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

<h4>Purpose</h4> 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. <h4>Methods</h4> Experimental data were extracted from...

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Main Authors: Zhuo-Lei Li (Author), Qi-Bing Luo (Author), Shan-Shan Xiao (Author), Ze-Hong Lin (Author), Ye-Ling Liu (Author), Meng-Yi Han (Author), Jing-Hua Zhong (Author), Tian-Xing Ji (Author), Xu-Guang Guo (Author)
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Published: Public Library of Science (PLoS), 2021-11-01T00:00:00Z.
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Summary:<h4>Purpose</h4> 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. <h4>Methods</h4> 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. <h4>Results</h4> 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. <h4>Conclusion</h4> GeneXpert vanA/vanB can diagnose VRE with high-accuracy and shows greater accuracy in diagnosing vanA. Author summary Vancomycin-resistant enterococci (VRE), firstly identified in the mid-1980, is a type of antimicrobial resistance bacteria. In recent years, they were found more colonization in patients with critical diseases, showing new resistance to many antibacterial drugs, which is a worrisome clinical problem worldwide. Traditionally, VRE testing is performed mainly by culture which is a standard reference but requires complex steps and takes a long time. Currently, GeneXpert vanA/vanB were approved as a rapid and sensitive molecular assay for detecting VRE. However, the accuracy of GeneXpert vanA/vanB is without systematic-analyses in evidence-based medicine. Therefore, we conducted a data integration and analysis in this study. Finally, we draw a conclusion that GeneXpert vanA/vanB has a high accuracy diagnosing VRE in comparation with conventional culture and PCR. Furthermore, GeneXpert vanA/vanB shows more accuracy in diagnosing vanA. In addition, we suggest that an additional test is needed for further detecting vanB. This finding provides a promising direction for the diagnosis of VRE to a certain extent.
Item Description:1935-2727
1935-2735