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Published on: July 9, 2012
Screening for vancomycin-resistant enterococci: an efficient and economical laboratory-developed test
H Fang1, A-K Ohlsson, G-X Jiang
1Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska University Hospital Huddinge, Karolinska Institute, 141 86, Stockholm, Sweden. hong.fang@karolinska.se
Summary
A new laboratory-developed test (Lab Assay) effectively screens for vancomycin-resistant enterococci (VRE) using broth enrichment and real-time PCR. This efficient and economical assay offers comparable diagnostic values to commercial kits, reducing costs.
Area of Science:
- Clinical Microbiology
- Molecular Diagnostics
- Infectious Disease Screening
Background:
- Vancomycin-resistant enterococci (VRE) pose a significant healthcare challenge.
- Accurate and efficient VRE screening is crucial for infection control.
- Existing screening methods may have limitations in cost or workflow integration.
Purpose of the Study:
- To develop and evaluate a novel laboratory-developed test (Lab Assay) for VRE screening.
- To assess the diagnostic performance and cost-effectiveness of the Lab Assay.
- To determine the compatibility of the assay with different real-time PCR platforms.
Main Methods:
- Development of a Lab Assay combining enrichment broth and real-time PCR for VRE detection.
- Parallel evaluation of 1,765 faecal/rectal swabs using Lab Assay and a commercial kit (Roche LightCycler).
- Determination of diagnostic values (sensitivity, specificity, PPV, NPV) and detection limits.
Main Results:
- Lab Assay demonstrated 100% sensitivity and 100% negative predictive value.
- Specificity was 79.92%, comparable to the commercial assay.
- The assay showed a detection limit of 10(0) to 10(1) CFU/ml for VanA and VanB VRE and was compatible with multiple PCR systems.
- A cost saving of 7 EUR per sample was achieved compared to the commercial kit.
Conclusions:
- The laboratory-developed broth-PCR method is a highly sensitive and specific assay for VRE screening.
- The assay is cost-effective, offering significant material cost savings.
- Its flexibility with PCR systems and integrated workflow potential make it an efficient alternative for routine VRE surveillance.
