolated from irrigation water, packing shed equipment, and fresh produce in Texas.

Fresh produce has been repeatedly implicated as a vehicle in the transmission of foodborne gastroenteritis. In an effort to assess the risk factors involved in the contamination of fresh produce with pathogenic bacteria, a total of 1,257 samples were collected from cantaloupe, oranges, and parsley (both in the field and after processing) and from the environment (i.e., irrigation water, soil, equipment, etc.). Samples were collected twice per season from two production farms per commodity and analyzed for the presence of Salmonella and Escherichia coli. E. coli was detected on all types of commodities (cantaloupe, oranges, and parsley), in irrigation water, and on equipment surfaces. A total of 25 Salmonella isolates were found: 16 from irrigation water, 6 from packing shed equipment, and 3 from washed cantaloupes. Salmonella was not detected on oranges or parsley. Serotyping, pulsed-field gel electrophoresis (PFGE), and repetitive element sequence-based PCR (rep-PCR) assays were applied to all Salmonella isolates to evaluate the genetic diversity of the isolates and to determine relationships between sources of contamination. Using PFGE, Salmonella isolates obtained from irrigation water and equipment were determined to be different from cantaloupe isolates; however, DNA fingerprinting did not conclusively define relationships between contamination sources. All Salmonella isolates were subjected to antimicrobial susceptibility testing using the disk diffusion method, and 20% (5 of 25) of the isolates had intermediate sensitivity to streptomycin. One Salmonella isolate from cantaloupe was resistant to streptomycin.

Anti-Bacterial Agents↗

PubMedDate not supplied

[Beta-lactam resistance in aquatic Enterobacter cloacae strains using phenotypic and genotypic criteria].

Bacterial resistance by producing of beta-lactamases represents an increasing problem of infections chemotherapy. beta-lactam hydrolyzing activities are detected in virtually all bacteria, from witch Enterobacter cloacae produce chromosomal beta-lactamases included in inducible class AmpC beta-lactamases. The purpose of this preliminary study was to investigate the antibiotic susceptibility of 7 inducible beta-lactamase-producing Enterobacter cloacae strains isolated from aquatic sources (river and polluted waters). The identification to the species level was performed with the API 32E system and susceptibility to antimicrobial agents was tested by the disk diffusion method according to NCCLS recommendations. The following antibiotics were tested: ampicillin, amoxycillin/clavulanic acid, ceftazidime, cefotaxime, cephalotin, cefamandole, cephaclor, imipenem, amikacin, gentamycin, kanamycin, tobramycin, ciprofloxacin, norfloxacin, ofloxacin, nalidixic acid, tetracycline and chloramphenicol. Minimum inhibitory concentrations (MICs) were performed using dilution method in Mueller-Hinton broth with a 0.06-64 micrograms/ml concentration range for all antimicrobials and bacterial inoculum of about 1-2 x 10(8) cfu/ml. For the data analysis NCCLS breakpoints for resistance and sensitivity were used. Interaction of beta-lactamase inhibitor clavulanate with cefotaxime was performed by double-disk synergy test. Detection of inducible beta-lactamase expression was performed by the inductibility disk diffusion test using cefotaxime, ceftazidime and imipenem. Genomic DNA was isolated using CTAB technique and bacterial plasmid isolation was performed by an alkaline lysis method. Genetic characterization was performed by agarose gel electrophoresis and spectrophotometric analysis. The majority of examined E. cloacae strains were sensitive to imipenem, cefamandole, amikacin and quinolones (norfloxacin and ofloxacin), a higher moderate resistance being observed only to nalidixic acid (higher than 50%) and ciprofloxacin (15%). The percentage of resistant strains ranged from 72% (to kanamycin) to 87% (to gentamicin). The best results (resistance about 99%) were obtained with ampicillin, amoxycillin/clavulanic acid, ceftazidime, cefotaxime, cephalotin, cephaclor, tobramycin, tetracycline and chloramphenicol. The disk diffusion tests showed the absence of extended-spectrum beta-lactamases production and the expression of inducible beta-lactamases. Electrophoretic patterns point out the presence of plasmid DNA. Plasmid profile revealed the presence of several different plasmids ranging from 2.5 kpb to more than 30 kpb. The presence of inducible beta-lactamase E. cloacae strains in aquatic media (river and polluted waters) and the closely related pattern of susceptibility among these strains reflect the possible contamination of these sources and the common origin of them.

Anti-Bacterial Agents↗

PubMedDate not supplied

[From prevalence to predictive values: considerations on the antimicrobial susceptibility testing dealing with change of susceptibility rates].

The aim of the study was to quantify the influence of the variation of the susceptibility prevalence (frequencies of susceptible, intermediate and resistant isolates) on the predictive value of antimicrobial susceptibility testing reports performed with disk diffusion method, under several scenarios of distinct susceptibility prevalence. Prevalence variation effect was assessed through a modeling approach that enabled to take into account the technical variability and to control prevalence through scenarios. Results show how the prevalence impacts on the disk diffusion performance with level of discrepancies varying with prevalence. The phenomenon may be quantitatively noteworthy for some antimicrobial agents considering the prevalence recorded with time or location, leading to lowered performances. For instance, with amoxicillin+clavulanic acid, predictive values of susceptible and resistant reports varied respectively from 70 to 96 and from 33 to 97 %. For a 18-mm diameter, the probability the isolate is truly susceptible varied from 16 to 73 % according to the prevalence tested. Characteristic of the prevalence effect are described and consequences on zone diameter breakpoint policy raised. They include to (i) reevaluate disk diffusion breakpoint consistency when the prevalence impact is noteworthy and (ii) estimate the consequences of an international harmonized breakpoint policy on prediction quality and appropriate patient management.

Bacterial Infections↗

PubMed1981

Facilitating quality control of the antimicrobial susceptibility test.

Standard reference strains of Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa were suspended in sterile deionized water and tested daily via disk agar diffusion for their antimicrobial susceptibilities. Inocula of E. coli and P. aeruginosa yielded acceptable results for up to 32 days; however, results on S. aureus were unacceptable due to loss of viability of the organism in water. E. coli and P. aeruginosa inocula, in water, can be used daily for quality control of the disk gear diffusion test.

Anti-Bacterial Agents↗

PubMed1995

Validation of a modified Kirby-Bauer disk diffusion method for metronidazole susceptibility testing of Helicobacter pylori.

Triple antimicrobial therapy that includes metronidazole has been recommended as a first-line therapy for Helicobacter pylori because it has the highest eradication rates. However, resistance in H. pylori to metronidazole has been reported worldwide and its presence may reduce the efficacy of triple therapy. Various methods for testing H. pylori against metronidazole have been used including agar dilution, disk diffusion and the Etest but there has been little standardization of methods. One hundred isolates of H. pylori from different patients were tested for susceptibility to metronidazole by agar dilution, Etest and disk diffusion (5 micrograms disk). The agar dilution results confirmed the MIC susceptibility breakpoint to be < or = 8 micrograms/ml. Using this breakpoint there was close agreement (98%) between Etest and agar dilution results. For susceptible strains, MICs by E-test were generally one twofold dilution lower. Using the error-rate bounded method, agreement between disk diffusion zone diameter and MIC was 98% for agar dilution with breakpoints of > or = 12 mm and < or = 8 micrograms/ml and 100% for Etest with breakpoints of > or = 12 mm and < or = 8 micrograms/ml. The Etest discriminated better than agar dilution between susceptible and resistant strains and was simple to perform. The disk diffusion test is a reliable and cheaper alternative to the Etest with susceptibility being a zone diameter > or = 12 mm with a 5 micrograms disk. The prevalence of metronidazole resistance in this study was 40% by Etest.

Diffusion↗

PubMed2002

Antimicrobial activity and chemical composition of some essential oils.

In this study the composition and antimicrobial properties of essential oils obtained from Origanum onites, Mentha piperita, Juniperus exalsa, Chrysanthemum indicum, Lavandula hybrida, Rosa damascena, Echinophora tenuifolia, Foeniculum vulgare were examined. To evaluate the in vitro antibacterial activities of these eight aromatic extracts; their in vitro antimicrobial activities were determined by disk diffusion testing, according to the NCCLS criteria. Escherichia coli (ATTC 25922), Staphylococcus aureus (ATCC 25923) and Pseudomonas aeruginosa (ATTC 27853 were used as standard test bacterial strains. Origanum onites recorded antimicrobial activity against all test bacteria, and was strongest against Staphylococcus aureus. For Rosa damascena, Mentha piperita and Lavandula hybrida antimicrobial activity was recorded only to Staphylococcus aureus. Juniperus exalsa, and Chrysanthemum indicum exhibited antibacterial activities against both Staphylococcus aureus and Escherichia coli. We also examined the in vitro antimicrobial activities of some components of the essential oils and found some components with antimicrobial activity.

Anti-Bacterial Agents↗

PubMedDate not supplied

Available laboratory tests to guide antimicrobial therapy.

Physicians are encountering more difficulties in treating and managing patients with infectious diseases due to the continued emergence of single and multi-drug resistant organisms. This emphasizes the need of laboratory tests that are of help in predicting or monitoring response to therapy. Several conventional, special, automated and molecular antimicrobial susceptibility tests are available including the disk diffusion test, determination of the minimal inhibitory concentration, the E test, serum bactericidal titers, and determination of antimicrobial levels in blood. This article addresses these and other antimicrobial tests to update and enlighten the physicians in selecting the most relevant test(s) that will help guiding the therapy of infections caused by different bacterial etiologic agents.

Anti-Bacterial Agents↗

PubMed2003

[Analysis of antimicrobial resistance of clinical isolates of enterococci from Beijing and other areas in China].

OBJECTIVE: To analyze the antimicrobial resistance of enterococci in Beijing and other areas in China. METHODS: Disk diffusion method was used to test the antimicrobial resistance of 1978 enterococcal isolates from 4 teaching hospitals in Beijing and 53 grade 3 A hospitals in other areas of China The laboratory data were analyzed by WHONET5 statistic software. RESULTS: Enterococcus. faecalis isolates and E. facium isolates accounted for 80.7% and 17.1% of the enterococcus isolates in Beijing and 79.4% and 15.2% in other areas respectively. The enterococcus isolates from urine, sputum, secretion with pus, blood, and bile accounted for 33.7%, 22.9%, 9.8%, 4.4%, and 3.0% of the enterococcus isolates in Beijing and 28.4%, 16.3%, 14.6%, 5.0%, and 4.5% in other areas respectively. The resistance rates of E. faecalis to vancomycin, teicoplanin, ampicillin, and high -level gentamicin were 2.0%, 1.4%, 17.7%, and 47.4% in Beijing, and 5.1%, 3.7%, 24%, and 49.2% in other areas; The resistance rates of E. faecium to vancomycin, teicoplanin, ampicillin, and high -level gentamicin were 1.5%, 2.6%, 64.2%, and 64.9% in Beijing, and 2.1%, 3.1%, 68.5%, and 62.3% in other areas respectively. The vancomycin-resistant rate of the total isolates of enterococci was 3.2%. CONCLUSION: Enterococcus faecalis is the main species in the enterococcus isolates from clinical samples. E. facium, as compared with E. faecalis resists many antimicrobial agents more strongly. Both of E. faecalis and E. facium show the least resistance to vancomycin and teicoplanin.

Drug Resistance, Bacterial↗