title: Comparison of direct cultivation on a selective solid medium, polymerase chain reaction from an enrichment broth, and the BD GeneOhm™ VanR Assay for identification of vancomycin-resistant enterococci in screening specimens.
abstract: Fast and reliable diagnostics of vancomycin-resistant enterococci (VRE) is an important prerequisite for containing VRE transmission rates and controlling VRE outbreaks among hospital patients. The BD GeneOhm™ VanR Assay (Becton Dickinson Diagnostics, Erembodegem, Belgium) is a real-time polymerase chain reaction (PCR) assay for screening perianal/rectal samples for the presence of vanA or vanB genes that can be associated with VRE. A set of 51 reference strains (vanA-G genotypes) were correctly identified. Performance of the assay was evaluated and compared with culture-based methods and subsequent PCR analysis in 2 university hospitals with a different VRE prevalence. A total of 1786 samples were analyzed. With the use of the BD GeneOhm™ VanR Assay, 88 of 102 vanA-positive specimens, 62 of 67 vanB-positive specimens, 3 of 4 vanA- and vanB-positive specimens, and 1403 of 1613 negative specimens were correctly identified. The overall sensitivity was 93.1%; the specificity was 87.0% mainly due to false-positive vanB results. Results did not differ between study institutions.
authors.affiliation: Robert Koch Institute, Wernigerode Branch, Wernigerode, Germany. wernerg@rki.de
authors.forename: Guido
authors.initials: G
authors.lastname: Werner
authors.forename: Annerose
authors.initials: A
authors.lastname: Serr
authors.forename: Sabine
authors.initials: S
authors.lastname: Schütt
authors.forename: Christian
authors.initials: C
authors.lastname: Schneider
authors.forename: Ingo
authors.initials: I
authors.lastname: Klare
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Witte
authors.forename: Constanze
authors.initials: C
authors.lastname: Wendt
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D016983:Enterococcus / Q000187:drug effects* / Q000235:genetics / Q000254:growth & development; D006801:Humans; D008403:Mass Screening / Q000379:methods*; D008826:Microbial Sensitivity Tests / Q000379:methods; D016133:Polymerase Chain Reaction / Q000379:methods; D012680:Sensitivity and Specificity; D014640:Vancomycin / Q000494:pharmacology*; D020713:Vancomycin Resistance
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin