Perspective d’expert
Lecture de 5 m
17 octobre 2025
GESTION DES ANTIMICROBIENS
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Le besoin
- Vancomycin Resistant Enterococci (VRE) are a growing public health threat and pose a risk to patient safety in healthcare facilities1
- In healthcare settings, colonized patients and environmental contamination contribute to VRE spread1
- High-risk patients colonized with VRE have 24 times the increased infection risk2
- Infections caused by VRE are associated with high mortality3
- VRE has an impact on patient length of stay, and in turn, hospitalization costs3
1 Levitus M. et al. Vancomycin-Resistant Enterococci. StatPearls 17 juillet 2023. https://www.ncbi.nlm.nih.gov/books/NBK513233/?report=reader#_NBK513233_pubdet. Consulté 11 décembre 2023.
2 Alevizakos M, et al. Colonization with vancomycin-resistant enterococci and risk for bloodstream infection among patients with malignancy: (Effet des tests diagnostiques moléculaires rapides sur les résultats cliniques des infections sanguines : un examen systématique et une méta-analyse.) Forum ouvert Infect Dis. 2016 Dec;4(1):ofw246.
3 Eichel V,M, et al. Epidemiology and outcomes of vancomycin-resistant enterococcus infections: (Effet des tests diagnostiques moléculaires rapides sur les résultats cliniques des infections sanguines : un examen systématique et une méta-analyse.) Journal of Hospital Infection 141 (2023) 119e128
2 Alevizakos M, et al. Colonization with vancomycin-resistant enterococci and risk for bloodstream infection among patients with malignancy: (Effet des tests diagnostiques moléculaires rapides sur les résultats cliniques des infections sanguines : un examen systématique et une méta-analyse.) Forum ouvert Infect Dis. 2016 Dec;4(1):ofw246.
3 Eichel V,M, et al. Epidemiology and outcomes of vancomycin-resistant enterococcus infections: (Effet des tests diagnostiques moléculaires rapides sur les résultats cliniques des infections sanguines : un examen systématique et une méta-analyse.) Journal of Hospital Infection 141 (2023) 119e128
La solution
- Rapid molecular detection of vanA/vanB genes associated with VRE colonization
- Fast, active screening of high-risk patients to support infection control measures aimed at reducing transmission risk
L’impact
- The Xpert vanA/vanB test facilitates efficient infection control surveillance programs, published studies demonstrated:4
– 93% reduction of turn around time from 70.5h with chromogenic agar culture to 4.6h
– High negative predictive value supports identification of non-colonized patients
– Associated with a reduction in the number of identified contact patients in published studies
– One published economic analysis reported lower overall costs in a institutional setting when molecular screening was used compared with culture - Some studies reported fewer isolation days following the adoption of rapid molecular screening compared with culture.5
4 Birgand G, et al. Lucet JC. Détection rapide des entérocoques résistants aux glycopeptides : impact sur la prise de décision et les coûts. Antimicrobial Resistant and Infection Control.
2013 Nov ; 2:30.
5 Holzknecht BJ, Hansen DS, Nielsen L, Kailow A, Jarløv JO. Screening for vancomycin-resistant enterococci with Xpert® vanA/vanB: diagnostic accuracy and impact on
infection control decision making. New Microbes New Infect. 2017 Jan 12;16:54-59
2013 Nov ; 2:30.
5 Holzknecht BJ, Hansen DS, Nielsen L, Kailow A, Jarløv JO. Screening for vancomycin-resistant enterococci with Xpert® vanA/vanB: diagnostic accuracy and impact on
infection control decision making. New Microbes New Infect. 2017 Jan 12;16:54-59
