Incidence of genes encoding vanA/vanB vancomycin resistance in rectal swabs of patients with diagnosed cancer, on the day of admission to hospital, in a non-epidemic period

Abstract

Introduction: Rapid diagnosis is important for preventing infections due to vancomycin-resistant enterococci. Aim: To evaluate the status of gastrointestinal colonisation with strains containing vanA/vanB genes in oncological patients. Material and methods: A total of 167 samples of rectal swabs taken from 161 patients (mean age: 63, range: 29-93 years) were examined, including 113 patients from surgical wards (70.2%) and 48 patients from non-surgical wards (29.8%), with diagnosed cancer. The tests were carried out within 24 h of admitting the patient to the department, using the Cepheid Xpert vanA/vanB test, with a CE marked GeneXpert ® Instrument Systems analyser. Samples with positive vanB gene results were additionally seeded on chromogenic media. Results: The presence of the vanA gene was found in 2.7% and 6.3% of the examined patients, respectively, from the surgical and non-surgical departments, which accounted for 3.7% of all the patients examined. The presence of the vanB gene was detected in 21.1% of the patients, but in no case was there any growth of vancomycin-resistant enterococci on the chromogenic medium. Conclusions: Patients admitted to non-surgical wards were more often colonised with vanA/vanB genes than were patients admitted to surgical wards, but the differences were not statistically significant.

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

“…The culture method for all clinical E. faecium isolates may neither be feasible nor cost-efficient in the setting of every routine lab, which makes it impossible to make a clear decision about the need to isolate the patient. Hence, supplementary tests are needed for further investigating [ 22 , 23 ].…”