Annals of Laboratory Medicine

Korean Society for Laboratory Medicine (대한진단검사의학회)
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Evaluation of the iNtRON VRE vanA/vanB Real-Time PCR Assay for Detection of Vancomycin-Resistant Enterococci

  • Huh, Hee Jae (Department of Laboratory Medicine and Genetics, Sungkyunkwan University School of Medicine) ;
  • Jang, Mi-Ae (Department of Laboratory Medicine and Genetics, Sungkyunkwan University School of Medicine) ;
  • Seo, Ja Young (Department of Laboratory Medicine, Gachon University Gil Hospital) ;
  • Kim, Ji-Youn (Center for Clinical Medicine, Samsung Biomedical Research Institute, Samsung Medical Center) ;
  • Ki, Chang-Seok (Department of Laboratory Medicine and Genetics, Sungkyunkwan University School of Medicine) ;
  • Kim, Jong-Won (Department of Laboratory Medicine and Genetics, Sungkyunkwan University School of Medicine) ;
  • Lee, Nam Yong (Department of Laboratory Medicine and Genetics, Sungkyunkwan University School of Medicine)
  • Received : 2014.04.15
  • Accepted : 2014.10.13
  • Published : 2015.01.02
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Abstract

Background: Recently, the iNtRON VRE vanA/vanB real-time PCR (iNtRON; iNtRON Biotechnology, Korea) assay, a multiplex real-time PCR method, was introduced. In this prospective study, we compared the iNtRON assay with the Seeplex VRE ACE detection kit (Seeplex; Seegene, Korea), a conventional multiplex PCR assay. Methods: A chromogenic agar-based culture, in which pre-selected vancomycin-resistant enterococci (VRE) was grown and subsequently plated on blood agar with vancomycin disks, was regarded as the reference method. A total of 304 consecutive rectal swab specimens were tested for VRE by culture and by iNtRON and Seeplex PCR assays. For the PCR assays, specimens were enriched for 16-24 hr before PCR. Results: VRE were isolated from 44 (14.5%) specimens by chromogenic agar-based culture. The clinical sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the iNtRON assay were 100% (95% confidence interval: 89.8%-100%), 99.2% (96.9%-99.9%), 95.6% (83.6%-99.2%), and 100% (98.2%-100%), respectively, while those of the Seeplex assay were 97.7% (86.2%-99.9%), 99.6% (97.5%-99.9%), 97.7% (86.2%-99.9%), and 99.6% (97.5%-99.9%), respectively. The iNtRON assay had a detection limit of $3,159copies/{\mu}L $ and $13,702copies/{\mu}L$ for the vanA and vanB genes, respectively. No cross-reactivity was observed in 11 non-VRE bacterial culture isolates. Conclusions: The overall performance of the iNtRON assay was comparable to that of a chromogenic agar-based culture method for prompt identification of VRE-colonized patients in hospitals. This assay could be an alternative or supportive method for the effective control of nosocomial VRE infection.

Keywords

Acknowledgement

Grant : 항생제내성균주은행

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