Evaluation of PCR-based screening for vancomycin-resistant enterococci compared with a chromogenic agar-based culture method

J Med Microbiol. 2011 Jul;60(Pt 7):945-949. doi: 10.1099/jmm.0.029777-0. Epub 2011 Apr 1.

Abstract

Rapid detection of vancomycin-resistant enterococci (VRE) infection is very important for control and prevention of nosocomial spread of these bacteria. A multiplex PCR method for rapid screening of VRE has recently been developed. We performed a prospective study of VRE screening tests to compare the performance of PCR to that of a chromogenic agar-based culture method. From January to December 2009, a total of 8815 rectal swab specimens were tested simultaneously for VRE by VRE selective culture and by PCR. The specimens were inoculated onto ChromID VRE agar containing 8 µg vancomycin ml⁻¹ and examined after 24 and 48 h of incubation. Identification and antibiotic susceptibility tests were performed using the automated VITEK-2 system and a supplementary E-test and disk diffusion test. Detection of the vanA and vanB genes was performed with the Seeplex VRE detection kit. Specimens were inoculated in enterococcosel broth for 16-24 h before PCR for enrichment of VRE. VRE were isolated from 741 of the 8815 specimens by chromogenic agar-based culture (8.4 %). vanA and vanB genotypes were detected in 758 (8.6 %) and 3 (0.03 %) specimens, respectively, by multiplex PCR. Sensitivity, specificity, positive predictive value and negative predictive value of PCR for detection of VRE were 98.2 %, 99.6 %, 95.7 %, and 99.8 %. No VRE were isolated from vanB-positive specimens. The overall performance of PCR is comparable to that of a chromogenic agar-based culture method for screening of VRE, so PCR could be an alternative or supportive method for effective control of nosocomial VRE infection.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Agar / chemistry
  • Anti-Bacterial Agents / pharmacology*
  • Bacteriological Techniques
  • Chromogenic Compounds
  • Enterococcus / drug effects*
  • Enterococcus / isolation & purification*
  • Gram-Positive Bacterial Infections / diagnosis
  • Gram-Positive Bacterial Infections / microbiology
  • Humans
  • Polymerase Chain Reaction / methods*
  • Prospective Studies
  • Vancomycin / pharmacology*
  • Vancomycin Resistance*

Substances

  • Anti-Bacterial Agents
  • Chromogenic Compounds
  • Vancomycin
  • Agar