Utility of direct, real-time PCR in the management of a nosocomial outbreak of vancomycin-resistant Enterococcus faecium (vanB genotype)

摘要

Recommended infection control measures for vancomycin-resistant Enterococcus (VRE) in hospital settings have included obtaining rectal swabs for screening high-risk patients. Unfortunately, standard culture methods for detection of VRE in rectal swabs may take several days for isolation and identification of the organism. Consequently, there has been interest in the development of rapid and sensitive nucleic acid amplification-based methods for detecting VRE from rectal swabs. In the past year, a VRE outbreak occurred in our 1,200-bed tertiary-care teaching hospital, involving 15 patients on the cardiovascular surgery unit. The outbreak was due to transmission of a single strain of vancomycin-resistant Enterococcus faecium, possessing the vanB2/3 gene determinant. VRE did not cause any infections in this outbreak; only patients with rectal colonization were identified. This outbreak provided an opportunity to assess the role of a real-time polymerase chain reaction(PCR) assay using rectal swab specimens to rapidly screen for VRE.