Detection of vanA genes in vancomycin-susceptible Enterococcus faecium isolates: implications for additional testing

To assess the frequency of silent vancomycin resistance, phenotypically susceptible <i>Enterococcus faecium</i> isolates underwent genotypic testing using Cepheid's Xpert <i>vanA</i>/<i>vanB</i> PCR. A total of 6% of isolates had silent <i>vanA</i> genes. However, the clinical relevance of silent <i>van</i> genes and the lack of rapid, random-access genotypic methods poses an ongoing challenge to laboratories.