University of Arizona, Tucson, AZ 85724-5059, USA.
Diagn Microbiol Infect Dis. 2011 Apr;69(4):382-9. doi: 10.1016/j.diagmicrobio.2010.11.005.
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.
快速检测万古霉素耐药肠球菌（VRE）携带者对于医疗机构来说可能很有用，可以最大程度地减少传播。为此，我们比较了 Cepheid GeneXpert vanA/vanB 检测法与直接培养和肉汤富集培养法检测肛周拭子中 VRE 的性能。肠球菌在含有 8 μg/mL 万古霉素的 Enterococcosel™琼脂、含有 6 μg/mL 万古霉素的胆盐-七叶苷-叠氮琼脂和胆盐-七叶苷-Enterococcosel 肉汤中进行培养。与参考标准（直接琼脂平板培养、肉汤富集培养和临床图表回顾的组合）相比，vanA/vanB 检测法的灵敏度、特异性、阳性预测值和阴性预测值分别为 96.4%、93.0%、92.0%和 96.9%（n=184）。vanA 的 95%检测限为 100 个菌落形成单位（CFU）/mL，vanB 的检测限为 114 CFU/mL。总之，GeneXpert vanA/vanB 检测法是一种快速、准确的方法，可用于 VRE 筛查计划，以识别携带 vanA/vanB 的患者，该方法使用肛周拭子标本。
