Poster Presentation Australian Society for Microbiology Annual Scientific Meeting 2019

Vancomycin Resistant Enterococci (VRE) screening quality assurance program: a five-year review of methods and performance (#113)

Norvie Aquino 1 , Elizabeth Haremza 1 , Debra Walker 1 , Katherine Ryan 1 , Allan Elsner 1 , Juliet Elvy 1
  1. Microbiology, The Royal College of Pathologists of Australasia Quality Assurance Programs (RCPAQAP), St Leonards, NSW, Australia


VRE are strains of Enterococci that have developed resistance to vancomycin, a glycopeptide antibiotic used to treat serious enterococcal infections.

Vancomycin-resistant Enterococcus was first described in England in 1988.  Since then, it has increasingly become a major nosocomial pathogen worldwide.

Given the importance of accurately reporting VRE, the RCPAQAP Microbiology introduced the program “Enterococci for identification, antimicrobial susceptibility and van gene detection” in 2011. It was renamed in 2013 to become the “Vancomycin Resistant Enterococcus (VRE) Screening” program to be more aligned with the relevant guidelines. Participants enrolled in this program are currently from Australia, New Zealand, Asia and Europe.  Enrolments grew from 52 participants in 2011 to 96 in 2018.


Four simulated samples representing rectal swabs are sent twice a year. Once reconstituted, samples are suitable for enterococcal culture and/or molecular testing.  Participants are asked to perform “VRE screen” testing as per their laboratory protocol.

The RCPAQAP direct data entry is used to capture methods, results and overall comments. From 2014 to 2018, methods and algorithms used by participating laboratories to test for VRE were analysed and participant performance was assessed.


The majority of participants use culture-based methods. However, overtime we have seen a minor increase from around 25% in 2014 up to 31% in 2018 of participants employing molecular methods alone or in combination with culture and other methods

Overall, participants delivered an acceptable level of performance, with greater than 90% reporting correct responses.


Over the course of five years, whilst false positive and false negative results remain an issue for some participants, overall there was a high level of concordance.