The main task of the national reference centre is the epidemiological surveillance of staphylococcal and enterococcal infections both inside and outside of hospitals, as well as the occurrence and spread of staphylococcal and enterococcal strains with important resistance and virulence traits or corresponding genetic determinants.

Tasks

In addition to analyzing samples for the submitter, the centre processes data to derive general conclusions. The existing network of cooperation with investigation offices, public health facilities, university institutes and clinics, hospitals and private laboratories is complemented by targeted studies with specificity for relevant clinical subjects.

In cooperation with a number of university institutes for medical microbiology and facilities of clinical disciplines, selected questions of the aetiology and infectiology of staphylococcal and enterococcal infections are being addressed. With regard to enterococci, special attention is paid to the analysis of resistance to antibiotics of last resort (linezolid, tigecycline, daptomycin). Therefore, we explicitly ask our submitters and collaborators to send relevant isolates with suspected (or confirmed) resistance and virulence properties to the National Reference Centre.

Part Staphylococci

Contact person: Franziska Layer-Nicolaou, Birgit Strommenger, Christiane Cuny

Based on knowledge of the clonal structures of Staphylococcus aureus (S. aureus) and coagulase-negative staphylococcal species, staphylococcal isolates that locally cause outbreaks are typed using conventional and molecular methods (first line: spa typing; for selected isolates: whole genome sequencing (WGS) and core genome multilocus sequence typing (cgMLST)). Furthermore, submitted isolates are further characterized with regard to relevant resistance and virulence traits (phenotypic resistance and toxin determination as well as gene detection by PCR). Database systems for molecular typing methods have been set up for the evaluation. These database systems form the basis of a network with institutions in Germany that conduct molecular typing, as well as for setting up and participating in a network of European reference laboratories for staphylococci.

Through the ordinance adapting the reporting obligation according to § 7 of the Infection Protection Act, the reporting obligation was extended to the direct detection of methicillin-resistant S. aureus (MRSA) from blood or cerebrospinal fluid (CSF). Since 01.07.2009, laboratories have been obliged to report the detection of MRSA from blood or CSF by name (see Epid Bull 26/2009 and Epid Bull 29/2009, in German). We ask all laboratories to send the reported MRSA isolates from blood and CSF to the National Reference Centre for detailed WGS-based analysis.

Part Enterococci

Contact persons: Jennifer Bender, Martin Fischer, Guido Werner

Based on knowledge of the clonal structures of Enterococcus (E.) faecium and E. faecalis, which locally cause outbreaks, enterococcal isolates are typed using conventional procedures and molecular methods. Conventional methods include in-house validated methods of susceptibility testing via broth microdilution. Molecular methods include the detection of specific markers by PCR (vanA, vanB). In cases of suspected clonal clusters, typing is performed based on WGS data and cgMLST. Another emphasis is taken on the determination and confirmation of resistances to last resort antibiotics (linezolid, daptomycin, tigecycline, lipoglycopeptides). We ask all laboratories to send isolates of Vancomycin-resistant enterococci (VRE) from blood and CSF to the National Reference Centre for detailed analysis.

Accreditation