Key words:group D streptococci,classification,enterococcal infections, Antibiotic susceptibility,vancomycin

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1 Key words:group D streptococci,classification,enterococcal infections, Antibiotic susceptibility,vancomycin

2 Table 1 Differentiation of group D streptococcia aderived from R.R.Facklam1,2),K.C.Gross-et al3),and G.S.Bosley et al4) bl -pyrrolidonyl-fi naphthylamide Table 2 Comparison of results obtained for physiological tests in the identification by the present method(minitek system) and API 20S system aresults with the Minitek system(includes PYR test in conventional and API 20S system) obtained after incubation 4h at 35t,and other API 20s system results obtained after 24 h at 35 Ž

3 Table 3 Results of additional confirmatory tests for group D streptococci from clinical isolates athe interpretation of result obtained at 24h or 48h of incubation Table 4 Frequency of API profile code among group D streptococci differentiated by the Present method a Differentiated by the Present method identified by API 20S system

4 Table 5 Frequency and distribution of group D streptococci from clinical specimens Table 6 Antibiotics resistance patterns of group D streptococci Table 7 Multiple drug-resistance patterns of group D streptococci

5 Fig. 1 Cumulative percentage and distribution of MIC of Vancomycin to group D streptococci

6 - specific 1) Moellering, R. C. Jr., Korzeniowski, O. M, Sande, M. A. & Wennersten, C. B.: Species. resistance to antimicrobial synersim in Streptococcus faecium and Streptococcus faecalis. J. Infect. Dis., 140: , ) Watanakunakorn, C.: Penicillin combined with gentamicin or streptomycin: Synersim against enterococci. J. Infect. Dis., 124: 581 3) Thorusberry, C., Baker, C.N. & Facklam, R. R.: Antibiotic susceptibility of Streptococcus bovis and other group D streptococci causing endocarditis. Antimicrob. Agents Chemother., 5: , ) Coudron, P. E., Mayhall, C. G., Facklam, R. R., Spadora, A. C., Lamb, V. A., Lybrand, M. R. & Dalton, H. P.: Streptococcus faecium Outbreak in a Neonatal Intensive Care Unit. J. Clin. Microbiol., 20: , 1984.

7 8) Facklam, R. R.: Recongnition of Group D Streptococcal Species of Human Origin by Biochemical and Physiological Tests. Appl. Microbiol., 23: , ) Gross, K. C., Hougton, M. P. & Senterfit, L. B.: Presumptive Speciation of Streptococcus bovis and other Group D Streptococci from Human Sources by using Arginine and pyruvate Tests. J. Clin. Microbiol., 1: 54-60, ) Bosley, G. B., Facklam, R. R. & Grossman, D.: Rapid Identification on Entercocci. J. Clin. Methods for the Biochemical Characterization of Oral Streptococci. J. Clin. Microbiol., 10: ) Jorgensen, J. H., Crawford, S. A. & Alexander, G. A.: Rapid Identification of Group D Streptococci with the API 20S System. J. Clin. Microbiol., 17: , ) Poutrel, B. & Ryniewicz, H. Z.: Evaluation of the API 20S System for Bovine Mastitis. J. Clin. Microbiol., 19: , ) Finland, M.: Changing patterns of susceptibility of common bacterial pathogens to antimicrobial agents. Ann. Intern. Med., 76: , Microbiol., 18: , ) Iannini, P. B., Ehret, J. & Eickhoff, T. C.: Chemotherapy, 23: 1-2, Effects of ampicillin-amikacin and ampicillinrefampin on enterococci. Antimicrob. Agents 12) Setterstrom, J. A., Gross, A. & Stanko, R. S.: Comparison of Minitek and Conventional Chemother., 9: , Evaluation of Rapid, Simple Species Classification for Group D Streptococci and Clinical Significance of the Isolates Hiroshi KAWAKAMI Department of Clinical Laboratory, Chiba Cancer Center Hospital A rapid and simple identification method was evaluated as a means of classifiing 153 isolates of group D streptococci from clinical specimens in to different species. All of these cultures were obtained from 141 patients in our hospital.the present method utilizes the system to determine six different biological properties simultaneously.these include:(i) hydrolysis of L-pyrrolidonyl-fl-naphthylamide and arginine and (ii) acid production from mannitol,sorbitol, aabinose and raffinose. (iii) the results were interpreted after incubation at 35 Ž for 4h under aerobic condition: A total of species differentiated by the present method gave positive growth in 6.5% NaCl and reaction of Phadebact D serogrouping. The results obtained using the present method were in good agreement with those of API 20S system identification.therefore,the usefulness of this method was suggested emphatically. Of 153 clinical isolates,134 isolates (87.6%) were speciated as S.faecalis,16 (10.6%) as S.faecium, 2 (1.3%) as S.avium,1(0.6%) as S.durans. Susceptibility test of these cultures to 7 antimicrobial agents was carried out.the results revealed that S.faecalis was resistant to TC with relatively high frequency but was sensitive to other agents. Conversely,S.faecium showed high frequent resistance to all agents except to CP.S.avium was resistant only 2 agents,tc and SBPC. The numbers of multiple drug-resistant strains among major species were as follows:7 of 134 S. faecalis (5.7%),16 of 16 S.faecium (100%),2 of 2 S.avium (100%).All of S.faecium strains showed resistance to 6 agents or more than 4 agents,although other strains were resistant mostly to 2 agents. 65 strains of S. faecalis including 7 resistant strains,16 of S.faecium and 2 of S.avium were measured for MIC of Vancomycin. A total of these strains had a maximal peak at 1.56,ƒÊg/ml of MIC which ranged between 0.39,ƒÊg/ml and 6.25,ƒÊg/ml.Of these strains, S. faecium had a maximal peak at 0.78,ƒÊg/ml of MIC which were lower than that of S.faecalis(1.56,ƒÊg/ml).

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