Fatma DEVRİM, Gamze GÜLFİDAN, SALİH GÖZMEN, Bengü DEMİRAĞ, Yeşim OYMAK, Yöntem YAMAN, Yeliz ORUÇ, Nevbahar YAŞAR, HURŞİT APA, SÜLEYMAN NURİ BAYRAM, Canan VERGİN, İLKER DEVRİM
Comparison of the BD GeneOhm VanR assay and a chromogenic agar-based culture method in screening for vancomycin-resistant enterococci in rectal specimens of pediatric hematology-oncology patients
Devrim F, Gülfidan G, Gözmen S, Demirağ B, Oymak Y, Yaman Y, Oruç Y, Yaşar N, Apa H, Bayram N, Vergin C, Devrim İ. Comparison of the BD GeneOhm VanR assay and a chromogenic agar-based culture method in screening for vancomycin-resistant enterococci in rectal specimens of pediatric hematology-oncology patients. Turk J Pediatr 2015; 57: 161-166.VRE species are an increasingly important and universal problem in intensive care units and hematology-oncology departments due to the spread of glycopeptide resistance. Rapid and accurate identification of VRE is therefore crucial. The intent of this study was to compare the diagnostic performance of a real-time PCR test, the BD GeneOhm VanR assay (GeneXpert vanA/vanB, Cepheid, USA), with conventional cultures for screening hospitalized immunocompromised hematology-oncology patients for VRE. Three hundred and six duplicate rectal swab specimens were obtained from 120 pediatric hematology-oncology patients. PCR and conventional culture-based studies were performed. One hundred and twenty patients, 46 female and 74 male, participated in the study. The mean age of the patients was 7.5±4.7 years. A total of 51 specimens from 306 samples were found to be positive for vanA or vanB. Mean turnaround time for PCR was 0.5±0.2 days. Compared to the culture method, the RT-PCR assay had an overall sensitivity of 91.8% (34/37) and a specificity of 93.6%. The positive predictive value and negative predictive value were 66.6% and 98.8%, respectively. This study demonstrates that RT-PCR is a suitable alternative to culture-based procedures for rapid and accurate identification of VRE in hematology-oncology patients, as the overall performance of PCR is comparable to that of a chromogenic agar-based culture method for VRE screening, especially for detection of VRE-negative patients.
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1. Biedenbach DJ, Moet GJ, Jones RN. Occurrence and antimicrobial resistance pattern comparisons among bloodstream infection isolates from the SENTRY Antimicrobial Surveillance Program (1997-2002). Diagn Microbiol Infect Dis 2004; 50: 59-69.2. Emori TG, Gaynes RP. An overview of nosocomial infections, including the role of the microbiology laboratory. Clin Microbiol Rev 1993; 6: 428-442.
3. Deshpande LM, Fritsche TR, Moet GJ, Biedenbach DJ, Jones RN. Antimicrobial resistance and molecular epidemiology of vancomycin-resistant enterococci from North America and Europe: a report from the SENTRY antimicrobial surveillance program. Diagn Microbiol Infect Dis 2007; 58: 163-170.
4. Fang H, Nord CE, Ullberg M. Screening for vancomycinresistant enterococci: results of a survey in Stockholm. APMIS 2010; 118: 413-417.
5. Hidron AI, Edwards JR, Patel J, et al. NHSN annual update: antimicrobial-resistant pathogens associated with healthcare-associated infections: annual summary of data reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2006-2007. Infect Control Hosp Epidemiol 2008; 29: 996-1011.
6. Lu JJ, Perng CL, Chiueh TS, et al. Detection and typing of vancomycin-resistance genes of enterococci from clinical and nosocomial surveillance specimens by multiplex PCR. Epidemiol Infect 2001; 126: 357-363.
7. Jayaratne P, Rutherford C. Detection of clinically relevant genotypes of vancomycin-resistant enterococci in nosocomial surveillance specimens by PCR. J Clin Microbiol 1999; 37: 2090-2092.
8. Petrich AK, Luinstra KE, Groves D, Chernesky MA, Mahony JB. Direct detection of vanA and vanB genes in clinical specimens for rapid identification of vancomycin resistant enterococci (VRE) using multiplex PCR. Mol Cell Probes 1999; 13: 275-281.
9. Roger M, Faucher MC, Forest P, St-Antoine P, Coutlée F. Evaluation of a vanA-specific PCR assay for detection of vancomycin-resistant Enterococcus faecium during a hospital outbreak. J Clin Microbiol 1999; 37: 3348-3349.
10. Dutka-Malen S. Evers S, Courvalin P. Detection of glycopeptide resistance genotypes and identification to the species level of clinically relevant enterococci by PCR. J Clin Microbiol 1995; 33: 1434.
11. Price CS, Paule S, Noskin GA, Peterson LR. Active surveillance reduces the incidence of vancomycinresistant enterococcal bacteremia. Clin Infect Dis 2003; 37: 921-928.
12. Drews SJ, Johnson G, Gharabaghi F, et al. A 24-hour screening protocol for identification of vancomycinresistant Enterococcus faecium. J Clin Microbiol 2006; 44: 1578-1580.
13. Palladino S, Kay ID, Flexman JP, et al. Rapid detection of vanA and vanB genes directly from clinical specimens and enrichment broths by real-time multiplex PCR assay. J Clin Microbiol 2003; 41: 2483-2486.
14. Sloan LM, Uhl JR, Vetter EA, et al. 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: 2636-2643.
15. 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: 3360-3365.
16. Hawkins RC. Laboratory turnaround time. Clin Biochem Rev 2007; 28: 179-194.
17. Satake S, Clark N, Rimland D, Nolte FS, Tenover FC. Detection of vancomycin-resistant enterococci in fecal samples by PCR. J Clin Microbiol 1997; 35: 2325-2330.
18. Mak A, Miller MA, Chong G, Monczak Y. Comparison of PCR and culture for screening of vancomycin-resistant enterococci: highly disparate results for vanA and vanB. J Clin Microbiol 2009; 47: 4136-4137.
19. Ballard SA, Grabsch EA, Johnson PD, Grayson ML. 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 2005; 49: 77-81.
20. Domingo MC, Huletsky A, Bernal A, et al. Characterization of a Tn5382-like transposon containing the vanB2 gene cluster in a Clostridium strain isolated from human faeces. J Antimicrob Chemother 2005; 55: 466-474.
21. Cetinkaya Y, Falk PS. Vancomycin-resistant enterococci. Clin Microbiol Rev 2000; 13: 686-707.
22. Grabsch EA, Chua K, Xie S, et al. Improved detection of vanB2-containing Enterococcus faecium with vancomycin susceptibility by Etest using oxgall supplementation. J Clin Microbiol 2008; 46: 1961-1964.
23. Ligozzi M, Lo Cascio G, Fontana R. vanA gene cluster in a vancomycin-resistant clinical isolate of Bacillus circulans. Antimicrob Agents Chemother 1998; 42: 2055-2059.
24. Power EG, Abdulla YH, Talsania HG, Spice W, Aathithan S, French GL. vanA genes in vancomycinresistant clinical isolates of Oerskovia turbata and Arcanobacterium (Corynebacterium) haemolyticum. J Antimicrob Chemother 1995; 36: 595-606.
25. Sievert DM, Rudrik JT, Patel JB, McDonald LC, Wilkins MJ, Hageman JC. Vancomycin-resistant Staphylococcus aureus in the United States, 2002-2006. Clin Infect Dis 2008; 46: 668-674.
26. D'Agata EM, Gautam S, Green WK, Tang YW. High rate of false-negative results of the rectal swab culture method in detection of gastrointestinal colonization with vancomycin-resistant enterococci. Clin Infect Dis 2002; 34: 167-172.
27. Lleò MM, Bonato B, Signoretto C, Canepari P. Vancomycin resistance is maintained in enterococci in the viable but nonculturable state and after division is resumed. Antimicrob Agents Chemother 2003; 47: 1154-1156.
28. Grabsch EA, Ghaly-Derias S, Gao W, Howden BP. Comparative study of selective chromogenic (chromID VRE) and bile esculin agars for isolation and identification of vanB-containing vancomycinresistant enterococci from feces and rectal swabs. J Clin Microbiol 2008; 46: 4034-4036.
29. Kuch A, Stefaniuk E, Ozorowski T, Hryniewicz W. New selective and differential chromogenic agar medium, chromID VRE, for screening vancomycin-resistant Enterococcus species. J Microbiol Methods 2009; 77: 124-126.
30. Usacheva EA, Ginocchio CC, Morgan M, et al. Prospective, multicenter evaluation of the BD GeneOhm VanR assay for direct, rapid detection of vancomycinresistant Enterococcus species in perianal and rectal specimens. Am J Clin Pathol 2010; 134: 219-226.
- ISSN: 0041-4301
- Yayın Aralığı: Yılda 6 Sayı
- Başlangıç: 1958
- Yayıncı: Hacettepe Üniversitesi Çocuk Sağlığı Enstitüsü Müdürlüğü
Sayıdaki Diğer Makaleler
Sun Young YOO, Sun Mi HWANG, Min Kyung LEE, Dae Sun JO, Pyoung Han HWANG
Tatjana DAMNJANOVİC, Goran CUTURİLO, Nela MAKSİMOVİC, Nikola DİMİTRİJEVİC, Vesna MİTİC, Biljana JEKİC, Ljiljana LUKOVİC, Vera BUNJEVACKİ, Tatjana VARLJEN, Valerija DOBRİCİC, Ida JOVANOVİC, Vladimir KOSTİC, Ivana NOVAKOVİC
Scientific publications in pediatrics over the last ten years in Turkey and worldwide
DEMET ALTUN, Orçun DABAK, Duygu Övünç HACIHAMDİOĞLU
A rare case of primary inoculation tuberculosis seen after varicella
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Occurrence of Wilms' tumor in a child with hereditary spherocytosis
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Ocular morbidities of premature children with mild or no retinopathy of prematurity
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Occurrence of Wilms' tumor in a child with hereditary spherocytosis
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ST-segment elevation following lightning strike: case report and review of the literature
ALPER AKIN, Meki BİLİCİ, Fikri DEMİR, AYFER GÖZÜ PİRİNÇÇİOĞLU, Ahmet YILDIRIM
Ebtesam M. ABDALLA, Lubna M. EL-DESOUKY, Nargues M. HASSANEİN