Ayhan Gozaydin, Infectious Diseases and Clinical Microbiology Specialist, Department of Infectious Diseases and Clinical Microbiology, Tepecik Education and Research Hospital, Izmir, Turkey.
Sukran Kose, Infectious Diseases and Clinical Microbiology Specialist, Department of Infectious Diseases and Clinical Microbiology, Tepecik Education and Research Hospital, Izmir, Turkey.
Pak J Med Sci. 2013 Apr;29(2):682-6. doi: 10.12669/pjms.292.2567.
Vancomycin resistance is due to change in ligase enzyme that destroys the binding of the drug. The gold standard is culture; but now molecular methods have also been developed. The aim was to detect the VRE rate at ICUs by culture and BD GeneOhm™ VanR and compare the results of both assays.
135 perianal swabs were taken from the patients at ICUs between January 1(st) 2009 and April 30(th) 2009. Samples were identified by conventional methods and BD GeneOhm VanR assay.
In newborn ICU, 41 patients (74.6%) were negative by both methods. Two (3.6%) were positive by both methods. Twelve (21.8%) of them were culture negative and PCR positive. In adult ICU, 73 (91.3%) patients were negative by both methods. Seven patients (8.8%) were positive by molecular method only.
This study showed low VRE positivity due to factors like inhibition in PCR or culture negativity due low inoculum for bacterial growth. Early detection of VRE is an important issue especially in ICUs and molecular techniques are important tools; but against all, we still need to confirm this method with culture based techniques and in order to do this further studies with higher number of patients with VRE colonisation are required.
万古霉素耐药性是由于连接酶的改变而导致药物结合被破坏。金标准是培养；但现在也已经开发出了分子方法。目的是通过培养和 BD GeneOhm™VanR 检测 ICU 中的 VRE 率，并比较两种检测方法的结果。
2009 年 1 月 1 日至 4 月 30 日期间，从 ICU 的患者中采集了 135 份肛周拭子。样本通过常规方法和 BD GeneOhm VanR 检测进行鉴定。
新生儿 ICU 中，两种方法均为阴性的患者有 41 例（74.6%）。两种方法均为阳性的患者有 2 例（3.6%）。其中 12 例（21.8%）培养阴性但 PCR 阳性。成人 ICU 中，两种方法均为阴性的患者有 73 例（91.3%）。仅分子方法阳性的患者有 7 例（8.8%）。
本研究显示 VRE 阳性率较低，这可能是由于 PCR 抑制或培养阴性（由于细菌生长的接种物低）等因素所致。早期检测 VRE 是一个重要问题，尤其是在 ICU 中，分子技术是重要的工具；但最重要的是，我们仍然需要通过基于培养的技术来验证这种方法，为此，我们需要对更多具有 VRE 定植的患者进行进一步研究。
