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Journal of Clinical Microbiology, June 2006, p. 2072-2077, Vol. 44, No. 6
0095-1137/06/$08.00+0     doi:10.1128/JCM.02636-05
Copyright © 2006, American Society for Microbiology. All Rights Reserved.

Evaluation of the BD Phoenix Automated Microbiology System for Identification and Antimicrobial Susceptibility Testing of Staphylococci and Enterococci

Karen C. Carroll,1* Anita P. Borek,2 Chad Burger,2 Brian Glanz,2 Hasan Bhally,2,{dagger} Susan Henciak,2 and Diane C. Flayhart2

Division of Microbiology, Department of Pathology, the Johns Hopkins University School of Medicine,1 Microbiology Laboratory, the Johns Hopkins Hospital, Baltimore, Maryland 212872

Received 20 December 2005/ Returned for modification 7 February 2006/ Accepted 29 March 2006

We evaluated the Phoenix automated microbiology system (BD Diagnostic Systems, Sparks, MD) for the identification (ID) and antimicrobial susceptibility testing (AST) of challenge and clinical staphylococci and enterococci recovered from patients in a tertiary-care medical center. In total, 424 isolates were tested: 90 enterococci; 232 Staphylococcus aureus isolates, including 14 vancomycin-intermediate S. aureus isolates; and 102 staphylococci other than S. aureus (non-S. aureus). The Phoenix panels were inoculated according to the manufacturer's instructions. The reference methods for ID comparisons were conventional biochemicals and cell wall fatty acid analysis with the Sherlock microbial identification system (v 3.1; MIDI, Inc. Newark, DE). Agar dilution was the reference AST method. The overall rates of agreement for identification to the genus and the species levels were 99.7% and 99.3%, respectively. All S. aureus isolates and enterococci were correctly identified by the Phoenix panels. For the non-S. aureus staphylococci, there was 98.0% agreement for the ID of 16 different species. The AST results were stratified by organism group. For S. aureus, the categorical agreement (CA) and essential agreement (EA) were 98.2% and 98.8%, respectively. Three of three very major errors (VMEs; 1.7%) were with oxacillin. For non-S. aureus staphylococci, the CA, EA, VME, major errors, and minor error rates were 95.7%, 96.8%, 0.7%, 1.7%, and 2.9%, respectively. The two VMEs were with oxacillin. For the enterococci, there was 100% CA and 99.3% EA. All 36 vancomycin-resistant enterococci were detected by the Phoenix system. The Phoenix system compares favorably to traditional methods for the ID and AST of staphylococci and enterococci.

* Corresponding author. Mailing address: Department of Pathology, The Johns Hopkins Medical Institutions, Meyer B1-193, 600 N. Wolfe St., Baltimore, MD 21287. Phone: (410) 955-5077. Fax: (410) 614-8087. E-mail: Kcarrol7{at}jhmi.edu.

{dagger} Present address: Waitemata District Health Board, Department Medicine, Level 3, North Shore Hospital, Private Bag, 93-05, Shakespeare Road, Takapuna, Auckland 9, New Zealand.

Journal of Clinical Microbiology, June 2006, p. 2072-2077, Vol. 44, No. 6
0095-1137/06/$08.00+0     doi:10.1128/JCM.02636-05
Copyright © 2006, American Society for Microbiology. All Rights Reserved.



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