M213-1

Urine (Nephrostomy tube): >100 x 106cfu/L Enterococcus gallinarum – Shipped November 01, 2021

HISTORY

A simulated urine sample collected through a nephrostomy tube from a 48 year old with renal stones was sent to category A laboratories.

Participants were expected to report colony count, organism identification and susceptibility to ampicillin, vancomycin, and ciprofloxacin.

MAIN EDUCATIONAL POINTS from M213-1

  1. While E. gallinarum is mainly associated with urinary tract infections in hospitalized patients, identification and susceptibility testing at least to ampicillin and a fuoroquinolone should be performed.
  2. In addition, vancomycin testing should be done to confirm that these isolates have low level but intrinsic (vanC) resistance to this agent. Patients colonized or infected with this species (and E. casseliflavus) do not require the same isolation precautions as true vancomycin-resistant enterococci.

Full critique (PDF)

Posted in Clinical Bacteriology Results, critiques Tagged with: