Comparison of multiple-locus variable-number tandem repeat analysis and pulsed-field gel electrophoresis in a setting of polyclonal endemicity of vancomycin-resistant Enterococcus faecium
In order to assess whether multiple-locus-variable number tandem repeat analysis (MLVA) could replace pulsed-field gel electrophoresis (PFGE) for genotyping vancomycin-resistant isolates of Enterococcus faecium (VREF), this study compared the typeability, discriminatory power, concordance and costs of these methods for VREF isolates obtained from patients, environmental samples and the hands of healthcare workers (HCWs) in a medical intensive care unit (ICU) where VREF was endemic. Over a 58-day period, 393 VREF isolates (373 vanA, one vanA/B, 19 vanB) were cultured from patient rectal swabs (n = 76), the environment (n = 270) and the hands of HCWs (n = 47). PFGE was able to divide 358 (91.1\%) isolates into 19 PFGE types (\textgreatersix bands different) and 24 subtypes (one to three bands different). MLVA was able to type 391 (99.5\%) isolates into 11 genotypes. The discriminatory power of PFGE subtypes was 83\%, as compared to 68\% for MLVA. Concordance between the two methods, based on matched or mismatched MLVA types and PFGE types or subtypes, was 67.5\% and 82.8\%, respectively. Using PFGE, 13 isolates could be genotyped in 3 days; MLVA genotyped 94 isolates in 2 days. For both methods, the estimated costs were Euro 7 (\$10)/isolate. PFGE and MLVA produced highly concordant results when assigning genotypes to nosocomial VREF isolates. MLVA was faster, but PFGE subtyping was more discriminatory.
%0 Journal Article
%1 top_comparison_2008
%A Top, J
%A Banga, N M I
%A Hayes, R
%A Willems, R J
%A Bonten, M J M
%A Hayden, M K
%D 2008
%J Clinical Microbiology and Infection: The Official Publication of the European Society of Clinical Microbiology and Infectious Diseases
%K Analysis, Bacterial Care Diseases, Electrophoresis, Endemic Enterococcus Environment, Factors, Gel, Health Humans, Infections, Intensive Minisatellite Personnel, Repeats, Resistance Sequence Techniques, Time Typing Units, Vancomycin faecium, {DNA,} {Gram-Positive} {Pulsed-Field,}
%N 4
%P 363--369
%R 10.1111/j.1469-0691.2007.01945.x
%T Comparison of multiple-locus variable-number tandem repeat analysis and pulsed-field gel electrophoresis in a setting of polyclonal endemicity of vancomycin-resistant Enterococcus faecium
%U http://www.ncbi.nlm.nih.gov/pubmed/18261124
%V 14
%X In order to assess whether multiple-locus-variable number tandem repeat analysis (MLVA) could replace pulsed-field gel electrophoresis (PFGE) for genotyping vancomycin-resistant isolates of Enterococcus faecium (VREF), this study compared the typeability, discriminatory power, concordance and costs of these methods for VREF isolates obtained from patients, environmental samples and the hands of healthcare workers (HCWs) in a medical intensive care unit (ICU) where VREF was endemic. Over a 58-day period, 393 VREF isolates (373 vanA, one vanA/B, 19 vanB) were cultured from patient rectal swabs (n = 76), the environment (n = 270) and the hands of HCWs (n = 47). PFGE was able to divide 358 (91.1\%) isolates into 19 PFGE types (\textgreatersix bands different) and 24 subtypes (one to three bands different). MLVA was able to type 391 (99.5\%) isolates into 11 genotypes. The discriminatory power of PFGE subtypes was 83\%, as compared to 68\% for MLVA. Concordance between the two methods, based on matched or mismatched MLVA types and PFGE types or subtypes, was 67.5\% and 82.8\%, respectively. Using PFGE, 13 isolates could be genotyped in 3 days; MLVA genotyped 94 isolates in 2 days. For both methods, the estimated costs were Euro 7 (\$10)/isolate. PFGE and MLVA produced highly concordant results when assigning genotypes to nosocomial VREF isolates. MLVA was faster, but PFGE subtyping was more discriminatory.
@article{top_comparison_2008,
abstract = {In order to assess whether multiple-locus-variable number tandem repeat analysis {(MLVA)} could replace pulsed-field gel electrophoresis {(PFGE)} for genotyping vancomycin-resistant isolates of Enterococcus faecium {(VREF),} this study compared the typeability, discriminatory power, concordance and costs of these methods for {VREF} isolates obtained from patients, environmental samples and the hands of healthcare workers {(HCWs)} in a medical intensive care unit {(ICU)} where {VREF} was endemic. Over a 58-day period, 393 {VREF} isolates (373 {vanA,} one {vanA/B,} 19 {vanB)} were cultured from patient rectal swabs (n = 76), the environment (n = 270) and the hands of {HCWs} (n = 47). {PFGE} was able to divide 358 (91.1\%) isolates into 19 {PFGE} types ({\textgreater}six bands different) and 24 subtypes (one to three bands different). {MLVA} was able to type 391 (99.5\%) isolates into 11 genotypes. The discriminatory power of {PFGE} subtypes was 83\%, as compared to 68\% for {MLVA.} Concordance between the two methods, based on matched or mismatched {MLVA} types and {PFGE} types or subtypes, was 67.5\% and 82.8\%, respectively. Using {PFGE,} 13 isolates could be genotyped in 3 days; {MLVA} genotyped 94 isolates in 2 days. For both methods, the estimated costs were Euro 7 (\$10)/isolate. {PFGE} and {MLVA} produced highly concordant results when assigning genotypes to nosocomial {VREF} isolates. {MLVA} was faster, but {PFGE} subtyping was more discriminatory.},
added-at = {2011-03-11T10:05:34.000+0100},
author = {Top, J and Banga, N M I and Hayes, R and Willems, R J and Bonten, M J M and Hayden, M K},
biburl = {https://www.bibsonomy.org/bibtex/20e1ee668d02ae3f2dd9e215602f4ddf4/jelias},
doi = {10.1111/j.1469-0691.2007.01945.x},
interhash = {cf0cb0b1087441faaf5d8d34d44e3237},
intrahash = {0e1ee668d02ae3f2dd9e215602f4ddf4},
issn = {{1198-743X}},
journal = {Clinical Microbiology and Infection: The Official Publication of the European Society of Clinical Microbiology and Infectious Diseases},
keywords = {Analysis, Bacterial Care Diseases, Electrophoresis, Endemic Enterococcus Environment, Factors, Gel, Health Humans, Infections, Intensive Minisatellite Personnel, Repeats, Resistance Sequence Techniques, Time Typing Units, Vancomycin faecium, {DNA,} {Gram-Positive} {Pulsed-Field,}},
month = apr,
note = {{PMID:} 18261124},
number = 4,
pages = {363--369},
timestamp = {2011-03-11T10:06:37.000+0100},
title = {Comparison of multiple-locus variable-number tandem repeat analysis and pulsed-field gel electrophoresis in a setting of polyclonal endemicity of vancomycin-resistant Enterococcus faecium},
url = {http://www.ncbi.nlm.nih.gov/pubmed/18261124},
volume = 14,
year = 2008
}