Evaluation of GeneXpert vanA/vanB assay for the detection of vancomycin-resistant enterococci in patients newly admitted to intensive care units

The automated Cepheid GeneXpert system provides rapid PCR results and can be used for the identification of VRE. We aimed to evaluate the use of the Cepheid Xpert vanA/vanB real-time PCR assay for the detection of VRE from rectal swabs of patients newly admitted to intensive care units in a hospital setting. Materials and methods: Rectal swab samples of patients newly admitted to 6 intensive care units from March 2011 to February 2012 were obtained. The specimens were analyzed by the GeneXpert system. The results were reported for both vanA and vanB as negative or positive. Results: Comparing the number of inpatients, most of the samples were delivered from the neurosurgery (48.3%), pediatrics (33.3%), and neonatology (20.6%) intensive care units. The positive samples according to GeneXpert vanA/vanB method were 33 (7.3%) among 454 rectal samples. Of these positive samples 22 (4.9%) were vanA, 10 (2.2%) were vanB, and 1 sample (0.2%) was vanA and vanB-harboring, by PCR. Conclusion: As a rapid, easy to use, and labor-saving method GeneXpert vanA/vanB can detect VRE-positive patients, particularly in risk groups, as soon as they are admitted to hospital so that infection control policies can be applied immediately.

Evaluation of GeneXpert vanA/vanB assay for the detection of vancomycin-resistant enterococci in patients newly admitted to intensive care units

The automated Cepheid GeneXpert system provides rapid PCR results and can be used for the identification of VRE. We aimed to evaluate the use of the Cepheid Xpert vanA/vanB real-time PCR assay for the detection of VRE from rectal swabs of patients newly admitted to intensive care units in a hospital setting. Materials and methods: Rectal swab samples of patients newly admitted to 6 intensive care units from March 2011 to February 2012 were obtained. The specimens were analyzed by the GeneXpert system. The results were reported for both vanA and vanB as negative or positive. Results: Comparing the number of inpatients, most of the samples were delivered from the neurosurgery (48.3%), pediatrics (33.3%), and neonatology (20.6%) intensive care units. The positive samples according to GeneXpert vanA/vanB method were 33 (7.3%) among 454 rectal samples. Of these positive samples 22 (4.9%) were vanA, 10 (2.2%) were vanB, and 1 sample (0.2%) was vanA and vanB-harboring, by PCR. Conclusion: As a rapid, easy to use, and labor-saving method GeneXpert vanA/vanB can detect VRE-positive patients, particularly in risk groups, as soon as they are admitted to hospital so that infection control policies can be applied immediately.

___

  • Gordts B, Van Landuyt H, Ieven M, Vandamme P, Goossens H. Vancomycin-resistant enterococci colonizing the intestinal tracts of hospitalized patients. J Clin Microbiol 1995; 33: 2842–6.
  • İncecik Ş, Saltoğlu N, Yaman A, Karayaylalı İ, Özalevli M, Gündüz M, Burgut R. The problem of antimicrobial resistance in nosocomial medical and surgical intensive care units infections in a university hospital; a two-year prospective study. Turk J Med Sci 2009; 39: 295–304.
  • Tacconelli E, Cataldo MA. Vancomycin-resistant enterococci (VRE): transmission and control. Int J Antimicrob Agents 2008; 31: 99–106.
  • Sahm DF, Free L, Smith C, Eveland M, Mundy LM. Rapid characterization schemes for surveillance isolates of vancomycin- resistant enterococci. J Clin Microbiol 1997; 35: 2026–30. 9. Drews SJ, Johnson G, Gharabaghi F, Roscoe M, Matlow A, Tellier R, Richardson SE. A 24-hour screening protocol for identification of vancomycin-resistant Enterococcus faecium. J Clin Microbiol 2006; 44: 1578–80.
  • Marner ES, Wolk DM, Carr J, Hewitt C, Dominguez LL, Kovacs T, Johnson DR, Hayden RT. Diagnostic accuracy of the Cepheid GeneXpert vanA/vanB assay ver. 1.0 to detect the vanA and vanB vancomycin resistance genes in Enterococcus from perianal specimens. Diagn Microbiol Infect Dis 2011; 69: 382–9.
  • Stamper PD, Cai M, Lema C, Eskey K, Carroll KC. Comparison of the BD GeneOhm VanR assay to culture for identification of vancomycin-resistant enterococci in rectal and stool specimens. J Clin Microbiol 2007; 45: 3360–5.
  • Bourdon N, Berenger R, Lepoultier R, Mouet A, Lesteven C, Borgey F, Fines-Guyon M, Leclercq R, Cattoir V. Rapid detection of vancomycin-resistant enterococci from rectal swabs by the Cepheid Xpert vanA/vanB assay. Diagn Microbiol Infect Dis 2010; 67: 291–3.
  • Wisplinghoff H, Wiegel P, Steinmetz M, Hofmann H, Arnemann J, Plum G. Evaluation of a novel rapid PCR-method to detect vancomycin-resistant enterococci (VRE) from clinical samples. 49th Intersc. Conf. Antimicrob. Agents Chemother; 12–15 September 2009; San Francisco, CA, United States. pp. D–783.
  • Gazin M, Lammens C, Goossens H, Malhotra-Kumar S, Team MWS. Evaluation of GeneOhm VanR and Xpert vanA/vanB molecular assays for the rapid detection of vancomycin-resistant enterococci. Eur J Clin Microbiol Infect Dis 2012; 31: 273–6.
  • Morgan DJ, Day HR, Furuno JP, Young A, Johnson JK, Bradham DD, Perencevich EN. Improving efficiency in active surveillance for methicillin-resistant Staphylococcus aureus or vancomycin- resistant Enterococcus at hospital admission. Infect Control Hosp Epidemiol 2010; 31: 1230–5.
  • Warren DK, Kollef MH, Seiler SM, Fridkin SK, Fraser VJ. The epidemiology of vancomycin-resistant Enterococcus colonization in a medical intensive care unit. Infect Control Hosp Epidemiol 2003; 24: 257–63.
  • Song JY, Cheong HJ, Jo YM, Choi WS, Noh JY, Heo JY, Kim WJ. Vancomycin-resistant Enterococcus colonization before admission to the intensive care unit: a clinico-epidemiologic analysis. Am J Infect Control 2009; 37: 734–40.
  • Ostrowsky BE, Venkataraman L, D’Agata EM, Gold HS, DeGirolami PC, Samore MH. Vancomycin-resistant enterococci in intensive care units: high frequency of stool carriage during a non-outbreak period. Arch Intern Med 1999; 159: 1467–72.
  • Minhas P, Perl TM, Carroll KC, Shepard JW, Shangraw KA, Fellerman D, Ziai WC. Risk factors for positive admission surveillance cultures for methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci in a neurocritical care unit. Crit Care Med 2011; 39: 2322–9.
  • Yoon YK, Kim HJ, Lee WJ, Lee SE, Yang KS, Park DW, Sohn JW, Kim MJ. Clinical prediction rule for identifying patients with vancomycin-resistant enterococci (VRE) at the time of admission to the intensive care unit in a low VRE prevalence setting. J Antimicrob Chemother 2012; 67: 2963–9.
  • Donskey CJ, Chowdhry TK, Hecker MT, Hoyen CK, Hanrahan JA, Hujer AM, Hutton-Thomas RA, Whalen CC, Bonomo RA, Rice LB. Effect of antibiotic therapy on the density of vancomycin-resistant enterococci in the stool of colonized patients. N Engl J Med 2000; 343: 1925–32.
  • Muto CA, Jernigan JA, Ostrowsky BE, Richet HM, Jarvis WR, Boyce JM, Farr BM, SHEA. SHEA guideline for preventing nosocomial transmission of multidrug-resistant strains of Staphylococcus aureus and Enterococcus. Infect Control Hosp Epidemiol 2003; 24: 362–86.
  • Zabicka D, Strzelecki J, Wozniak A, Strzelecki P, Sadowy E, Kuch A, Hryniewicz W. Efficiency of the Cepheid Xpert vanA/ vanB assay for screening of colonization with vancomycin- resistant enterococci during hospital outbreak. Antonie Van Leeuwenhoek 2012; 101: 671–5.
  • Ballard SA, Pertile KK, Lim M, Johnson PD, Grayson ML. Molecular characterization of vanB elements in naturally occurring gut anaerobes. Antimicrob Agents Chemother 2005; 49: 1688–94.
  • Sloan LM, Uhl JR, Vetter EA, Schleck CD, Harmsen WS, Manahan J, Thompson RL, Rosenblatt JE, Cockerill FR 3rd. Comparison of the Roche LightCycler vanA/vanB detection assay and culture for detection of vancomycin-resistant enterococci from perianal swabs. J Clin Microbiol 2004; 42: 2636–43.
  • Mehta MS, Paule SM, Hacek DM, Thomson RB, Kaul KL, Peterson LR. Optimization of a laboratory-developed test utilizing roche analyte-specific reagents for detection of Staphylococcus aureus, methicillin-resistant S. aureus, and vancomycin-resistant Enterococcus species. J Clin Microbiol 2008; 46: 2377–80.
  • Şen M, Gözel MG, Çelik C, Bakıcı MZ, Açıkalın Coşkun K, Özgür A, Engin A, Dökmetaş İ, Bakır M, Tutar Y et al. Sivas Cumhuriyet Üniversitesi Hastanesi’nde Enterococcus faecium ile oluşan bir vankomisin dirençli enterokok (VRE) epidemisi: ön rapor. 4th EKMUD Congress (Infectious Diseases & Clinical Microbiology); 9–12 May 2012; Pendik, İstanbul, Turkey. pp. 153.
  • Atalay S, Ece G, Şamlıoğlu P, Maraş G, Koşe I, Koşe S. [Evaluation of vancomycin-resistant enterococcus cases at a tertiary level hospital in İzmir, Turkey]. Mikrobiyol Bul 2012; 46: 553–9.
  • Esen Ş, Yıldız İE, Güney AK, Günaydın M. Cepheid Xpert vanA/vanB testinin rektal örneklerde vankomisin-dirençli enterokokların hızlı tespiti için değerlendirilmesi. 4th EKMUD Congress (Infectious Diseases & Clinical Microbiology); 9–12 May 2012; Pendik, İstanbul, Turkey. pp. 189.
  • Durmaz S, Erçal BD, Atalay A, Perçin D. Vankomisine dirençli enterokok saptanmasında GeneXpert vanA/vanB real time- PCR yöntemi ile kültür yönteminin karşılaştırılması. XXXIV. Türk Mikrobiyoloji Kongresi; 7–11 Kasım 2010; Girne, Kuzey Kıbrıs Türk Cumhuriyeti. pp. 237.
Turkish Journal of Medical Sciences-Cover
  • ISSN: 1300-0144
  • Yayın Aralığı: Yılda 6 Sayı
  • Yayıncı: TÜBİTAK
Sayıdaki Diğer Makaleler

Tissue Doppler evaluation of the right ventricle in major pulmonary resections

Ulaş KUMBASAR, Hasan Şevket KAVUKÇU, Nezih ÖZDEMİR, Adem GÜNGÖR, Rıfat Murat AKAL, Hakan KUTLAY, Ayten CANGIR, Sevilay KARAHAN, İlker ÖKTEN

Retrospective evaluation of 104 tinea capitis cases

Ömer ÇALKA, Serap Güneş BİLGİLİ, Ayşe Serap KARADAĞ, Sevda ÖNDER

Effect of melatonin on contractile activity in intraurethrally instilled E. coli-induced acute prostatitis rat model

Bakhtiyar HUSEYNOV, Nadire ESER, İbrahim Atilla ARIDOĞAN, Şeyda ERDOĞAN, Yusuf Kenan DAĞLIOĞLU, Hacer Sinem BÜYÜKNACAR, Fatih KÖKSAL, Cemil GÖÇMEN

Evaluation of GeneXpert vanA/vanB assay for the detection of vancomycin-resistant enterococci in patients newly admitted to intensive care units

Server YAĞCI, Çiğdem Ataman HATİPOĞLU, Şerife ALTUN, Cemal BULUT

Pre-versus postoperative tramadol instillation: both are effective for decreasing pain and/or agitation in pediatric adenotonsillectomy

Gülçin AYDIN, Alparslan APAN, Emine Arzu KÖSE, Gökşen ÖZ

Satisfaction and anxiety in an initiative with local anesthesia

Mert ZEYTİNOĞLU, Sevgi TÜRKMEN, Çağatay ÜSTÜN

Does renal parenchymal thickness affect bleeding in percutaneous nephrolithotomy?

Mehmet Murat RİFAİOĞLU, Kadir ÖNEM, Hüseyin ÇELİK, Mürsel DAVARCI, Mehmet ÇETİNKAYA, Mehmet İNCİ, Aylin GÜNEŞLİ YETİŞKEN, Fatih Rüştü YALÇINKAYA

Vasoactive mediators in congenital heart diseases with shunt lesions and pulmonary hypertension

Fatma Sedef TUNAOĞLU, Ayşe ZENGİN TURAN, Fatma Rana OLGUNTÜRK, Serdar KULA, Ayşe Deniz OĞUZ

The expression of cell adhesion molecules in colorectal cancer tissue and its clinical values

Dong CHEN, Huiying ZHAO, Feng YE

Retrospective evaluation of 104 tinea capitis cases*

Ayşe Serap KARADAĞ, Ömer ÇALKA, Serap BİLGİLİ GÜNEŞ, Sevda ÖNDER