METHODS: Three data resources were used: 1) West Virginia University Hospitals Clinical Microbiology Laboratories (WVUH), 2) Mountain State Oral-Facial Dental Microbiology Laboratory and 3) TSN (The Surveillance Network) Database USA, a national repository of 381 hospitals receiving daily culture results via electronic interface. Data was collated (8/01/05-07/31/06) from seven anatomic sources: blood, urine, wounds, mouth, alimentary track, throats and dental/periodontics.
RESULTS: E. faecalis was recovered very infrequently from 20,255 in oral cultures, 0.0007% nationally, but 9.3% from 560 oral WVUH cultures. Based on national, and WVUH cultures, rankings for urine, blood, wound and alimentary track respectively, were: 2.1/6.2%, 0.6/1.0%, 0.8/2.0%, and 0.01/0.03%. The Vancomycim Resistant E. fecalis (2.8%) phenotype was last compared to 10 selected resistant phenotypes with Methicillin resistant S. epidermidus (62.4%) and methicillin resistant S. aureus (17.9%) second. Antibiotic susceptibility profiles for selected antibiotics, WVUH vs.nationally, were quite similar: Gentimicin 72/73%, erythromycin, 15.7/17.3%, Levofloxacin, 58.1/62.3% and tetracycline 29.1/24.3%.
CONCLUSIONS: In recovery of E. faecalis from normal body sites, positive oral cultures are infrequent. It may exist in plaque as “viable but non-cultable.” E. faecalis resistance profile is well established, but highlighting its vancomycin phenotype via Relative Resistance is a unique feature and highlights its relative infrequency.