Volume 22-18
15 September 1996

[Table of Contents]

SURVEY OF VANCOMYCIN-RESISTANT ENTEROCOCCI IN THE FRASER VALLEY OF BRITISH COLUMBIA

Vancomycin susceptibility testing was performed on 305 clinical isolates of enterococci collected at random from all types of specimens from both inpatients and outpatients between February and May 1996 from 12 hospitals in the Fraser Valley of British Columbia.

The identification of enterococci was based on conventional biochemical methods. All 305 isolates were subcultured to bile-esculin azide agar (BEA) and BEA supplemented with 6 mg/L of vancomycin (BEAV). Six of the 305 enterococcal isolates grew on BEAV and underwent further vancomycin susceptibility testing by E-test (AB biodisk) and Kirby-Bauer disk diffusion (NCCLS standards).

The four isolates of Enterococcus faecalis grew on BEAV but were susceptible to vamcomycin by disk diffusion and E-test with MICs between 2 and 4 mg/L. Two isolates of E. casseliflavus grew on BEAV and demonstrated low-level vancomycin resistance by E-test with MICs of 8 and 12 mg/L respectively. Vancomycin resistance was not detected by disk diffusion for these two isolates.

Although the results of the study demonstrate that high-level vancomycin resistant enterococci (VRE) do not exist in the Fraser Valley, surveillance is continuing. Routine screening cultures are now being done for VRE in area hospitals on those patients who were recently admitted to health-care facilities outside the province of British Columbia.

Source:

A Lau, ART, Laboratory Scientist, Fraser Valley Regional Laboratory Services, J Roy, MD, Microbiologist; C Wong, MD, Infectious Diseases, Royal Columbian Hospital, New Westminster; A Skidmore, MD, Microbiologist, Surrey Memorial Hospital, J Tomblin, MD, Microbiologist, Peace Arch District Hospital, White Rock; S Henwick, MD, Matsqui-Sumas-Abbottsford Hospital, Abbotsford, British Columbia.

Editorial Comment

As indicated in the 1 August issue of CCDR, VRE are emerging as important nosocomial pathogens in Canada. The hospitals in the Fraser Valley are, as are many health care facilities across Canada, responding proactively to this threat by initiating ongoing surveillance for VRE in selected patients. The Canadian Nosocomial Infection Surveillance Program is actively developing an ongoing program to track the emergence and spread of VRE in Canada. In addition, Guidelines for Preventing the Spread of Vancomycin Resistant Enterococcus in Canada are currently being developed and should be available in draft form in the fall of 1996.

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