Enterococcus speciation

[John Perrin]

Miller, J. Michael PhD ", Mike (JMM8 at CIDHIP1.EM.CDC.GOV) wrote:
: Bob Morell poses a pertinent question for clinical microbiologists faced with 
: whether or not to identify Enterococcus to the species level.  More than 90% 
: of the Enterococcus isolated from humans will usually be either E. faecalis 
: or E. faecium.  Little clinical utility can be gained by speciating, except 
: knowing that E. faecium may be more likely to be resistant to Penicillin.  In 
: terms of clinical outcome, I don't think speciating the enterococci will help 
: us very much.  Clearly, it is much more important to be accurate in our 
: susceptibility testing of this isolate, especially since some of the 
: automated methods are not very accurate in identifying low-moderate levels of 
: vancomycin resistance.  Unless there are epidemiologic reasons to do so, I 
: would not go to expensive lengths to speciate.
:  
 I think that these days with so many laboratories worried about cost 
containment that speciating enterococci is not necessary.  However, there 
is also patient to worry about.  In the lab I used to work in we would 
speciate only those enterococci recovered from sterile body sites and 
fluids, such as pleural fluid, blood, deep tissues, etc.  I must agree 
that accurate sensitivity testing is more important than speciation.