title: Performance characteristics of the Cepheid Xpert vanA assay for rapid identification of patients at high risk for carriage of vancomycin-resistant Enterococci.
abstract: 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.
authors.affiliation: Clinical Microbiology Service, Department of Laboratory Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York, USA. babadyn@mskcc.org
authors.forename: N Esther
authors.initials: NE
authors.lastname: Babady
authors.forename: Kathleen
authors.initials: K
authors.lastname: Gilhuley
authors.forename: Diane
authors.initials: D
authors.lastname: Cianciminio-Bordelon
authors.forename: Yi-Wei
authors.initials: YW
authors.lastname: Tang
mesh_terms: D001426:Bacterial Proteins / Q000235:genetics*; D001431:Bacteriological Techniques / Q000379:methods*; D019729:Carbon-Oxygen Ligases / Q000235:genetics*; D002353:Carrier State / Q000175:diagnosis* / Q000382:microbiology; D016983:Enterococcus / Q000235:genetics* / Q000302:isolation & purification; D005243:Feces / Q000382:microbiology; D016908:Gram-Positive Bacterial Infections / Q000175:diagnosis* / Q000382:microbiology; D006801:Humans; D011237:Predictive Value of Tests; D011933:Reagent Kits, Diagnostic; D012680:Sensitivity and Specificity; D020713:Vancomycin Resistance
chemical_list: D001426:Bacterial Proteins; D011933:Reagent Kits, Diagnostic; C071437:VanA ligase, Bacteria; D019729:Carbon-Oxygen Ligases