Faster and economical screening for vancomycin-resistant enterococci by sequential use of chromogenic agar and real-time polymerase chain reaction

Abstract

The use of culture on selective media, followed by direct colony PCR confirmation allows faster and economical VRE screening.

Development of a Real-Time PCR Protocol Requiring Minimal Handling for Detection of Vancomycin-Resistant Enterococci with the Fully Automated BD Max System

“…Additionally, the same PCR can also be used for the confirmation of resistance conferred by vanA and vanB from culture isolates (as was done here on a limited number of isolates) or from positive blood culture bottles with Gram-positive cocci (data not shown). Similar approaches of combining culture methods or mass spectrometry with PCRs for the rapid detection of VRE have been reported (32,33). The BD Max VRE PCR facilitates such diagnostic procedures by using automated PCR with minimal handling times.…”

Development of high-resolution melting curve analysis in rapid detection of vanA gene, Enterococcus faecalis, and Enterococcus faecium from clinical isolates

“…Vancomycin resistance Enterococcus (VRE) is an important cause of nosocomial infections [6]. Enterococcus faecalis and Enterococcus faecium were identified as the two most prevalent Enterococcus spp.…”

“…Enterococcus faecalis and Enterococcus faecium were identified as the two most prevalent Enterococcus spp. causing healthcare-associated infections (HAI) [4,6]. E. faecium has been reported as the most common Enterococcus spp.…”

“…E. faecium has been reported as the most common Enterococcus spp. [6]. There are six main VRE phenotypes: vanA, vanB, vanC, vanD, vanE, and vanG, with a high prevalence reported for vanA and vanB.…”

Commentary: Automatic Digital Plate Reading for Surveillance Cultures

“…Debate exists regarding the optimal methods that should be used for MRSA and VRE surveillance programs, with labor costs and turnaround time as the major limitations of culture-based methods that employ chromogenic agar (15)(16)(17)(18). Conversely, molecular screening methods offer improved turnaround time at the expense of increased reagent costs and, in some studies, reduced sensitivity and specificity compared to phenotypic methods, the latter resulting from detection of resistance genes from species other than the target species and/or variability in the organization or sequence of genetic loci encoding resistance (e.g., mecA variant or dropout strains, nonfunctional or unexpressed vanA genes, and vanB genes present in gastrointestinal commensals other than enterococci) (17,(19)(20)(21)(22)(23)(24).…”