K Number
K243405
Device Name
Xpert vanA
Manufacturer
Date Cleared
2024-11-21

(20 days)

Product Code
Regulation Number
866.1640
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Xpert® vanA test performed on the GeneXpert® Instrument Systems is a qualitative in vitro diagnostic test designed for detection of the vanA gene sequence associated with vancomycin resistance in bacteria obtained from rectal swab specimens from patients at risk for intestinal colonization with vancomycin-resistant bacteria. The test utilizes automated real-time polymerase chain reaction (PCR) to detect the vanA gene that is frequently associated with vancomycin-resistant enterococci (VRE). The Xpert vanA test is intended to aid in the recognition, prevention, and control of vancomycin-resistant organisms that colonize patients in healthcare settings. The Xpert vanA test is not intended to diagnose infections caused by vancomycin-resistant bacteria nor to guide or monitor treatment for vancomycin-resistant bacterial infections. Concomitant cultures are necessary to recover organisms for identification of vancomycin-resistant bacteria, antimicrobial susceptibility testing, and for epidemiological typing.
Device Description
The Xpert van4 test is an automated in vitro diagnostic test for the qualitative detection of the vanA gene sequence associated with vancomycin resistance in bacteria obtained directly from rectal swab specimens. The specimen is collected on a double swab, one of which is placed in a tube containing sample reagent. Following brief vortexing, the content of the sample reagent is transferred to the uniquely labeled Sample Chamber of a disposable fluidic cartridge (the Xpert vanA cartridge). The user initiates a test from the user interface of the GeneXpert® instrument system platform and places the cartridge with sample into the GeneXpert® instrument system which performs hands-off real-time, multiplex polymerase chain reaction (PCR) for the detection of vanA DNA. In the GeneXpert® Instrument Systems (comprised of the GeneXpert® Dx System, GeneXpert® System with Touchscreen, and GeneXpert® Infinity System), sample preparation, amplification, and real-time detection are all fully automated and completely integrated. The platform requires the use of single-use disposable cartridges that hold the PCR reagents and host the PCR process. Because the cartridges are self-contained, cross-contamination between samples is minimized. Depending on the specific instrument, a GeneXpert® instrument system may contain 1-80 modules, each of which are randomly accessible and capable of performing separate sample preparation and real-time PCR tests. Each module contains a syringe drive for dispensing fluids (i.e., the syringe drive activates the plunger that works in concert with the rotary valve in the cartridge to move fluids between chambers), an ultrasonic horn for lysing cells or spores, and a proprietary I-CORE thermocycler for performing real-time PCR and detection. The Xpert van4 test includes reagents for the detection of the gene for vancomycin resistance (van4) as well as an internal sample processing control (SPC) to control for adequate processing of the target bacteria and to monitor the presence of inhibitor(s) in the PCR assay. The SPC also ensures that the PCR conditions (temperature and time) are appropriate for the amplification reaction and that the PCR reagents are functional. The Probe Check Control (PCC) verifies reagent rehydration, PCR tube filling in the cartridge, probe integrity, and dye stability. The Xpert van 4 test performed on the GeneXpert® Instrument Systems provides results in less than 45 minutes. Each instrument in the GeneXpert® instrument family is equipped with a Windows OS-based personal computer that is preloaded with software applications for running the tests and viewing the results, as described in Table 1.
More Information

Not Found

No
The description focuses on automated PCR and detection, with no mention of AI or ML algorithms for data analysis or interpretation.

No
This device is an in vitro diagnostic test designed to detect a gene associated with vancomycin resistance, aiding in the recognition, prevention, and control of resistant organisms. It explicitly states it is "not intended to diagnose infections caused by vancomycin-resistant bacteria nor to guide or monitor treatment for vancomycin-resistant bacterial infections," meaning it does not directly treat or diagnose a disease state in a patient.

Yes

The "Intended Use / Indications for Use" section explicitly states, "The Xpert® vanA test performed on the GeneXpert® Instrument Systems is a qualitative in vitro diagnostic test..." and the "Device Description" section reiterates, "The Xpert van4 test is an automated in vitro diagnostic test for the qualitative detection of the vanA gene sequence..."

No

The device description clearly outlines a system that includes hardware components such as the GeneXpert® Instrument Systems (comprised of different models), disposable fluidic cartridges, syringe drives, ultrasonic horns, and thermocyclers. While software is mentioned as being preloaded on a computer for running tests and viewing results, it is an integral part of a larger hardware-based system for performing automated real-time PCR.

Based on the provided text, the device is indeed an IVD (In Vitro Diagnostic).

Here's why:

  • Intended Use / Indications for Use: Explicitly states it is a "qualitative in vitro diagnostic test".
  • Device Description: Describes it as an "automated in vitro diagnostic test".
  • Function: It is designed to detect a specific gene sequence (vanA) in a biological sample (rectal swab) to aid in the recognition, prevention, and control of vancomycin-resistant organisms. This is a classic function of an in vitro diagnostic device.
  • Testing Method: It utilizes real-time PCR, which is a common technique used in IVD tests.
  • Sample Type: It analyzes a biological specimen (rectal swab).

The text consistently refers to the device as an in vitro diagnostic test and describes its use in analyzing biological samples outside of the body to provide information about a patient's condition (in this case, the presence of a gene associated with vancomycin resistance).

N/A

Intended Use / Indications for Use

The Xpert® vanA test performed on the GeneXpert® Instrument Systems is a qualitative in vitro diagnostic test designed for detection of the vanA gene sequence associated with vancomycin resistance in bacteria obtained from rectal swab specimens from patients at risk for intestinal colonization with vancomycin-resistant bacteria. The test utilizes automated real-time polymerase chain reaction (PCR) to detect the vanA gene that is frequently associated with vancomycin-resistant enterococci (VRE). The Xpert vanA test is intended to aid in the recognition, prevention, and control of vancomycin-resistant organisms that colonize patients in healthcare settings. The Xpert vanA test is not intended to diagnose infections caused by vancomycin-resistant bacteria nor to guide or monitor treatment for vancomycin-resistant bacterial infections. Concomitant cultures are necessary to recover organisms for identification of vancomycin-resistant bacteria, antimicrobial susceptibility testing, and for epidemiological typing.

Product codes (comma separated list FDA assigned to the subject device)

NIJ, OOI

Device Description

The Xpert vanA test is an automated in vitro diagnostic test for the qualitative detection of the vanA gene sequence associated with vancomycin resistance in bacteria obtained directly from rectal swab specimens. The specimen is collected on a double swab, one of which is placed in a tube containing sample reagent. Following brief vortexing, the content of the sample reagent is transferred to the uniquely labeled Sample Chamber of a disposable fluidic cartridge (the Xpert vanA cartridge). The user initiates a test from the user interface of the GeneXpert® instrument system platform and places the cartridge with sample into the GeneXpert® instrument system which performs hands-off real-time, multiplex polymerase chain reaction (PCR) for the detection of vanA DNA.

In the GeneXpert® Instrument Systems (comprised of the GeneXpert® Dx System, GeneXpert® System with Touchscreen, and GeneXpert® Infinity System), sample preparation, amplification, and real-time detection are all fully automated and completely integrated. The platform requires the use of single-use disposable cartridges that hold the PCR reagents and host the PCR process. Because the cartridges are self-contained, cross-contamination between samples is minimized.

Depending on the specific instrument, a GeneXpert® instrument system may contain 1-80 modules, each of which are randomly accessible and capable of performing separate sample preparation and real-time PCR tests. Each module contains a syringe drive for dispensing fluids (i.e., the syringe drive activates the plunger that works in concert with the rotary valve in the cartridge to move fluids between chambers), an ultrasonic horn for lysing cells or spores, and a proprietary I-CORE thermocycler for performing real-time PCR and detection.

The Xpert vanA test includes reagents for the detection of the gene for vancomycin resistance (vanA) as well as an internal sample processing control (SPC) to control for adequate processing of the target bacteria and to monitor the presence of inhibitor(s) in the PCR assay. The SPC also ensures that the PCR conditions (temperature and time) are appropriate for the amplification reaction and that the PCR reagents are functional. The Probe Check Control (PCC) verifies reagent rehydration, PCR tube filling in the cartridge, probe integrity, and dye stability.

The Xpert vanA test performed on the GeneXpert® Instrument Systems provides results in less than 45 minutes.

Each instrument in the GeneXpert® instrument family is equipped with a Windows OS-based personal computer that is preloaded with software applications for running the tests and viewing the results, as described in Table 1.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Rectal swab specimens

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Professional Use, by trained users (in healthcare settings)

Description of the training set, sample size, data source, and annotation protocol

Not Found

Description of the test set, sample size, data source, and annotation protocol

Not Found

Summary of Performance Studies (study type, sample size, AUC, MRMC, standalone performance, key results)

The performance of the Xpert vanA test when used with the GeneXpert Infinity System instruments was assessed through verification studies, including a prepared cartridge hold time study and functional testing.

Hold time refers to the duration between the preparation of the cartridge (i.e., addition of sample) and the initiation of the test. The maximum acceptable hold time for a prepared cartridge was verified as 4 hours.

Functional testing was conducted using both contrived positive (vancomycin-resistant (vanA) Enterococcus faecalis cells added to negative matrix) and negative matrix only) samples. The study results showed 100% agreement of reportable results, with no statistically significant differences in Ct values observed between assay runs in instruments of the GeneXpert Dx System and GeneXpert Infinity System. This study demonstrated equivalent performance of the Xpert vanA test when performed on any member of the GeneXpert® Instrument Systems family.

The assessment of the results from these studies determined that the performance claims of the Xpert vanA test were not impacted by the modifications made to the predicate device.

Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)

100% agreement of reportable results

Predicate Device(s): If the device was cleared using the 510(k) pathway, identify the Predicate Device(s) K/DEN number used to claim substantial equivalence and list them here in a comma separated list exactly as they appear in the text. List the primary predicate first in the list.

Xpert vanA Assay (K092953)

Reference Device(s): Identify the Reference Device(s) K/DEN number and list them here in a comma separated list exactly as they appear in the text.

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information for the subject device only (e.g. presence / absence, what scope was granted / cleared under the PCCP, any restrictions, etc).

Not Found

§ 866.1640 Antimicrobial susceptibility test powder.

(a)
Identification. An antimicrobial susceptibility test powder is a device that consists of an antimicrobial drug powder packaged in vials in specified amounts and intended for use in clinical laboratories for determining in vitro susceptibility of bacterial pathogens to these therapeutic agents. Test results are used to determine the antimicrobial agent of choice in the treatment of bacterial diseases.(b)
Classification. Class II (performance standards).

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November 21, 2024

Cepheid % Riva Dill-Garlow, Ph.D. Regulatory Affairs Senior Specialist 904 Caribbean Drive Sunnyvale, California 94089

Re: K243405

Trade/Device Name:Xpert vanA
Regulation Number:21 CFR §866.1640
Regulation Name:Antimicrobial Susceptibility Test Powder
Regulatory Class:Class II
Product Code:NIJ, OOI
Dated:October 31, 2024
Received:November 1, 2024

Dear Riva Dill-Garlow:

We have reviewed your section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food, Drug, and Cosmetic Act (the Act) that do not require approval of a premarket approval application (PMA). You may, therefore, market the device, subject to the general controls provisions of the Act. Although this letter refers to your product as a device, please be aware that some cleared products may instead be combination products. The 510(k) Premarket Notification Database available at https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm identifies combination product submissions. The general controls provisions of the Act include requirements for annual registration. listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you, however, that device labeling must be truthful and not misleading.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations (CFR), Title 21, Parts 800 to 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.

Additional information about changes that may require a new premarket notification are provided in the FDA guidance documents entitled "Deciding When to Submit a 510(k) for a Change to an Existing Device" (https://www.fda.gov/media/99812/download) and "Deciding When to Submit a 510(k) for a Software Change to an Existing Device" (https://www.fda.gov/media/99785/download).

Your device is also subject to, among other requirements, the Quality System (QS) regulation (21 CFR $820), which includes, but is not limited to, 21 CFR §820.30, Design controls; 21 CFR §820.90, Nonconforming product; and 21 CFR §820.100, Corrective and preventive action. Please note that regardless of whether a change requires premarket review, the QS regulation requires device manufacturers to review

1

and approve changes to device design and production (21 CFR §820.70 and 21 CFR §820.70) and document changes and approvals in the device master record (21 CFR §820.181).

Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies. You must comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR §801); labeling (21 CFR §801 and $809); medical device reporting of medical device-related adverse events) (21 CFR $803) for devices or postmarketing safety reporting (21 CFR Part 4, Subpart B) for combination products (see https://www.fda.gov/combination-products/guidance-regulatory-information/postmarketing-safety-reportingcombination-products); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR §820) for devices or current good manufacturing practices (21 CFR Part 4. Subpart A) for combination products; and, if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR Parts 1000-1050.

All medical devices, including Class I and unclassified devices and combination product device constituent parts are required to be in compliance with the final Unique Device Identification System rule ("UDI Rule"). The UDI Rule requires, among other things, that a device bear a unique device identifier (UDI) on its label and package (21 CFR §801.20(a)) unless an exception or alternative applies (21 CFR §801.20(b)) and that the dates on the device label be formatted in accordance with 21 CFR §801.18. The UDI Rule (21 CFR §830.300(a) and §830.320(b)) also requires that certain information be submitted to the Global Unique Device Identification Database (GUDID) (21 CFR 8830 Subpart E). For additional information on these requirements, please see the UDI System webpage at https://www.fda.gov/medical-device-advicecomprehensive-regulatory-assistance/unique-device-identification-system-udi-system.

Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR $807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR §803), please go to https://www.fda.gov/medical-device-safety/medical-device-reporting-mdrhow-report-medical-device-problems.

For comprehensive regulatory information about mediation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/medicaldevices/device-advice-comprehensive-regulatory-assistance) and CDRH Learn (https://www.fda.gov/training-and-continuing-education/cdrh-learn). Additionally, you may contact the Division of Industry and Consumer Education (DICE) to ask a question about a specific regulatory topic. See the DICE website (https://www.fda.gov/medical-device-advice-comprehensive-regulatoryassistance/contact-us-division-industry-and-consumer-education-dice) for more information or contact DICE by email (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100).

Sincerely,

Ribhi Shawar-S

Ribhi Shawar, Ph.D. (ABMM) Branch Chief General Bacteriology and Antimicrobial Susceptibility Branch Division of Microbiology Devices OHT7: Office of In Vitro Diagnostics Office of Product Evaluation and Quality Center for Devices and Radiological Health

2

Indications for Use

510(k) Number (if known) K243405

Device Name Xpert® van A

Indications for Use (Describe)

The Xpert® vanA test performed on the GeneXpert® Instrument Systems is a qualitative in vitro diagnostic test designed for detection of the vanA gene sequence associated with vancomycin resistance in bacteria obtained from rectal swab specimens from patients at risk for intestinal colonization with vancomycin-resistant bacteria. The test utilizes automated real-time polymerase chain reaction (PCR) to detect the vanA gene that is frequently associated with vancomycin-resistant enterococci (VRE). The Xpert vanA test is intended to aid in the recognition, and control of vancomycinresistant organisms that colonize patients in healthcare settings. The Xpert vanA test is not intended to diagnose infections caused by vancomycin-resistant bacteria nor to guide or monitor treatment for vancomycin-resistant bacterial infections. Concomitant cultures are necessary to recover organisms for identification of vancomycin-resistant bacteria, antimicrobial susceptibility testing, and for epidemiological typing.

X Prescription Use (Part 21 CFR 801 Subpart D)

Over-The-Counter Use (21 CFR 801 Subpart C)

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Image /page/3/Picture/0 description: The image shows the Cepheid logo above the text "Xpert vanA". The Cepheid logo is a stylized blue wave above the company name. The text "Xpert" has a registered trademark symbol next to it, and "vanA" is written below it.

510(k) Summary for Xpert vanA

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Image /page/4/Picture/1 description: The image contains the logo for Cepheid, a molecular diagnostics company. The logo features a stylized blue wing-like graphic above the company name, "Cepheid." Below the company name is the text "Xpert® vanA", which likely refers to one of Cepheid's diagnostic tests, Xpert vanA, which is used to detect vancomycin-resistant enterococci.

TABLE OF CONTENTS

510(K) SUMMARY
1.1DEVICE DESCRIPTION
1.2DEVICE INTENDED USE……………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………
1.3TECHNICAL CHARACTERISTICS
1.4SUBSTANTIAL EQUIVALENCE
1.5SUMMARY OF PERFORMANCE DATA
1.6CONCLUSION

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Image /page/5/Picture/0 description: The image shows the Cepheid logo with the text "Cepheid." in a stylized font. Below the logo, the text "Xpert® vanA" is displayed, with the "®" symbol indicating a registered trademark. The text is aligned to the left and is in a smaller font size compared to the logo.

1 510(k) Summary

As required by 21 CFR Section 807.92.

| Submitted by: | Cepheid
904 Caribbean Drive
Sunnyvale, CA 90489
Phone number: (408) 541-4191 |
|----------------------------------|--------------------------------------------------------------------------------------------|
| Contact: | Riva Dill-Garlow, PhD |
| Date of Preparation: | October 31, 2024 |
| Device: | |
| Trade name | Xpert® vanA |
| Common name | Xpert vanA test |
| Type of Test | Qualitative nucleic acid amplification test of the vanA gene
directly from rectal swabs |
| Regulation number: | 21 CFR §866.1640 |
| Classification name: | Antimicrobial susceptibility test powder |
| Product code: | NIJ, OOI |
| Classification
Advisory Panel | Microbiology (83) |
| Prescription Use | Yes |
| Predicate Device | Xpert vanA Assay (K092953) |

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Image /page/6/Picture/0 description: The image shows the Cepheid logo above the text "Xpert® vanA". The Cepheid logo consists of a stylized wing-like design above the company name. The text "Xpert® vanA" is written in a simple, sans-serif font, with the "®" symbol indicating a registered trademark.

1.1 Device Description

The Xpert van4 test is an automated in vitro diagnostic test for the qualitative detection of the vanA gene sequence associated with vancomycin resistance in bacteria obtained directly from rectal swab specimens. The specimen is collected on a double swab, one of which is placed in a tube containing sample reagent. Following brief vortexing, the content of the sample reagent is transferred to the uniquely labeled Sample Chamber of a disposable fluidic cartridge (the Xpert vanA cartridge). The user initiates a test from the user interface of the GeneXpert® instrument system platform and places the cartridge with sample into the GeneXpert® instrument system which performs hands-off real-time, multiplex polymerase chain reaction (PCR) for the detection of vanA DNA.

In the GeneXpert® Instrument Systems (comprised of the GeneXpert® Dx System, GeneXpert® System with Touchscreen, and GeneXpert® Infinity System), sample preparation, amplification, and real-time detection are all fully automated and completely integrated. The platform requires the use of single-use disposable cartridges that hold the PCR reagents and host the PCR process. Because the cartridges are self-contained, cross-contamination between samples is minimized.

Depending on the specific instrument, a GeneXpert® instrument system may contain 1-80 modules, each of which are randomly accessible and capable of performing separate sample preparation and real-time PCR tests. Each module contains a syringe drive for dispensing fluids (i.e., the syringe drive activates the plunger that works in concert with the rotary valve in the cartridge to move fluids between chambers), an ultrasonic horn for lysing cells or spores, and a proprietary I-CORE thermocycler for performing real-time PCR and detection.

The Xpert van4 test includes reagents for the detection of the gene for vancomycin resistance (van4) as well as an internal sample processing control (SPC) to control for adequate processing of the target bacteria and to monitor the presence of inhibitor(s) in the PCR assay. The SPC also ensures that the PCR conditions (temperature and time) are appropriate for the amplification reaction and that the PCR reagents are functional. The Probe Check Control (PCC) verifies reagent rehydration, PCR tube filling in the cartridge, probe integrity, and dye stability.

The Xpert van 4 test performed on the GeneXpert® Instrument Systems provides results in less than 45 minutes.

Each instrument in the GeneXpert® instrument family is equipped with a Windows OS-based personal computer that is preloaded with software applications for running the tests and viewing the results, as described in Table 1.

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Image /page/7/Picture/1 description: The image shows the Cepheid logo above the text "Xpert® vanA". The Cepheid logo is a stylized blue wing-like shape. The text "Cepheid" is in a serif font, and the text "Xpert® vanA" is in a sans-serif font.

Table 1: Instrument Systems and Software in the GeneXpert® Instrument Family
Members

| Instrument Family
Members | Instrument
Systems | Systems
Software | Instruments |
|----------------------------------|------------------------------------------|-----------------------|----------------------------------------------|
| GeneXpert®
Instrument Systems | GeneXpert® Dx
System | GeneXpert Dx | GX-I† GX-II GX-IV GX-XVI |
| | GeneXpert®
System with
Touchscreen | Cepheid OS | GX-II GX-IV GX-XVI |
| | GeneXpert®
Infinity System | GeneXpert
Xpertise | GeneXpert Infinity-48s GeneXpert Infinity-80 |

ً No longer manufactured but is in circulation in the market

1.2 Device Intended Use

The Xpert® vanA test performed on the GeneXpert® Instrument Systems is a qualitative in vitro diagnostic test designed for detection of the vanA gene sequence associated with vancomvcin resistance in bacteria obtained from rectal swab specimens from patients at risk for intestinal colonization with vancomycin-resistant bacteria. The test utilizes automated real-time polymerase chain reaction (PCR) to detect the vanA gene that is frequently associated with vancomycin-resistant enterococci (VRE). The Xpert vanA test is intended to aid in the recognition, prevention, and control of vancomycin-resistant organisms that colonize patients in healthcare settings. The Xpert van A test is not intended to diagnose infections caused by vancomycin-resistant bacteria nor to guide or monitor treatment for vancomycin-resistant bacterial infections. Concomitant cultures are necessary to recover organisms for identification of vancomycin-resistant bacteria, antimicrobial susceptibility testing, and for epidemiological typing.

1.3 Technical Characteristics

The Xpert vanA test has the same technological characteristics as the predicate device.

1.4 Substantial Equivalence

The purpose of this Special 510(k) submission is to modify the cleared, legally marketed device (Xpert vanA) to include the GeneXpert® Infinity System instruments (see Table 1 above). The Xpert vanA test was originally cleared for use on the GeneXpert® Dx System (K092953). Both the GeneXpert Dx System and the GeneXpert Infinity System are members of the instrument family "GeneXpert® Instrument Systems" which is now incorporated in the Intended Use/Indications for Use of this device. Table 2 shows the similarities and Table 3 shows the differences between the Xpert vanA test and predicate device. The differences between Xpert van A test and predicate device do not raise different questions of safety and effectiveness.

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Image /page/8/Picture/0 description: The image contains the Cepheid logo, which features a stylized blue wing design above the company name in black. Below the logo, the text "Xpert® vanA" is displayed, with "Xpert" in a larger font size and the registered trademark symbol. The text is left-aligned and appears to be part of a product or service name offered by Cepheid.

Similarities
AttributeModified Device
Xpert® vanAPredicate (K092953)
Xpert® vanA
RegulationSame21 CFR §866.1640
Antimicrobial susceptibility test powder
Product CodeSameNIJ
System, Test, Genotypic detection, Resistant markers,
Enterococcus species
Device ClassSameOOI
Real Time Nucleic Acid Amplification System
Class II
Purpose of UseSameIdentification of the vanA gene sequence that is associated
with vancomycin-resistant enterococci (VRE)
SpecimenSameRectal Swab
Test TechnologySameNucleic Acid (DNA) Amplification (real time PCR) for
qualitative detection of vanA with specific primers and
TaqMan probes
Test AutomationSameDetection: Fluorogenic target-specific hybridization
Fully automated DNA extraction, detection, and results
interpretation
Test FormatSameSingle-use in disposable, multi-chambered, fluidic cartridge
Test Targets
(sequence)SamevanA
Internal ControlsSameSample Processing Control (SPC) Probe Check Control (PCC)
Time to ResultsSameLess than 45 minutes to results
Intended Use
EnvironmentSameProfessional Use, by trained users
Test AccessSamePrescription Use only

Table 2. Similarities between Xpert vanA and the Predicate Device

Table 3. Differences Between Xpert vanA and the Predicate Device

Differences
AttributeModified DevicePredicate (K092953)
Xpert® vanAXpert® vanA
Intended Use /
Indications for
UseThe Xpert® vanA test performed on the
GeneXpert® Instrument Systems is a
qualitative in vitro diagnostic test designed
for detection of the vanA gene sequence
associated with vancomycin resistance in
bacteria obtained from rectal swab
specimens from patients at risk for
intestinal colonization with vancomycin-
resistant bacteria. The test utilizes
automated real-time polymerase chain
reaction (PCR) to detect the vanA gene
that is frequently associated with
vancomycin-resistant enterococci (VRE).The Cepheid Xpert® vanA Assay
performed in the GeneXpert® Dx System
is a qualitative in vitro diagnostic test
designed for rapid detection of the vanA
gene sequence associated with
vancomycin resistance in bacteria obtained
from rectal swab specimens from patients
at risk for intestinal colonization with
vancomycin-resistant bacteria. The test
utilizes automated real-time polymerase
chain reaction (PCR) to detect the vanA
gene that is frequently associated with
vancomycin-resistant enterococci (VRE).

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Image /page/9/Picture/1 description: The image shows the Cepheid logo with the text "Xpert vanA" below it. The Cepheid logo consists of a stylized blue wave-like design above the word "Cepheid" in a serif font. Below the logo, the text "Xpert" is followed by a circled "R" symbol, and then "vanA" is written in italics.

Differences
AttributeModified DevicePredicate (K092953)
Xpert® vanAXpert® vanA
The Xpert vanA test is intended to aid in the recognition, prevention, and control of vancomycin-resistant organisms that colonize patients in healthcare settings. The Xpert vanA test is not intended to diagnose infections caused by vancomycin-resistant bacteria nor to guide or monitor treatment for vancomycin-resistant bacterial infections. Concomitant cultures are necessary to recover organisms for identification of vancomycin-resistant bacteria, antimicrobial susceptibility testing, and for epidemiological typing.The Xpert vanA Assay is intended to aid in the recognition, prevention, and control of vancomycin-resistant organisms that colonize patients in healthcare settings. The Xpert vanA Assay is not intended to diagnose infections caused by vancomycin-resistant bacteria nor to guide or monitor treatment for vancomycin-resistant bacterial infections. Concomitant cultures are necessary to recover organisms for identification of vancomycin-resistant bacteria, antimicrobial susceptibility testing and for epidemiological typing.
Instrument
SystemsGeneXpert Dx System GeneXpert System with Touchscreen GeneXpert Infinity SystemGeneXpert Dx System GeneXpert System with Touchscreen
Systems
Software for
instrument
familyGeneXpert Dx software Cepheid OS software Xpertise softwareGeneXpert Dx software Cepheid OS software

1.5 Summary of Performance Data

The performance of the Xpert vanA test when used with the GeneXpert Infinity System instruments was assessed through verification studies, including a prepared cartridge hold time study and functional testing.

Hold time refers to the duration between the preparation of the cartridge (i.e., addition of sample) and the initiation of the test. The maximum acceptable hold time for a prepared cartridge was verified as 4 hours.

Functional testing was conducted using both contrived positive (vancomycin-resistant (vanA) Enterococcus faecalis cells added to negative matrix) and negative matrix only) samples. The study results showed 100% agreement of reportable results, with no statistically significant differences in Ct values observed between assay runs in instruments of the GeneXpert Dx System and GeneXpert Infinity System. This study demonstrated equivalent performance of the Xpert van 4 test when performed on any member of the GeneXpert® Instrument Systems family.

The assessment of the results from these studies determined that the performance claims of the Xpert vanA test were not impacted by the modifications made to the predicate device.

1.6 Conclusion

The results of the verification studies demonstrated that the performance of the modified Xpert van 4 test on the GeneXpert Infinity System is equivalent to the performance of the predicate

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Image /page/10/Picture/0 description: The image shows the logo for Cepheid, a molecular diagnostics company. Below the logo is the text "Xpert® vanA". The Cepheid logo consists of a stylized blue wing-like shape above the company name.

device, the original Xpert vanA (K092953), and that the modifications proposed in the modified device have not changed the fundamental scientific technology of the predicate device.