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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Autores principales:	Zhuo-Lei Li, Qi-Bing Luo, Shan-Shan Xiao, Ze-Hong Lin, Ye-Ling Liu, Meng-Yi Han, Jing-Hua Zhong, Tian-Xing Ji, Xu-Guang Guo
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/4194c8de5c6048e9af2ec540d834282f
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spelling	oai:doaj.org-article:4194c8de5c6048e9af2ec540d834282f2021-11-18T09:12:16ZEvaluation of GeneXpert vanA/vanB in the early diagnosis of vancomycin-resistant enterococci infection1935-27271935-2735https://doaj.org/article/4194c8de5c6048e9af2ec540d834282f2021-11-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8575182/?tool=EBIhttps://doaj.org/toc/1935-2727https://doaj.org/toc/1935-2735<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.Zhuo-Lei LiQi-Bing LuoShan-Shan XiaoZe-Hong LinYe-Ling LiuMeng-Yi HanJing-Hua ZhongTian-Xing JiXu-Guang GuoPublic Library of Science (PLoS)articleArctic medicine. Tropical medicineRC955-962Public aspects of medicineRA1-1270ENPLoS Neglected Tropical Diseases, Vol 15, Iss 11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270
spellingShingle	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Zhuo-Lei Li Qi-Bing Luo Shan-Shan Xiao Ze-Hong Lin Ye-Ling Liu Meng-Yi Han Jing-Hua Zhong Tian-Xing Ji Xu-Guang Guo Evaluation of GeneXpert vanA/vanB in the early diagnosis of vancomycin-resistant enterococci infection
description	<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.
format	article
author	Zhuo-Lei Li Qi-Bing Luo Shan-Shan Xiao Ze-Hong Lin Ye-Ling Liu Meng-Yi Han Jing-Hua Zhong Tian-Xing Ji Xu-Guang Guo
author_facet	Zhuo-Lei Li Qi-Bing Luo Shan-Shan Xiao Ze-Hong Lin Ye-Ling Liu Meng-Yi Han Jing-Hua Zhong Tian-Xing Ji Xu-Guang Guo
author_sort	Zhuo-Lei Li
title	Evaluation of GeneXpert vanA/vanB in the early diagnosis of vancomycin-resistant enterococci infection
title_short	Evaluation of GeneXpert vanA/vanB in the early diagnosis of vancomycin-resistant enterococci infection
title_full	Evaluation of GeneXpert vanA/vanB in the early diagnosis of vancomycin-resistant enterococci infection
title_fullStr	Evaluation of GeneXpert vanA/vanB in the early diagnosis of vancomycin-resistant enterococci infection
title_full_unstemmed	Evaluation of GeneXpert vanA/vanB in the early diagnosis of vancomycin-resistant enterococci infection
title_sort	evaluation of genexpert vana/vanb in the early diagnosis of vancomycin-resistant enterococci infection
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/4194c8de5c6048e9af2ec540d834282f
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Evaluation of GeneXpert vanA/vanB in the early diagnosis of vancomycin-resistant enterococci infection

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