Performance of CHROMagar VRE Medium for the Detection of Airborne Vancomycin-Resistant/Sensitive Enterococcus Species

Vancomycin-sensitive and vancomycin-resistant Enterococcus (VSE and VRE) species have become a significant health problem. CHROMagar medium, which permits direct, color-based identification of target pathogens, could potentially be used to rapidly monitor airborne VSE and VRE. In this study, the efficiency of CHROMagar VRE medium without vancomycin supplementation (CVSE) for collecting airborne vancomycin-sensitive Enterococcus faecalis was evaluated in a chamber study. Subsequently, the performance of bioaerosol samplers combined with CVSE and CHROMagar VRE (CVRE) was evaluated in a hospital environment, a wastewater treatment plant, and a pig-rearing facility. Our results demonstrated that an Andersen impactor was much more effective than a Nuclepore filter for collecting airborne E. faecalis at relative humidity levels of 30% and 55%. In addition, approximately 10% of the isolated environmental Enterococcus strains were vancomycin-resistant. The average sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the colony identification were 58.5%, 81.3%, 5.5%, and 99.1%, respectively, for CVSE and 100%, 88.3%, 8.4%, and 100%, respectively, for CVRE. These findings indicate that the use of CHROMagar might provide a rapid method for detecting airborne VSE or VRE, shortening the detection time to 24-48h. However, any mauve-colored colonies recovered on CVSE or CVRE by air sampling should be subjected to further identification tests.