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

• Published in: Turkish journal of pediatrics Vol. 57; no. 2; p. 161
• Main Authors: Devrim, Fatma, Gülfidan, Gamze, Gözmen, Salih, Demirağ, Bengü, Oymak, Yeşim, Yaman, Yöntem, Oruç, Yeliz, Yaşar, Nevbahar, Apa, Hurşit, Bayram, Nuri, Vergin, Canan, Devrim, İlker
• Format: Journal Article
• Language: English
• Published: Turkey Hacettepe University Faculty of Medicine 01.03.2015; Hacettepe University Institute of Child Health
• Subjects: Adolescent; Agar; Child; Child, Preschool; Female; Hematology; Hospitalization; Humans; Immunocompromised Host; Infant; Male; Real-Time Polymerase Chain Reaction; Rectum - microbiology; Sensitivity and Specificity; Vancomycin-Resistant Enterococci - isolation & purification
• ISSN: 0041-4301; 2791-6421

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.