title: Comparison of the BD GeneOhm VanR assay and a chromogenic agar-based culture method in screening for vancomycin-resistant enterococci in rectal specimens of pediatric hematology-oncology patients.
abstract: VRE species are an increasingly important and universal problem in intensive care units and hematology-oncology departments due to the spread of glycopeptide resistance. Rapid and accurate identification of VRE is therefore crucial. The intent of this study was to compare the diagnostic performance of a real-time PCR test, the BD GeneOhm VanR assay (GeneXpert vanA/ vanB, Cepheid, USA), with conventional cultures for screening hospitalized immunocompromised hematology-oncology patients for VRE. Three hundred and six duplicate rectal swab specimens were obtained from 120 pediatric hematology-oncology patients. PCR and conventional culture-based studies were performed. One hundred and twenty patients, 46 female and 74 male, participated in the study. The mean age of the patients was 7.5±4.7 years. A total of 51 specimens from 306 samples were found to be positive for vanA or vanB. Mean turnaround time for PCR was 0.5±0.2 days. Compared to the culture method, the RT-PCR assay had an overall sensitivity of 91.8% (34/37) and a specificity of 93.6%. The positive predictive value and negative predictive value were 66.6% and 98.8%, respectively. This study demonstrates that RT-PCR is a suitable alternative to culture-based procedures for rapid and accurate identification of VRE in hematology-oncology patients, as the overall performance of PCR is comparable to that of a chromogenic agar-based culture method for VRE screening, especially for detection of VRE-negative patients.
authors.affiliation: Department of Pediatrics, Dr. Behçet Uz Children's Hospital, İzmir, Turkey. İlkerdevrim2003@yahoo.com.
authors.forename: Fatma
authors.initials: F
authors.lastname: Devrim
authors.forename: Gamze
authors.initials: G
authors.lastname: Gülfidan
authors.forename: Salih
authors.initials: S
authors.lastname: Gözmen
authors.forename: Bengü
authors.initials: B
authors.lastname: Demirağ
authors.forename: Yeşim
authors.initials: Y
authors.lastname: Oymak
authors.forename: Yöntem
authors.initials: Y
authors.lastname: Yaman
authors.forename: Yeliz
authors.initials: Y
authors.lastname: Oruç
authors.forename: Nevbahar
authors.initials: N
authors.lastname: Yaşar
authors.forename: Hurşit
authors.initials: H
authors.lastname: Apa
authors.forename: Nuri
authors.initials: N
authors.lastname: Bayram
authors.forename: Canan
authors.initials: C
authors.lastname: Vergin
authors.forename: İlker
authors.initials: İ
authors.lastname: Devrim
mesh_terms: D000293:Adolescent; D000362:Agar; D002648:Child; D002675:Child, Preschool; D005260:Female; D006405:Hematology; D006760:Hospitalization; D006801:Humans; D016867:Immunocompromised Host; D007223:Infant; D008297:Male; D060888:Real-Time Polymerase Chain Reaction; D012007:Rectum / Q000382:microbiology*; D012680:Sensitivity and Specificity; D065507:Vancomycin-Resistant Enterococci / Q000302:isolation & purification*
chemical_list: D000362:Agar