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

PLoS Negl Trop Dis. 2021 Nov 8;15(11):e0009869. doi: 10.1371/journal.pntd.0009869. eCollection 2021 Nov.

Abstract

Purpose: 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.

Methods: 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.

Results: 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.

Conclusion: GeneXpert vanA/vanB can diagnose VRE with high-accuracy and shows greater accuracy in diagnosing vanA.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Anti-Bacterial Agents / pharmacology
  • Bacterial Proteins / genetics*
  • Bacterial Proteins / metabolism
  • Carbon-Oxygen Ligases / genetics*
  • Carbon-Oxygen Ligases / metabolism
  • Gram-Positive Bacterial Infections / diagnosis*
  • Gram-Positive Bacterial Infections / microbiology*
  • Humans
  • Sensitivity and Specificity
  • Vancomycin / pharmacology
  • Vancomycin-Resistant Enterococci / classification
  • Vancomycin-Resistant Enterococci / drug effects
  • Vancomycin-Resistant Enterococci / genetics
  • Vancomycin-Resistant Enterococci / isolation & purification*

Substances

  • Anti-Bacterial Agents
  • Bacterial Proteins
  • VanA ligase, Bacteria
  • VanB protein, Enterococcus
  • Vancomycin
  • Carbon-Oxygen Ligases

Grants and funding

The author(s) received no specific funding for this work.