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

Erin S. Marner, Donna M. Wolk, Jeanne Carr, Carolyn Hewitt, Lorraine L. Dominguez, Thomas Kovacs, Desiree R. Johnson, Randall T. Hayden

Research output: Contribution to journalArticlepeer-review

30 Scopus citations

Abstract

Rapid detection of vancomycin-resistant enterococci (VRE) carriers could be useful to health care facilities to minimize transmission. To that end, we compared the performance of the Cepheid GeneXpert vanA/. vanB assay with that of direct and broth-enriched culture methods for detection of VRE from perianal swabs. Enterococci were cultivated on Enterococcosel™ agar with 8 μg/mL vancomycin, Bile Esculin Azide Agar with 6 μg/mL vancomycin, and Bile Esculin Azide Enterococcosel Broth. Compared to the reference standard (combination of direct agar plating, broth-enriched culture, and clinical chart review), the sensitivity, specificity, positive predictive value, and negative predictive value of the vanA/. vanB assay were 96.4%, 93.0%, 92.0%, and 96.9%, respectively (n = 184). The 95% limit of detection was 100 colony-forming units (CFU)/mL for vanA and 114 CFU/mL for vanB. In summary, the GeneXpert vanA/. vanB assay is a rapid and accurate method to identify vanA/. vanB-colonized patients for VRE screening programs that use perianal swab specimens.

Original languageEnglish (US)
Pages (from-to)382-389
Number of pages8
JournalDiagnostic Microbiology and Infectious Disease
Volume69
Issue number4
DOIs
StatePublished - Apr 2011

Keywords

  • Culture
  • GeneXpert
  • Real-time PCR
  • VRE

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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