Brain heart infusion ( BHI ) is a growth medium for growing microorganisms. It is a nutrient-rich medium, and can therefore be used to culture a variety of fastidious organisms. In particular, it has been used to culture streptococci , pneumococci and meningococci , which can be otherwise challenging to grow. BHI is made by combining an infusion from boiled bovine or porcine heart and brain with a variety of other nutrients. BHI broth is often used in food safety , water safety , and antibiotic sensitivity tests.
14-528: VRE may refer to: Science and technology [ edit ] Vancomycin-resistant Enterococcus , a bacterial strain Variable renewable energy , an electricity generation class Virtual research environment , a class of online collaboration platform Transport [ edit ] Virginia Railway Express , United States (commenced 1992) Volare Airlines , Italy (1998–2015; ICAO: VRE ) Topics referred to by
28-470: A suspension of the organism onto a commercially available brain heart infusion agar (BHIA) plate containing 6 μg/ml vancomycin. The Clinical and Laboratory Standards Institute (CLSI) recommends performing a vancomycin MIC test and also motility and pigment production tests to distinguish species with acquired resistance (vanA and vanB) from those with vanC intrinsic resistance. Detection of vancomycin resistance by
42-477: Is different from Wikidata All article disambiguation pages All disambiguation pages Vancomycin-resistant Enterococcus Vancomycin-resistant Enterococcus , or vancomycin-resistant enterococci ( VRE ), are bacterial strains of the genus Enterococcus that are resistant to the antibiotic vancomycin . Six different types of vancomycin resistance are shown by enterococcus: Van-A, Van-B, Van-C, Van-D, Van-E and Van-G. The significance
56-504: Is that Van-A VRE is resistant to both vancomycin and teicoplanin , Van-B VRE is resistant to vancomycin but susceptible to teicoplanin, and Van-C is only partly resistant to vancomycin. The mechanism of resistance to vancomycin found in enterococcus involves the alteration of the peptidoglycan synthesis pathway. The D-alanyl-D-lactate variation results in the loss of one hydrogen-bonding interaction (four, as opposed to five for D-alanyl-D-alanine) being possible between vancomycin and
70-627: Is thought that a significant percentage of intensively farmed chickens also carry VRE. Other regions have noted a similar distribution, but with increased incidence of VRE. For example, a 2006 study of nosocomial VRE revealed a rapid spread of resistance among enterococci along with an emerging shift in VRE distribution in the Middle East region, such as Iran. Treatment failures in enterococcal infections result from inadequate information regarding glycopeptide resistance of endemic enterococci due to factors such as
84-404: The peptide . The D-alanyl-D-serine variation causes a six-fold loss of affinity between vancomycin and the peptide, likely due to steric hindrance . To become vancomycin-resistant, vancomycin-sensitive enterococci typically obtain new DNA in the form of plasmids or transposons which encode genes that confer vancomycin resistance. This acquired vancomycin resistance is distinguished from
98-449: The US, linezolid is commonly used to treat VRE. The combination of daptomycin and ampicillin is another option to treat VRE infections, especially for bacteremia. For invasive vancomycin-resistant E. faecalis infections, both ampicillin-ceftriaxone and ampicillin- gentamicin combinations have been used successfully, with the latter specifically showing success in treating endocarditis. If
112-527: The United States in 1987. In the United States, vancomycin-resistant E. faecium was associated with 4% of healthcare-associated infections reported to the Centers for Disease Control and Prevention National Healthcare Safety Network from January 2006 to October 2007. VRE can be carried by healthy people who have come into contact with the bacteria, usually in a hospital ( nosocomial infection ), although it
126-458: The VRE strain is vanB, teicoplanin and dalbavancin are suitable therapeutic options. Another antibiotic often used as off-label salvage therapy in systemic VRE infections is oritavancin , a semisynthetic glycopeptide that has demonstrated synergic activity with fosfomycin . High-level vancomycin-resistant E. faecalis and E. faecium are clinical isolates first documented in Europe in 1986 and
140-685: The natural vancomycin resistance of certain enterococcal species including E. gallinarum and E. casseliflavus/flavescens . Once the individual has VRE, it is important to ascertain which strain. Screening for VRE can be accomplished in a number of ways. For inoculating peri-rectal/anal swabs or stool specimens directly, one method uses bile esculin azide agar plates containing 6 μg/ml of vancomycin. Black colonies should be identified as an enterococcus to species level and further confirmed as vancomycin resistant by an MIC method before reporting as VRE. Vancomycin resistance can be determined for enterococcal colonies available in pure culture by inoculating
154-653: The presence of VanA and VanB. The study from Iran reported the first case of VRE isolates that carried VanB gene in enterococcal strains from Iran. This study also noted the first documented isolation of nosocomial E. raffinosus and E. mundtii in the Middle East region. Brain heart infusion BHI is broadly used for culturing a variety of microorganisms, both in clinical and research settings. A number of fastidious organisms, including some bacteria, yeasts, and other fungi, grow well on BHI. It can also be used to differentiate between enterococci and group D streptococci. The earliest version of brain heart infusion media
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#1732851239395168-403: The same term [REDACTED] This disambiguation page lists articles associated with the title VRE . If an internal link led you here, you may wish to change the link to point directly to the intended article. Retrieved from " https://en.wikipedia.org/w/index.php?title=VRE&oldid=1217877429 " Category : Disambiguation pages Hidden categories: Short description
182-454: The use of PCR targeting vanA and vanB can also be performed. Ceftriaxone (a third generation cephalosporin ) use is a risk factor for colonization and infection by VRE, and restriction of cephalosporin usage has been associated with decreased VRE infection and transmission in hospitals. Lactobacillus rhamnosus GG (LGG), a strain of L. rhamnosus , was used successfully for the first time to treat gastrointestinal carriage of VRE. In
196-469: Was made in 1899 when Edward Rosenow combined dextrose broth with calf brain tissue to grow streptococci. This was modified in 1923 by Russell Haden while working on dental pathogens. Modern BHI typically uses an infusion from porcine brains and hearts rather than calf brain tissue, and uses disodium phosphate as a buffer, rather than the calcium carbonate used by Rosenow and Haden. BHI typically contains infusion of beef or pig heart as well as calf brain,
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