Occurrence of a PCR-Positive but Culture-Negative Case for vanB Vancomycin-Resistant Enterococci in Stool Surveillance.
- Author:
Dahae WON
1
;
Ki Ho HONG
;
Kyungah YUN
;
Heungsup SUNG
;
Mi Na KIM
Author Information
- Publication Type:Case Report
- Keywords: Vancomycin; Enterococcus; vanB; PCR; Enrichment; Broth; Surveillance; Culture; Stool
- MeSH: Agar; Bacteriuria; Enterococcus; Humans; Korea; Long-Term Care; Parkinson Disease; Pneumonia, Aspiration; Polymerase Chain Reaction; Real-Time Polymerase Chain Reaction; Stress, Psychological; Ursidae; Vancomycin
- From:Laboratory Medicine Online 2013;3(4):264-268
- CountryRepublic of Korea
- Language:Korean
- Abstract: We present here occurence of PCR-positive but culture-negative for vanB vancomycin-resistant enterococci (VRE) from an enrichment broth of a stool surveillance culture in a patient suffering from Parkinson's disease, who was transferred from a long-term care facility because of aspiration pneumonia. He developed VRE bacteriuria at the hospital day 42. vanA and vanB genes were detected from 6 microg/mL vancomycin-containing BBL Enterococcosel broth (BD), of which color changed to black after overnight incubation, by both Seeplex VRE detection (Seegene, Seoul, Korea) and Anyplex VanR real-time PCR (Seegene). Subculture of an aliquot of the blackened broth on blood agar plate produced only vanA VRE. All of the four subsequent consecutive surveillance cultures for 1 month until discharge at hospital day 75 resulted in PCR-positive but culture-negative for vanB VRE from the enrichment broths. Therefore, the presence of a non-enterococcal intrinsic reservoir bearing vanB is more likely than low burden of vanB VRE. Considering the rare occurrence of vanB VRE in Korea, vanB-positive PCR results from the enrichment broth requires confirmation by microbiological studies.