A new multiplex PCR assay for the simultaneous detection of vancomycin-resistant enterococci from rectal swabs.
OBJECTIVE
This study describes the diagnostic performance of a recently available multiplex PCR-based kit for the simultaneous detection and identification of Enterococcus faecium, Enterococcus faecalis, vanA, vanB, vanC1 and vanC2/C3 genes, directly from rectal swabs constituting the most complete existing molecular assay currently available.


METHODS
The diagnostic performance of this assay was evaluated by a multicenter study involving three independent public hospitals and consisted in the analysis of 187 rectal swabs from patients at high risk for vancomycin-resistant enterococci colonization.


RESULTS
When bacteria culture was used as the gold standard, the sensitivity, specificity, positive and negative predicted values for the assay were 96.8%, 76.0%, 67.7% and 97.9%, respectively. When a composite reference standard consisting of culture and DNA sequencing of PCR products was used as the gold standard, the sensitivity, specificity, positive and negative predicted values for the PCR-based assay were 97.8%, 96.9%, 96.7% and 97.9%, respectively.


CONCLUSIONS
Based on these results, we conclude that this assay is considerably more sensitive than traditional microbiological methods for detecting vancomycin-resistant enterococci from rectal swabs. It is also much faster than culture. We believe that the implementation of this assay in routine clinical laboratories could help to reduce hospital-acquired vancomycin-resistant enterococci infections.
Benadof
Dona
D
Laboratorio de Microbiología, Roberto del Rio Hospital, Zañartu Ave. 1085, Santiago, Chile.
San Martín
Marcela
M
Aguirre
Judith
J
Paredes
Liliana
L
Malig
Rodrigo
R
Melo
Francisco
F
Lehouque
Gaëlle
G
D001431:Bacteriological Techniques / Q000379:methods; D013293:Enterococcus faecalis / Q000187:drug effects* / Q000235:genetics* / Q000302:isolation & purification; D016984:Enterococcus faecium / Q000187:drug effects* / Q000235:genetics* / Q000302:isolation & purification; D006801:Humans; D016133:Polymerase Chain Reaction / Q000379:methods*; D011237:Predictive Value of Tests; D012007:Rectum / Q000382:microbiology*; D012680:Sensitivity and Specificity; D020713:Vancomycin Resistance