Table 1.

Stewardship guidance for Verigene reporting^a

Verigene result	Reported organism	Comment
S. aureus	S. aureus	Methicillin susceptible. Consider de-escalating to oxacillin or cefazolin if no severe allergy.
S. epidermidis ± mecA	S. epidermidis (1 of 2 sets)
Staphylococcus spp.	Coagulase-negative staphylococcus, NOT S. epidermidis or S. lugdunensis (1 of 2 sets)	Common contaminant, often does not require treatment.b
S. aureus + S. epidermidis + mecA	S. aureus S. epidermidis	Methicillin resistance detected but cannot be assigned to either S. aureus or S. epidermidis. Refer to final ID and sensitivities.c
E. faecalis + vanA and/or vanB	E. faecalis, vancomycin resistant; initiate VRE contact precaution	Consider de-escalating to ampicillin, ampicillin/sulbactam or piperacillin/tazobactam; synergistic gentamicin may be required with ampicillin in some circumstances.
E. faecalis	E. faecalis
E. faecium + vanA and/or vanB	E. faecium, vancomycin resistant	Initiate VRE contact precaution. Consider daptomycin or linezolid.
S. pyogenes S. agalactiae	β-hemolytic strep group A β-hemolytic strep group B	Consider de-escalating to oxacillin, cefazolin, or other penicillin if no severe allergy.
S. anginosis	S. anginosis
S. pneumoniae	S. pneumoniae	Other members of Streptococcus mitis group may also give a positive result.c
Listeria spp.	Listeria spp.	Ampicillin is the preferred drug therapy. Consider switching to ampicillin if no severe allergy. For severe beta-lactam allergy, consider trimethoprim-sulfamethoxazole.
Not-detect	The Gram-positive organism(s) seen on Gram stain will be identified by routine culture and susceptibility methods. The organism(s) could not be identified by the Verigene Molecular Assay.c
Verigene culture discordant result	Corrected report	This isolate was originally Not Detected by Verigene Molecular Assay.

^aThe stewardship guidance is based on institutional practice and guidelines and may not be generalizable.

^bRemove comment if second bottle turns positive for same morphology.

^cRemove comment when culture results are updated.

VRE indicates vancomycin-resistant enterococci.