AiM  Vol.4 No.12 , September 2014
Rapid Detection Tool for Vancomycin-Resistant Enterococcus (VRE) Directly from Human Specimens
Abstract: A new, simple, and one-step tool for the direct detection of vancomycin-resistant Enterocococcus (VRE) EPI-V® (Pilots Point LLC, Sarasota, FL) is presented. It contains all the ingredients in a unique stable powder form in a standard test tube. One only needs to add water, inoculate the specimen, and incubate. Specimens consisted of 553 sequential human rectal/perirectal swabs for VRE surveillance. The presence of VRE was denoted by the production of two sequential color changes corresponding to growth in bile-esculin and production of a positive PYR reaction. The EPI-V® tool was compared to reference VRE detection methods. EPI-V® showed a sensitivity of  102% and a specificity of 98.4% for the detection of VRE. The EPI-V® tool offers significant advantages: no skilled technologist time required, simple quality control, highly conserved incubator and refrigerator space, and low cost.
Keywords: VRE, Stool, Carriage, Detection
Cite this paper: Edberg, S. (2014) Rapid Detection Tool for Vancomycin-Resistant Enterococcus (VRE) Directly from Human Specimens. Advances in Microbiology, 4, 835-838. doi: 10.4236/aim.2014.412092.

[1]   Anonymous (1995) Vancomycin Resistant Enterococci in Hospitals in the United Kingdom. Communicable Disease Report (CDR) Weekly, 5, 281.

[2]   Centers for Disease Control and Prevention (1995) Recommendations for Preventing the Spread of Vancomycin Resistance. Recommendations of the Hospital Infection Control Practices Advisory Committee (HICPAC). Morbidity and Mortality Weekly Report (MMWR), 44, 1-13.

[3]   Chadwick, P.R. and Oppenheim, B.A. (1995) Neomycin Blood Agar as Selective Medium for Vancomycin-Resistant Enterococcus faecium. Journal of Clinical Microbiology, 48, 1068-1070.

[4]   CLSI (2011) Performance Standards for Antimicrobial Susceptibility Testing; Twenty-First Informational Supplement. CLSI Document M100-S21. Clinical and Laboratory Standards Institute, Wayne, PA.

[5]   Edberg, S.C., Allen, M.J., Smith, D.B. and the National Collaborative Study (1988) National Field Evaluation of a Defined Substrate Method for the Simultaneous Enumeration of Total Coliforms and Escherichia coli from Drinking Water: Comparison with the Standard Multiple Tube Fermentation Method. Applied and Environmental Microbiology, 54, 1595-1601.

[6]   Edberg, S.C. and Edberg, M.M. (1988) A Defined Substrate Technology for the Enumeration of Microbial Indicators of Environmental Pollution. Yale Journal of Biology and Medicine, 61, 389-399.

[7]   Edberg, S.C., Hardalo, C.J., Kontnick, C. and Campbell, S. (1994) Rapid Detection of Vancomycin-Resistant Enterococci. Journal of Clinical Microbiology, 32, 2182-2184.

[8]   Edmond, M.B., Ober, J.F., Weinbaum, D.L., Pfaller, M.A, Hwang, T., Sabford, M.D. and Wenzel, R.P. (1995) Vancomycin-Resistant Enterococcus faecium Bacteremia: Risk Factors for Infection. Clinical Infectious Diseases, 20, 1126-1133.

[9]   Facklam, R., Pigott, N., Franklin, R. and Elliott, J. (1995) Evaluation of Three Disk Tests for Identification of Enterococci, Leuconostocs, and Pediococci. Journal of Clinical Microbiology, 33, 885-887.

[10]   Gordts, B., Van Landuyt, H., Leven, M., Vandamme, P. and Goossens, H. (1995) Vancomycin-Resistant Enterococci Colonizing the Intestinal Tracts of Hospitalized Patients. Journal of Clinical Microbiology, 33, 2842-2846.

[11]   Heath, C.H., Blackmore, T.K. and Gordon, D.L. (1996) Emerging Resistance in Enterococcus spp. Medical Journal of Australia, 164, 116-120.

[12]   Lam, S., Singer, C., Tucci, V., Morthland, V.H., Pfaller, M.A. and Isenberg, H.D. (1995) The Challenge of Vancomycin-Resistant Enterococci: A Clinical and Epidemiologic Study. American Journal of Infection Control, 23, 170-180.

[13]   Murray, P.R., Baron, E.J., Jorgensen, J.H., Landry, M.L. and Pfaller, M.A. (2007) Manual of Clinical Microbiology. 9th Edition, American Society for Microbiology, Washington, DC.

[14]   Edberg, S.C. (2013) Enhanced Reagent for the Detection of L-Pyrrolidonyl-β-naphthalyamide (PYR) Hydrolysis. 23rd European Congress on Clinical Microbiology and Infectious Diseases, Berlin, 27-30 April 2013.

[15]   Noskin, G.A., Cooper, I. and Peterson, L.R. (1995) Vancomycin-Resistant Enterococcus faecium Sepsis Following Persistent Colonization. JAMA Internal Medicine, 155, 1445-1447.

[16]   Noskin, G.A., Stosor, V., Cooper, I. and Peterson, L.R. (1995) Recovery of Vancomycin-Resistant Enterococci on Fingertips and Environmental Surfaces. Infection Control and Hospital Epidemiology, 16, 577-581.

[17]   Swenson, J.M., Clark, N.C., Ferraro, M.J., Sahm, D.F., Doern, G., Pfaller, M.A., Reller, L.B., Weinstein, M.P., Zabransky, RJ. and Tenover, F.C. (1994) Development of a Standardized Screening Method for Detection of Vancomycin Resistant Enterococci. Journal of Clinical Microbiology, 32, 1700-1704.