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Test Code VRERP Vancomycin-Resistant Enterococcus, Molecular Detection, PCR, Varies

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

Varies


Necessary Information


Specimen source is required.



Specimen Required


The high sensitivity of amplification by polymerase chain reaction requires the specimen to be processed in an environment in which contamination of the specimen by vancomycin-resistant Enterococcus DNA is unlikely.

 

Submit only 1 of the following specimens:

 

Preferred:

Specimen Type: Perianal, perirectal, rectal, anal

Supplies: Culturette (BBL Culture Swab) (T092)

Container/Tube: Culture transport swab (Dacron or rayon swab with aluminum or plastic shaft with either Stuart or Amies liquid medium)

Specimen Volume: Swab

Specimen Stability Information: Refrigerated (preferred)/Frozen

 

Acceptable:

Specimen Type: Preserved feces

Supplies: Culture and Sensitivity Stool Transport Vial (T058)

Container/Tube: Commercially available transport system specific for recovery of enteric pathogens from fecal specimens (15 mL of non-nutritive transport medium containing phenol red as a pH indicator, either Cary-Blair, Para-Pak C and S vial)

Specimen Volume: Representative portion of feces

Collection Instructions:

1. Collect fresh feces and submit 1 gram or 5 mL in container with transport medium.

2. Within 2 hours of collection, place feces in preservative.

Specimen Stability Information: Ambient (preferred)/ Refrigerated

 

Specimen Type: Unpreserved feces

Supplies:

-Stool Container, Small (Random), 4 oz Random (T288)

-Stool Collection Kit, Random (T635)

Container/Tube: Fecal container

Specimen Volume: Representative portion of feces

Collection Instructions: Collect fresh fecal specimen and submit representative sample in fecal container.

Specimen Stability Information: Refrigerated (preferred)/Frozen


Specimen Stability Information

Specimen Type Temperature Time
Varies Varies

Reference Values

Negative

Day(s) Performed

Monday through Sunday

CPT Code Information

87500

Clinical Information

Vancomycin-resistant enterococci (VRE) are major nosocomial disease-causing bacteria. Patients who are particularly vulnerable to fatal disease from VRE include those with hematologic malignancies and liver transplants. Nosocomial spread of VRE occurs as the result of fecal carriage. Risks for both colonization and infection include prolonged hospitalization, intensive care unit stay, transplantation, hematologic malignancies, and prolonged exposure to antibiotics.

 

The Centers for Disease Control and Prevention provides recommendations to prevent the spread of VRE in institutional settings. These recommendations include isolation of patients experiencing active VRE infection, screening of patients by perianal swab or fecal testing to identify carriers of VRE, and subsequent isolation or cohorting of VRE carriers. Identification and isolation of VRE carriers has been shown to be cost-effective.

 

In Enterococcus faecalis or Enterococcus faecium, vancomycin resistance is usually associated with the presence of vanA or vanB. The presence of these genes is detected by a molecular method in this assay.

Report Available

1 to 4 days

Reject Due To

E-swab, calcium alginate or, cotton-tipped swab
Swab sent in gel transport medium, viral or universal transport medium
Dry swab
Formalin or PVA fixative
Reject

Method Name

Real-Time Polymerase Chain Reaction (PCR)

Forms

If not ordering electronically, complete, print, and send a Microbiology Test Request (T244) with the specimen.

Specimen Minimum Volume

See Specimen Required