Evaluation of GeneXpert vanA/vanB in the early diagnosis of vancomycin-resistant enterococci infection

Abstract

Purpose Vancomycin-resistant enterococci infection is a worrying worldwide clinical problem. To evaluate the accuracy of GeneXpert vanA/vanB in the diagnosis of VRE, we conducted a systematic review in the study. Methods Experimental data were extracted from publications until May 03 2021 related to the diagnostic accuracy of GeneXpert vanA/vanB for VRE in PubMed, Embase, Web of Science and the Cochrane Library. The accuracy of GeneXpert vanA/vanB for VRE was evaluated using summary receiver to operate characteristic curve, pooled sensitivity, pooled specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio. Results 8 publications were divided into 3 groups according to two golden standard references, vanA and vanB group, vanA group, vanB group, including 6 researches, 5 researches and 5 researches, respectively. The pooled sensitivity and specificity of group vanA and vanB were 0.96 (95% CI, 0.93–0.98) and 0.90 (95% CI, 0.88–0.91) respectively. The DOR was 440.77 (95% CI, 37.92–5123.55). The pooled sensitivity and specificity of group vanA were 0.86 (95% CI, 0.81–0.90) and 0.99 (95% CI, 0.99–0.99) respectively, and those of group vanB were 0.85 (95% CI, 0.63–0.97) and 0.82 (95% CI, 0.80–0.83) respectively. Conclusion GeneXpert vanA/vanB can diagnose VRE with high-accuracy and shows greater accuracy in diagnosing vanA.

High Gastrointestinal Colonization Rate of Vancomycin-Resistant Enterococci among Hospitalized Patients: Potential Source for Resistant Gene

“…Participants with no formal education were about 4 times more likely to be colonized with VRE than their counterparts. The finding was consistent with studies conducted in Nigeria [ 27 ], Ethiopia (925), and China [ 28 ]. Participants without formal education may have a tendency of using antibiotics without appropriate prescription and sharing of antibiotics, both of which could lead to the development of antibiotic resistance.…”

“…Long duration of hospital stay and use of antibiotics are among the frequently reported risk factors for VRE colonization and infection. The gradual increase and clonal expansion of VRE might have contributed to a higher prevalence [ 28 , 29 ]. In addition to this, variation in the prevalence of VRE could be due to socioeconomic variation, exposure to antibiotics for a prolonged duration, and habit of antibiotic use.…”

The Revolution of Lateral Flow Assay in the Field of AMR Detection

“…All the steps in these assays, which use PCR or RT-PCR technology [ 107 , 108 , 109 ], are automated. These all-in-one tests have been applied to the direct detection of antibiotic resistance genes in clinical samples [ 110 , 111 ]. While these systems are easy to use and provide rapid results (around 1 h), they are expensive and require costly specific equipment which limits their use.…”