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首页> 外文期刊>Journal of Clinical Microbiology >Comparison of the BD GeneOhm VanR Assay to Culture for Identification of Vancomycin-Resistant Enterococci in Rectal and Stool Specimens
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Comparison of the BD GeneOhm VanR Assay to Culture for Identification of Vancomycin-Resistant Enterococci in Rectal and Stool Specimens

机译：BD GeneOhm VanR测定法与培养物中用于鉴定直肠和粪便样品中耐万古霉素的肠球菌的比较

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Active screening for vancomycin-resistant enterococci (VRE) in rectal and stool specimens has been recommended to limit the spread of antimicrobial resistance within certain high-risk populations. Directly from 502 rectal swabs and stool specimens, we evaluated the diagnostic performance of the BD GeneOhm VanR assay (BD GeneOhm, San Diego, CA), a rapid real-time PCR test that detects the presence of vanA and/or vanB genes. The VanR assay was compared to culture consisting of both bile-esculin-azide agar with 6 μg/ml vancomycin (BEAV agar) (BD Diagnostics, Sparks, MD) and BEAV broth with 8 μg/ml vancomycin (Hardy Diagnostics, Santa Maria, CA). Enterococci were identified to the species level using standard biochemical tests and a Phoenix automated microbiology system (BD Diagnostics, Sparks, MD). The susceptibility of the enterococci to vancomycin and teicoplanin was determined using an Etest (AB Biodisk, Solna, Sweden). VRE were initially isolated from 147 cultures, and the VanR assay detected 142 of the 147 positive cultures for a sensitivity of 96.6%. The specificity was 87.0% (309/355) largely due to false positives seen with the vanB portion of the assay. The sensitivity when testing rectal swabs was 98.3%, and the sensitivity for stool samples was 95.4% (P = 0.643). The specificity of rectal swabs was comparable to that of the stool specimens (87.5% and 86.5%, respectively). When used only to detect VanA resistance, the VanR assay was 94.4% (136/144) sensitive and 96.4% (345/358) specific, with positive and negative predictive values of 91.3% and 97.7%, respectively. In summary, the BD GeneOhm VanR assay is a good screening test for VRE in our population of predominantly vanA-colonized patients. However, patient samples testing only vanB positive should be confirmed by another method for the presence of VRE.
机译：建议在直肠和粪便标本中主动筛选耐万古霉素的肠球菌（VRE），以限制某些高危人群中抗菌素耐药性的传播。我们直接从502个直肠拭子和粪便标本中，评估了BD GeneOhm VanR测定法（BD GeneOhm，圣地亚哥，加利福尼亚州）的诊断性能，该方法是一种快速的实时PCR测试，用于检测 vanA 的存在。和/或 vanB 基因。将VanR分析与含有6μg/ ml万古霉素（BEAV琼脂）的胆汁-叠氮化物琼脂（BD Diagnostics，Sparks，MD）和含有8μg/ ml万古霉素的BEAV肉汤（Hardy Diagnostics，Santa Maria， CA）。使用标准生化测试和Phoenix自动微生物系统（BD Diagnostics，Sparks，MD）将肠球菌鉴定到物种水平。肠球菌对万古霉素和替考拉宁的敏感性使用Etest（AB Biodisk，Solna，瑞典）测定。最初从147种培养物中分离出VRE，VanR分析检测到147种阳性培养物中的142种，敏感性为96.6％。特异性为87.0％（309/355），主要是由于在检测的 vanB 部分看到的假阳性。测试直肠拭子的敏感性为98.3％，粪便样品的敏感性为95.4％（ P = 0.643）。直肠拭子的特异性与粪便标本相当（分别为87.5％和86.5％）。仅用于检测VanA耐药性时，VanR测定的特异性为94.4％（136/144），特异性为96.4％（345/358），阳性和阴性预测值分别为91.3％和97.7％。总而言之，BD GeneOhm VanR测定法是对我们以 vanA 为主的人群中VRE的良好筛选测试。但是，应通过另一种VRE存在的方法确认仅测试 vanB 阳性的患者样品。

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