ABSTRACT
We describe a 24-h protocol for the identification of patients who are positive for vancomycin-resistant Enterococcus faecium (VRE), using stool and rectal swab samples and VRE screening broth, automated DNA extraction, and real-time PCR for vanA and vanB genes. Compared to conventional screening methods, this protocol had a high sensitivity and specificity and a negative predictive value.
Subject(s)
Bacterial Proteins/genetics , Carbon-Oxygen Ligases/genetics , Enterococcus faecium/isolation & purification , Gram-Positive Bacterial Infections/microbiology , Vancomycin Resistance/genetics , Automation , Enterococcus faecium/drug effects , Enterococcus faecium/genetics , Feces/microbiology , Gram-Positive Bacterial Infections/diagnosis , Humans , Polymerase Chain Reaction/methods , Sensitivity and Specificity , Vancomycin/pharmacologyABSTRACT
Previous studies have shown high rates of asymptomatic carriage of toxin-producing Clostridium difficile in infants. We performed a retrospective case control study comparing infants younger than 1 year old with diarrhea and C. difficile toxin (CDT) in the stool, to age-matched controls with diarrhea lacking CDT in the stool. We found no difference in clinical characteristics including fever, vomiting, or hematochezia. Treatment with metronidazole had no significant effect on the clinical outcome. Alternative etiologies for diarrhea (most commonly viral) were found in more than 50% of patients in both groups. We recommend that other causes of diarrhea be considered before C. difficile colitis in this age group.
