{
  "schema_version": "1.0",
  "level": "species",
  "genus": "Enterococcus",
  "species": "faecium",

  "overview": {
    "short": "Enterococcus faecium is a Gram-positive, facultatively anaerobic coccus notable for antimicrobial resistance and healthcare-associated infections.",
    "clinical_context": "Frequently associated with bacteremia, urinary tract infections, and hospital-acquired infections, particularly vancomycin-resistant strains (VRE)."
  },

  "expected_fields": {
    "Gram Stain": "Positive",
    "Shape": "Cocci",
    "Motility": "Negative",
    "Capsule": "Variable",
    "Spore Formation": "Negative",
    "Haemolysis": "Variable",
    "Haemolysis Type": "Variable",
    "Media Grown On": [
      "Blood Agar",
      "Bile Esculin Agar"
    ],
    "Colony Morphology": [
      "Small",
      "Grey",
      "Smooth"
    ],
    "Oxygen Requirement": "Facultative Anaerobe",
    "Growth Temperature": "10//45",
    "Catalase": "Negative",
    "Oxidase": "Negative",
    "Indole": "Negative",
    "Urease": "Negative",
    "Citrate": "Negative",
    "Methyl Red": "Positive",
    "VP": "Negative",
    "H2S": "Negative",
    "DNase": "Negative",
    "ONPG": "Negative",
    "Coagulase": "Negative",
    "Gelatin Hydrolysis": "Negative",
    "Esculin Hydrolysis": "Positive",
    "Nitrate Reduction": "Negative",
    "NaCl Tolerant (>=6%)": "Positive",
    "Lipase Test": "Negative",
    "Lysine Decarboxylase": "Negative",
    "Ornithine Decarboxylase": "Negative",
    "Ornitihine Decarboxylase": "Negative",
    "Arginine dihydrolase": "Negative",
    "Glucose Fermentation": "Positive",
    "Lactose Fermentation": "Negative",
    "Sucrose Fermentation": "Variable",
    "Maltose Fermentation": "Positive",
    "Mannitol Fermentation": "Negative",
    "Sorbitol Fermentation": "Negative",
    "Xylose Fermentation": "Negative",
    "Rhamnose Fermentation": "Negative",
    "Arabinose Fermentation": "Negative",
    "Raffinose Fermentation": "Negative",
    "Trehalose Fermentation": "Positive",
    "Inositol Fermentation": "Negative",
    "Gas Production": "Negative",
    "TSI Pattern": "Unknown",
    "Colony Pattern": "Unknown",
    "Pigment": "None",
    "Motility Type": "None"
  },

  "species_markers": [
    {
      "field": "Arginine dihydrolase",
      "value": "Negative",
      "importance": "high",
      "notes": "Primary discriminator separating E. faecium from E. faecalis."
    },
    {
      "field": "Mannitol Fermentation",
      "value": "Negative",
      "importance": "medium",
      "notes": "E. faecium typically does not ferment mannitol."
    }
  ],

  "common_confusions": [
    {
      "species": "Enterococcus faecalis",
      "reason": "Shared genus traits and overlapping sugar fermentation profiles."
    }
  ],

  "when_to_question_identification": [
    "Arginine dihydrolase positivity suggests E. faecalis.",
    "Strong mannitol fermentation is inconsistent.",
    "Unexpected antimicrobial susceptibility patterns."
  ],

  "recommended_next_tests": [
    {
      "test": "Arginine dihydrolase",
      "reason": "Key biochemical discriminator from E. faecalis.",
      "api_kit": "API Strep"
    },
    {
      "test": "Vancomycin susceptibility testing",
      "reason": "Critical due to frequent resistance in E. faecium.",
      "api_kit": "VITEK 2 GP"
    },
    {
      "test": "MALDI-TOF MS",
      "reason": "Accurate species-level identification.",
      "api_kit": "Not applicable"
    }
  ]
}