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This analysis reveals misclassification of antibiotic resistance in Enterococcus faecalis, suggesting reporting improvements are necessary.
The overall CA of AST results for DAP between VITEK-2 and BMD was 28.4%, with an EA of 20.2%. In the DAP-sensitive group, CA was 100%, but in the DAP-nonsensitive group, VITEK-2 misclassified 7.4% of sensitive isolates as resistant and 92.2% as intermediate. The consistency between VITEK-2 and BMD decreased significantly as the VITEK-2 MIC value increased. No significant correlation was found between VITEK-2 results and Ca²⁺-deficient BMD. None of the sequenced E. faecalis isolates carried known DAP resistance genes. If the DAP MIC value ≥ 4 detected by VITEK-2 is not reported, it may lead to the loss of daptomycin susceptibility data in clinical practice and also cause bias in the national bacterial resistance detection results.
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Xing et al. (2026) studied this question.
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