Clinical Microbiology Service, Department of Laboratory Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
J Clin Microbiol. 2012 Nov;50(11):3659-63. doi: 10.1128/JCM.01776-12. Epub 2012 Sep 12.
We compared the performance characteristics of culture and the Cepheid Xpert vanA assay for routine surveillance of vancomycin-resistant enterococci (VRE) from rectal swabs in patients at high risk for VRE carriage. The Cepheid Xpert vanA assay had a limit of detection of 100 CFU/ml and correctly detected 101 well-characterized clinical VRE isolates with no cross-reactivity in 27 non-VRE and related culture isolates. The clinical sensitivity, specificity, positive predictive value, and negative predictive value of the Xpert vanA PCR assay were 100%, 96.9%, 91.3%, and 100%, respectively, when tested on 300 consecutively collected rectal swabs. This assay provides excellent predictive values for prompt identification of VRE-colonized patients in hospitals with relatively high rates of VRE carriage.
我们比较了培养法和 Cepheid Xpert vanA 检测法在常规监测高风险携带万古霉素耐药肠球菌（VRE）患者直肠拭子中 VRE 的性能特征。Cepheid Xpert vanA 检测法的检测限为 100CFU/ml，正确检测了 101 个特征明确的临床 VRE 分离株，在 27 个非 VRE 和相关培养分离株中无交叉反应。当对 300 份连续采集的直肠拭子进行检测时，Xpert vanA PCR 检测法的临床灵敏度、特异性、阳性预测值和阴性预测值分别为 100%、96.9%、91.3%和 100%。该检测法在万古霉素耐药率较高的医院中，对快速识别 VRE 定植患者具有出色的预测价值。
