1887

Abstract

Rapid detection of vancomycin-resistant enterococci (VRE) infection is very important for control and prevention of nosocomial spread of these bacteria. A multiplex PCR method for rapid screening of VRE has recently been developed. We performed a prospective study of VRE screening tests to compare the performance of PCR to that of a chromogenic agar-based culture method. From January to December 2009, a total of 8815 rectal swab specimens were tested simultaneously for VRE by VRE selective culture and by PCR. The specimens were inoculated onto ChromID VRE agar containing 8 µg vancomycin ml and examined after 24 and 48 h of incubation. Identification and antibiotic susceptibility tests were performed using the automated VITEK-2 system and a supplementary E-test and disk diffusion test. Detection of the and genes was performed with the Seeplex VRE detection kit. Specimens were inoculated in enterococcosel broth for 16–24 h before PCR for enrichment of VRE. VRE were isolated from 741 of the 8815 specimens by chromogenic agar-based culture (8.4 %). and genotypes were detected in 758 (8.6 %) and 3 (0.03 %) specimens, respectively, by multiplex PCR. Sensitivity, specificity, positive predictive value and negative predictive value of PCR for detection of VRE were 98.2 %, 99.6 %, 95.7 %, and 99.8 %. No VRE were isolated from -positive specimens. The overall performance of PCR is comparable to that of a chromogenic agar-based culture method for screening of VRE, so PCR could be an alternative or supportive method for effective control of nosocomial VRE infection.

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2011-07-01
2020-08-11
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References

  1. Ballard S. A., Grabsch E. A., Johnson P. D., Grayson M. L. 2005a). Comparison of three PCR primer sets for identification of vanB gene carriage in feces and correlation with carriage of vancomycin-resistant enterococci: interference by vanB-containing anaerobic bacilli. Antimicrob Agents Chemother 49:77–81 [CrossRef][PubMed]
    [Google Scholar]
  2. Ballard S. A., Pertile K. K., Lim M., Johnson P. D., Grayson M. L. 2005b). Molecular characterization of vanB elements in naturally occurring gut anaerobes. Antimicrob Agents Chemother 49:1688–1694 [CrossRef][PubMed]
    [Google Scholar]
  3. Carmeli Y., Eliopoulos G., Mozaffari E., Samore M. 2002; Health and economic outcomes of vancomycin-resistant enterococci. Arch Intern Med 162:2223–2228 [CrossRef][PubMed]
    [Google Scholar]
  4. CDC 1995; Recommendations for preventing the spread of vancomycin resistance. Recommendations of the Hospital Infection Control Practices Advisory Committee (HICPAC). MMWR Recomm Rep 44:RR-121–13[PubMed]
    [Google Scholar]
  5. Cetinkaya Y., Falk P., Mayhall C. G. 2000; Vancomycin-resistant enterococci. Clin Microbiol Rev 13:686–707 [CrossRef][PubMed]
    [Google Scholar]
  6. D’Agata E. M., Gautam S., Green W. K., Tang Y. W. 2002; High rate of false-negative results of the rectal swab culture method in detection of gastrointestinal colonization with vancomycin-resistant enterococci. Clin Infect Dis 34:167–172 [CrossRef][PubMed]
    [Google Scholar]
  7. DiazGranados C. A., Zimmer S. M., Klein M., Jernigan J. A. 2005; Comparison of mortality associated with vancomycin-resistant and vancomycin-susceptible enterococcal bloodstream infections: a meta-analysis. Clin Infect Dis 41:327–333 [CrossRef][PubMed]
    [Google Scholar]
  8. Domingo M. C., Huletsky A., Bernal A., Giroux R., Boudreau D. K., Picard F. J., Bergeron M. G. 2005; Characterization of a Tn5382-like transposon containing the vanB2 gene cluster in a Clostridium strain isolated from human faeces. J Antimicrob Chemother 55:466–474 [CrossRef][PubMed]
    [Google Scholar]
  9. Dutka-Malen S., Evers S., Courvalin P. 1995; Detection of glycopeptide resistance genotypes and identification to the species level of clinically relevant enterococci by PCR. J Clin Microbiol 33:24–27[PubMed]
    [Google Scholar]
  10. Grabsch E. A., Chua K., Xie S., Byrne J., Ballard S. A., Ward P. B., Grayson M. L. 2008a). Improved detection of vanB2-containing Enterococcus faecium with vancomycin susceptibility by Etest using oxgall supplementation. J Clin Microbiol 46:1961–1964 [CrossRef][PubMed]
    [Google Scholar]
  11. Grabsch E. A., Ghaly-Derias S., Gao W., Howden B. P. 2008b). Comparative study of selective chromogenic (chromID VRE) and bile esculin agars for isolation and identification of vanB-containing vancomycin-resistant enterococci from feces and rectal swabs. J Clin Microbiol 46:4034–4036 [CrossRef][PubMed]
    [Google Scholar]
  12. Hashimoto Y., Tanimoto K., Ozawa Y., Murata T., Ike Y. 2000; Amino acid substitutions in the VanS sensor of the VanA-type vancomycin-resistant Enterococcus strains result in high-level vancomycin resistance and low-level teicoplanin resistance. FEMS Microbiol Lett 185:247–254 [CrossRef][PubMed]
    [Google Scholar]
  13. Kuch A., Stefaniuk E., Ozorowski T., Hryniewicz W. 2009; New selective and differential chromogenic agar medium, chromID VRE, for screening vancomycin-resistant Enterococcus species. J Microbiol Methods 77:124–126 [CrossRef][PubMed]
    [Google Scholar]
  14. Lee T. A., Hacek D. M., Stroupe K. T., Collins S. M., Peterson L. R. 2005; Three surveillance strategies for vancomycin-resistant enterococci in hospitalized patients: detection of colonization efficiency and a cost-effectiveness model. Infect Control Hosp Epidemiol 26:39–46 [CrossRef][PubMed]
    [Google Scholar]
  15. Lee S. Y., Park K. G., Lee G. D., Park J. J., Park Y. J. 2010; Comparison of Seeplex VRE detection kit with ChromID VRE agar for detection of vancomycin-resistant enterococci in rectal swab specimens. Ann Clin Lab Sci 40:163–166[PubMed]
    [Google Scholar]
  16. Ligozzi M., Lo Cascio G., Fontana R. 1998; vanA gene cluster in a vancomycin-resistant clinical isolate of Bacillus circulans. Antimicrob Agents Chemother 42:2055–2059[PubMed]
    [Google Scholar]
  17. Lleò M. M., Bonato B., Signoretto C., Canepari P. 2003; Vancomycin resistance is maintained in enterococci in the viable but nonculturable state and after division is resumed. Antimicrob Agents Chemother 47:1154–1156 [CrossRef][PubMed]
    [Google Scholar]
  18. Mak A., Miller M. A., Chong G., Monczak Y. 2009; Comparison of PCR and culture for screening of vancomycin-resistant enterococci: highly disparate results for vanA and vanB. J Clin Microbiol 47:4136–4137 [CrossRef][PubMed]
    [Google Scholar]
  19. Park I. J., Lee W. G., Lee H., Yong D., Lee K., Kim E. C., Jeong S. H., Park Y. J., Choi T. Y. et al. 2006; [Mechanism of VanB phenotype in vancomycin-resistant enterococci carrying vanA gene.]. Korean J Lab Med 26:412–417 (in Korean) [CrossRef][PubMed]
    [Google Scholar]
  20. Petrich A. K., Luinstra K. E., Groves D., Chernesky M. A., Mahony J. B. 1999; Direct detection of vanA and vanB genes in clinical specimens for rapid identification of vancomycin resistant enterococci (VRE) using multiplex PCR. Mol Cell Probes 13:275–281 [CrossRef][PubMed]
    [Google Scholar]
  21. Power E. G., Abdulla Y. H., Talsania H. G., Spice W., Aathithan S., French G. L. 1995; vanA genes in vancomycin-resistant clinical isolates of Oerskovia turbata and Arcanobacterium (Corynebacterium) haemolyticum. J Antimicrob Chemother 36:595–606 [CrossRef][PubMed]
    [Google Scholar]
  22. Price C. S., Paule S., Noskin G. A., Peterson L. R. 2003; Active surveillance reduces the incidence of vancomycin-resistant enterococcal bacteremia. Clin Infect Dis 37:921–928 [CrossRef][PubMed]
    [Google Scholar]
  23. Roger M., Faucher M. C., Forest P., St-Antoine P., Coutlée F. 1999; Evaluation of a vanA-specific PCR assay for detection of vancomycin-resistant Enterococcus faecium during a hospital outbreak. J Clin Microbiol 37:3348–3349[PubMed]
    [Google Scholar]
  24. Shin J. W., Yong D., Kim M. S., Chang K. H., Lee K., Kim J. M., Chong Y. 2003; Sudden increase of vancomycin-resistant enterococcal infections in a Korean tertiary care hospital: possible consequences of increased use of oral vancomycin. J Infect Chemother 9:62–67, discussion 104–105 [CrossRef][PubMed]
    [Google Scholar]
  25. Sievert D. M., Rudrik J. T., Patel J. B., McDonald L. C., Wilkins M. J., Hageman J. C. 2008; Vancomycin-resistant Staphylococcus aureus in the United States, 2002–2006. Clin Infect Dis 46:668–674 [CrossRef][PubMed]
    [Google Scholar]
  26. Stamper P. D., Cai M., Lema C., Eskey K., Carroll K. C. 2007; Comparison of the BD GeneOhm VanR assay to culture for identification of vancomycin-resistant enterococci in rectal and stool specimens. J Clin Microbiol 45:3360–3365 [CrossRef][PubMed]
    [Google Scholar]
  27. Usacheva E. A., Ginocchio C. C., Morgan M., Maglanoc G., Mehta M. S., Tremblay S., Karchmer T. B., Peterson L. R. 2010; Prospective, multicenter evaluation of the BD GeneOhm VanR assay for direct, rapid detection of vancomycin-resistant Enterococcus species in perianal and rectal specimens. Am J Clin Pathol 134:219–226 [CrossRef][PubMed]
    [Google Scholar]
  28. Weigel L. M., Clewell D. B., Gill S. R., Clark N. C., McDougal L. K., Flannagan S. E., Kolonay J. F., Shetty J., Killgore G. E., Tenover F. C. 2003; Genetic analysis of a high-level vancomycin-resistant isolate of Staphylococcus aureus. Science 302:1569–1571 [CrossRef][PubMed]
    [Google Scholar]
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