Interpretation of ERMI
I am trying to interpret my first few ERMI’s and nasal swabs – first, do the actual individual numbers on the ERMI for the various fungi mean anything (for example, Aureobasidium
pullulans 16000, Cladosporium herbarum 44000) or is it just the ERMI itself that is the important value? And secondly, what constitutes a positive nasal culture – number of resistant organisms or types (ie pen R versus oxacillin R)? If it is the number of resistant organisms, how many?
Please take a look at the ERMI articles available on the site. Review as well the PowerPoints (1) on SAIIE; and (2) SAIIE meets ERMI. There is a huge amount of discussion that we could share on this topic. The talk I did last week at the International Mold meetings may be of interest. The “HERTSMI-2″ score looks at 5 organisms from group I in ERMI and assigns weight to the values. Any score over 10 is a problem; with moldy buildings routinely having scores of over 16.This construct thankfully ignores Cladosporium and Aureobasidium.
The key issue in nasal cultures is the resistance patterns. Count the number of distinct classes of antibiotic resistance. If two or more, statistically that is an organism that must be eradicated. The oxacillin (read this one as methicillin) resistance is quite common in these organisms.