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Chapter 5.10 : Screen Tests To Detect High-Level Aminoglycoside Resistance in spp.

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Screen Tests To Detect High-Level Aminoglycoside Resistance in spp., Page 1 of 2

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Abstract:

High-level aminoglycoside resistance (HLAR) in enterococci is most commonly detected by assessing growth at high concentrations of gentamicin (500 μg/ml) and sometimes streptomycin (1,000 μg/ml in broth and 2,000 μg/ml in agar) ( ). Strains that show HLAR to gentamicin will not be synergistically killed with combinations of cell wall-active drugs (generally ampicillin, penicillin, or vancomycin) plus gentamicin. HLAR to gentamicin also means HLAR to tobramycin, netilmicin, amikacin, and kanamycin. HLAR to streptomycin equals resistance to combinations of cell wall-active drugs and streptomycin. See additional information in Appendix 5.10–1 . The agar screen test is described in detail here, and reference is made to use of standard disk diffusion and broth microdilution MIC test procedures for detecting HLAR.

Citation: Leber A. 2016. Screen Tests To Detect High-Level Aminoglycoside Resistance in spp., p 5.10.1-5.10.5. In Clinical Microbiology Procedures Handbook, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818814.ch5.10
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Image of Enterococcus HLAR Agar Screen Test QC
Enterococcus HLAR Agar Screen Test QC

HLAR Agar Screen Test QC

Citation: Leber A. 2016. Screen Tests To Detect High-Level Aminoglycoside Resistance in spp., p 5.10.1-5.10.5. In Clinical Microbiology Procedures Handbook, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818814.ch5.10
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References

/content/book/10.1128/9781555818814.chap5.10
1. CLSI. 2015. Methods for Dilution Antimicrobial Susceptibility Tests for Bacteria That Grow Aerobically, 10th ed. Approved Standard M07-A10. CLSI, Wayne, PA.
2. Chow JW. 2000. Aminoglycoside resistance in enterococci. Clin Infect Dis 31:586589.
3. CLSI. 2012. Performance Standards for Antimicrobial Disk Susceptibility Tests, 11th ed. Approved standard M02-A11. CLSI, Wayne, PA.
4. CLSI. 2015. Performance Standards for Antimicrobial Disk Susceptibility Tests, 12th ed. Approved standard. M02-A12. CLSI, Wayne, PA.
5. Bethel CD, Boonlayangoor S. 2010. Screen tests to detect high-level aminoglycoside resistance in Enterococcus spp. In Garcia LS (ed), Clinical Microbiology Procedures Handbook, 3 ed. ASM Press, Washington, DC.
6. Jenkins SG, Schuetz AN. 2012. Current concepts in laboratory testing to guide antimicrobial therapy. Mayo Clin Proc 87:290308.
7. Swenson JM, Patel JB, Jorgensen JH. 2011. Special phenotypic methods for detecting antibacterial resistance, p 1155–1179. In Versalovic J, Carroll KC, Funke G, Jorgensen JH, Landry ML, Warnock DW (ed), Manual of Clinical Microbiology, 10th ed. ASM Press, Washington, DC.
1. Hollenbeck BL, Rice LB. 2012. Intrinsic and acquired resistance mechanisms in enterococcus. Virulence 3(5):421569.

Tables

Generic image for table
Aminoglycoside-modifying enzymes that confer HLAR on Enterococcus spp.

Aminoglycoside-modifying enzymes that confer HLAR on spp.

Citation: Leber A. 2016. Screen Tests To Detect High-Level Aminoglycoside Resistance in spp., p 5.10.1-5.10.5. In Clinical Microbiology Procedures Handbook, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818814.ch5.10

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