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Evaluation of the novel artus C. difficile QS-RGQ, VanR QS-RGQ and MRSA/SA QS-RGQ assays for the laboratory diagnosis of Clostridium difficile infection (CDI), and for vancomycin-resistant enterococci (VRE) and methicillin-resistant Staphylococcus aureus (MRSA) screening

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Abstract

Clostridium difficile, methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) are worldwide prevalent healthcare-associated pathogens. We have evaluated three Qiagen artus QS-RGQ assays for the detection of these pathogens. We examined 200 stool samples previously tested for C. difficile infection (CDI), 94 rectal swabs previously screened for VRE and 200 MRSA screening nasal swabs. With the routine diagnostic laboratory results being adopted as the gold standard, the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the artus C. difficile assay were 100%, for the artus VanR QS-RGQ assay, 95, 68, 44 and 98%, and for the artus MRSA/SA assay, 80, 94, 93 and 83%, respectively. The artus VanR assay detected the vanA and/or vanB genes in 32% of culture-negative VRE screens; in 71% of these cases, only vanB was detected. An over-estimation of the rate of faecal VRE colonisation could be due to a patient population with high rates of faecal carriage of non-enterococcal species carrying vanB. Based on our findings, we conclude that all three artus QS-RGQ assays could be a useful addition to a diagnostic laboratory, and that the optimal choice of assay should be determined according to user needs.

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Acknowledgements

We thank QIAGEN for supplying the QIAsymphony RGQ MDx system, artus assays, related reagents and consumables, as well as for their technical expertise. We also thank Cepheid for supplying the Xpert SA Nasal Complete assays and technical advice.

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Authors and Affiliations

  1. Microbiology Department, Leeds Teaching Hospitals NHS Trust, Leeds, UK

    K. A. Morris & M. H. Wilcox

  2. Public Health England Leeds Regional Laboratory, Leeds, UK

    L. R. Macfarlane-Smith

  3. Leeds Institute for Biomedical and Clinical Sciences, University of Leeds, Leeds, UK

    M. H. Wilcox

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  1. K. A. Morris
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  2. L. R. Macfarlane-Smith
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  3. M. H. Wilcox
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Corresponding author

Correspondence to K. A. Morris.

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Funding

This study was funded by Qiagen (grant number 403774_Qiagen_2014).

Conflict of interest

MHW declares that he has the following conflict of interests: I have received consulting fees from Qiagen and grant funding from Cepheid. In addition, QIAGEN supplied the QIAsymphony RGQ MDx system, artus assays, related reagents and consumables, as well as technical expertise. Cepheid supplied the Xpert SA Nasal Complete assays and technical advice.

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No ethical approval was required for this study.

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No informed consent was required for this study.

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Morris, K.A., Macfarlane-Smith, L.R. & Wilcox, M.H. Evaluation of the novel artus C. difficile QS-RGQ, VanR QS-RGQ and MRSA/SA QS-RGQ assays for the laboratory diagnosis of Clostridium difficile infection (CDI), and for vancomycin-resistant enterococci (VRE) and methicillin-resistant Staphylococcus aureus (MRSA) screening. Eur J Clin Microbiol Infect Dis 36, 823–829 (2017). https://doi.org/10.1007/s10096-016-2867-6

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