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Mizusawa M, Carroll KC. Novel strategies for rapid identification and susceptibility testing of MRSA. Expert Rev Anti Infect Ther 2020; 18:759-778. [PMID: 32329637 DOI: 10.1080/14787210.2020.1760842] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Methicillin-resistant Staphylococcus aureus (MRSA) is associated with adverse clinical outcomes and increased morbidity, mortality, length of hospital stay, and health-care costs. Rapid diagnosis of MRSA infections has been associated with positive impact on clinical outcomes. AREAS COVERED We searched relevant papers in PubMed for the last 10 years. In major papers, we scanned the bibliographies to ensure that important articles were included. This review describes screening and diagnostic test methods for MRSA and their analytical performances with a focus on rapid molecular-based assays including those that are on the horizon. Future novel technologies will allow more rapid detection of phenotypic resistance. In the case of whole-genome sequencing, detection of mutations may predict resistance, transmission, and virulence. EXPERT OPINION Currently there are many diagnostic options for the detection of MRSA in surveillance and clinical samples. In general, these are highly accurate and have resulted in improvements in targeted management and reduction in hospital or intensive care unit length of stay for both MSSA and MRSA. Impact on mortality has been variable. Promising novel technologies will not only accurately identify pathogens and detect their resistance markers but will allow discovery of virulence determinants that might further affect patient management.
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Affiliation(s)
- Masako Mizusawa
- Section of Infectious Diseases, Department of Internal Medicine, University of Missouri , Kansas, MO, USA
| | - Karen C Carroll
- Department of Pathology, Division of Medical Microbiology, The Johns Hopkins University School of Medicine , Baltimore, MD, USA
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Ayebare A, Bebell LM, Bazira J, Ttendo S, Katawera V, Bangsberg DR, Siedner MJ, Firth PG, Boum Ii Y. Comparative assessment of methicillin resistant Staphylococcus aureus diagnostic assays for use in resource-limited settings. BMC Microbiol 2019; 19:194. [PMID: 31438852 PMCID: PMC6704615 DOI: 10.1186/s12866-019-1566-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 08/05/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The rise of methicillin-resistant Staphylococcus aureus (MRSA) is a global health concern. Paucity of data on MRSA carriage prevalence and diagnostic methods in resource-limited settings hampers efforts to define the problem and plan an appropriate response. Additionally, high variability in cost and logistical characteristics of MRSA screening methods may impede infection control efforts. We compared the performance of locally-available chromogenic agar BD CHROMagar MRSA II and two PCR-based assays (Hain GenoQuick MRSA and Cepheid Xpert SA Complete) for the detection of asymptomatic MRSA carriage in nasal swabs. RESULTS During 2015, we enrolled 500 patients from five hospital wards at a Ugandan regional referral hospital. We found 30% prevalence of methicillin-sensitive Staphylococcus aureus (MSSA) nasal carriage, and 5.4% MRSA nasal carriage prevalence. Compared to a composite reference standard defined as a positive test result on any one of the three assays, Hain GenoQuick MRSA demonstrated the highest sensitivity (96%) followed by direct plating on CHROMagar at (70%), with the lowest sensitivity observed with Xpert SA Complete (52%). Cepheid Xpert provided the most rapid results (< 1 h) but was the most expensive (US $45-50/test). Substantially more labor was required for the Hain GenoQuick MRSA compared to Xpert SA Complete or CHROMagar tests. CONCLUSION MRSA nasal carriage prevalence rates were low, and high diagnostic sensitivity was achieved using Hain GenoQuick MRSA. Chromogenic media had significantly lower sensitivity, but may represent a viable local option given its lower cost compared to PCR-based assays.
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Affiliation(s)
- A Ayebare
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda. .,Epicentre Mbarara Research Centre, Mbarara, Uganda.
| | - L M Bebell
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA, USA.,Massachusetts General Hospital Center for Global Health, Boston, MA, USA
| | - J Bazira
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - S Ttendo
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - V Katawera
- World Health Organization, Monrovia, Liberia
| | - D R Bangsberg
- Oregon Health & Science University-Portland State University School of Public Health, Portland, OR, USA
| | - M J Siedner
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.,Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA, USA.,Massachusetts General Hospital Center for Global Health, Boston, MA, USA
| | - P G Firth
- Massachusetts General Hospital Department of Anesthesia, Critical Care and Pain Medicine, Boston, MA, USA
| | - Y Boum Ii
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda. .,Epicentre Mbarara Research Centre, Mbarara, Uganda.
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Sáinz-Rodríguez R, de Toro-Peinado I, Valverde-Troya M, Ruíz MPB, Palop-Borrás B. [Evaluation of a rapid assay for detection of PBP2a Staphylococcus aureus]. REVISTA ESPANOLA DE QUIMIOTERAPIA : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE QUIMIOTERAPIA 2019; 32:370-374. [PMID: 31293115 PMCID: PMC6719650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Methicillin-resistant Staphylococcus aureus (MRSA) is a significant pathogen causing both healthcare-associated and community-acquired infection. Rapid and accurate detection of this pathogen is crucial for the use of appropriate antimicrobial therapy and the control of nosocomial spread. METHODS A total of 107 S. aureus strains were assayed for methicillin resistance: Vitek2® (bioMérieux), CHROMagarTM MRSA II (BD Becton Dickinson), disk diffusion in agar for cefoxitin 30 μg and immunochromatography PBP2a SA Culture Colony Test (AlereTM). The results of conventional tests were compared with the "gold standard" PCR test for mecA gene. RESULTS Sensitivity and specificity were: disk diffusion for cefoxitin 100% and 100% respectively, Vitek2® 100 and 100%, CHROMagarTM MRSA II 100 and 96%, and ICPBP2a detection 98,25% and 100%. CONCLUSIONS ICPBP2a Culture Colony Test (AlereTM) is fast, efficient and economical technique for detection of penicillin binding protein 2a (PBP2a) from isolates. This assay is a useful tool for the management of hospital outbreaks.
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Affiliation(s)
| | | | | | | | - Begoña Palop-Borrás
- Correspondencia: Begoña Palop-Borrás Servicio de Microbiología Hospital Regional Universitario de Málaga Avda. Carlos Haya, s/n 29010 Málaga E-mail:
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Burckhardt I, Horner S, Burckhardt F, Zimmermann S. Detection of MRSA in nasal swabs-marked reduction of time to report for negative reports by substituting classical manual workflow with total lab automation. Eur J Clin Microbiol Infect Dis 2018; 37:1745-1751. [PMID: 29943308 PMCID: PMC6133036 DOI: 10.1007/s10096-018-3308-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 06/18/2018] [Indexed: 02/03/2023]
Abstract
In 2016, the workflow for MRSA detection in nasal swabs was changed from a classic-manual workflow to an automated workflow using total lab automation (TLA; BD Kiestra). This change entailed a reduction of the incubation time from 2 days to 20 h and reading of plates on weekdays and weekends instead of weekdays only. The workflow alteration did not include the introduction of 24/7. We wanted to follow up on the consequences for the times to report (TTR). We compared the TTR of all nasal swabs, which were sent for MRSA detection from June until August in 2015 (workflow-classic-manual) and in 2016 (workflow-automated). We calculated median TTR and interquartile ranges for the three possible reporting outcomes (negative, MRSA-known, MRSA-new) per day and workflow. A multivariable linear regression modeled the exposure variables workflow, day, and reporting outcome on TTR including interaction variables. The quantity and reasons for a TTR longer than 3 days were analyzed. During both 3-month periods, a total of 16,111 reports were issued (2015:7620; 2016:8491). The median TTR for negative reports was 48:28 (hh:mm) in 2015 and 23:58 in 2016. In the linear regression, all exposure variables had a strong and highly significant (p < 0.001) influence on the TTR. The number of reports with a TTR longer than 3 days shrank from 2418 (2015) to 60 (2016). The workflow alteration halved the median TTR for negative reports and the number of reports with a TTR longer than 3 days was reduced by 97.5%.
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Affiliation(s)
- Irene Burckhardt
- Department for Infectious Diseases, Microbiology and Hygiene, University Hospital of Heidelberg, Im Neuenheimer Feld 324, 69115, Heidelberg, Germany.
| | - Susanne Horner
- Department for Infectious Diseases, Microbiology and Hygiene, University Hospital of Heidelberg, Im Neuenheimer Feld 324, 69115, Heidelberg, Germany
| | | | - Stefan Zimmermann
- Department for Infectious Diseases, Microbiology and Hygiene, University Hospital of Heidelberg, Im Neuenheimer Feld 324, 69115, Heidelberg, Germany
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Dahal M, Schwan WR. Management of methicillin-resistant Staphylococcus aureus mediated ventilator-associated pneumonia. CURRENT TRENDS IN MICROBIOLOGY 2018; 12:95-107. [PMID: 31341354 PMCID: PMC6656405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Prevention strategies and clinical management of methicillin- resistant Staphylococcus aureus (MRSA) infections in ventilated patients who develop ventilator-associated pneumonia (VAP) are important. Since MRSA are the most frequently isolated bacteria in patients with VAP, and a significant cause of morbidity and mortality in intubated patients, rapid diagnosis and early treatment could reduce mortality. This review will examine preventive steps (i.e. screening ventilated patients for MRSA, decolonization, and hand washing), assessing clinical presentations before the results of culture are obtained to direct empiric treatment, and the appropriate antibiotic therapy upon culture confirmation of MRSA that could help in the management of VAP.
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Affiliation(s)
| | - William R. Schwan
- Corresponding Author: William Schwan, Department of Microbiology, University of Wisconsin-La Crosse, 1725 State St., La Crosse, WI 54601, 608-785-6980,
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Abstract
Hospital-associated infection (HAI) in immunocompromised patients can result in high rates of morbidity and mortality. Infections caused by multidrug-resistant organisms (MDROs) are especially worrisome because of the limited choice of remaining antibiotics available when a patient becomes colonized or infected with an MDRO. It is therefore important that immunocompromised patients be cared for in an environment that limits the risk for acquiring infections. However, with healthcare being increasingly delivered in settings other than the traditional inpatient hospital wards, a bigger effort will need to be set forth to prevent or rapidly diagnose HAI. The last few years have seen a significant increase in the number of singleplex and multiplex molecular assays for the detection of many of the organisms responsible for HAI, but more is needed as infections caused by organisms like Legionella pneumophila and Aspergillus species are still diagnosed with methods that have relatively low yield and are slow to provide actionable results. Finally, the use of novel techniques for outbreak investigations will provide new information on transmission of infectious agents in healthcare settings and allow stronger, evidence-based recommendations to be developed for prevention of HAIs in the immunocompromised host.
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Schuster D, Rickmeyer J, Gajdiss M, Thye T, Lorenzen S, Reif M, Josten M, Szekat C, Melo LDR, Schmithausen RM, Liégeois F, Sahl HG, Gonzalez JPJ, Nagel M, Bierbaum G. Differentiation of Staphylococcus argenteus (formerly: Staphylococcus aureus clonal complex 75) by mass spectrometry from S. aureus using the first strain isolated from a wild African great ape. Int J Med Microbiol 2016; 307:57-63. [PMID: 27931949 DOI: 10.1016/j.ijmm.2016.11.003] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 10/25/2016] [Accepted: 11/18/2016] [Indexed: 11/30/2022] Open
Abstract
The species Staphylococcus argenteus was separated recently from Staphylococcus aureus (Tong S.Y., F. Schaumburg, M.J. Ellington, J. Corander, B. Pichon, F. Leendertz, S.D. Bentley, J. Parkhill, D.C. Holt, G. Peters, and P.M. Giffard, 2015). The objective of this work was to characterise the genome of a non-human S. argenteus strain, which had been isolated from the faeces of a wild-living western lowland gorilla in Gabon, and analyse the spectrum of this species in matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS). The full genome sequence revealed a scarcity of virulence genes and absence of resistance genes, indicating a decreased virulence potential compared to S. aureus and the human methicillin-resistant S. argenteus isolate MSHR1132T. Spectra obtained by MALDI-TOF MS and the analysis of available sequences in the genome databases identified several MALDI-TOF MS signals that clearly differentiate S. argenteus, the closely related Staphylococcus schweitzeri and S. aureus. In conclusion, in the absence of biochemical tests that identify the three species, mass spectrometry should be employed as method of choice.
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Affiliation(s)
- Dominik Schuster
- Institute of Medical Microbiology, Immunology and Parasitology, University Clinic of Bonn, Sigmund-Freud Str. 25, 53105 Bonn, Germany
| | - Jasmin Rickmeyer
- Institute of Medical Microbiology, Immunology and Parasitology, University Clinic of Bonn, Sigmund-Freud Str. 25, 53105 Bonn, Germany
| | - Mike Gajdiss
- Institute of Medical Microbiology, Immunology and Parasitology, University Clinic of Bonn, Sigmund-Freud Str. 25, 53105 Bonn, Germany
| | - Thorsten Thye
- Bernhard Nocht Institute for Tropical Medicine, Dept. Molecular Medicine, Bernhard-Nocht-Straße 74, 20359 Hamburg, Germany
| | - Stephan Lorenzen
- Bernhard Nocht Institute for Tropical Medicine, Dept. Molecular Medicine, Bernhard-Nocht-Straße 74, 20359 Hamburg, Germany
| | - Marion Reif
- Institute of Medical Microbiology, Immunology and Parasitology, University Clinic of Bonn, Sigmund-Freud Str. 25, 53105 Bonn, Germany
| | - Michaele Josten
- Institute of Medical Microbiology, Immunology and Parasitology, University Clinic of Bonn, Sigmund-Freud Str. 25, 53105 Bonn, Germany
| | - Christiane Szekat
- Institute of Medical Microbiology, Immunology and Parasitology, University Clinic of Bonn, Sigmund-Freud Str. 25, 53105 Bonn, Germany
| | - Luís D R Melo
- Institute of Medical Microbiology, Immunology and Parasitology, University Clinic of Bonn, Sigmund-Freud Str. 25, 53105 Bonn, Germany
| | - Ricarda M Schmithausen
- Institute of Medical Microbiology, Immunology and Parasitology, University Clinic of Bonn, Sigmund-Freud Str. 25, 53105 Bonn, Germany
| | - Florian Liégeois
- UMR IRD224-CNRS5290-UM MIVEGEC (Maladies Infectieuses et Vecteurs: Ecologie, Génétique, Evolution et Contrôle), Centre IRD France-Sud, 911, Avenue Agropolis, 34394 Montpellier, France
| | - Hans-Georg Sahl
- Institute of Medical Microbiology, Immunology and Parasitology, University Clinic of Bonn, Sigmund-Freud Str. 25, 53105 Bonn, Germany
| | - Jean-Paul J Gonzalez
- CIRMF (Centre International de Recherches Médicales de Franceville), BP 769 Franceville, Gabon
| | - Michael Nagel
- CIRMF (Centre International de Recherches Médicales de Franceville), BP 769 Franceville, Gabon
| | - Gabriele Bierbaum
- Institute of Medical Microbiology, Immunology and Parasitology, University Clinic of Bonn, Sigmund-Freud Str. 25, 53105 Bonn, Germany.
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Chromogenic media for MRSA diagnostics. Mol Biol Rep 2016; 43:1205-1212. [DOI: 10.1007/s11033-016-4062-3] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Accepted: 08/16/2016] [Indexed: 01/10/2023]
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Edmiston CE, Ledeboer NA, Buchan BW, Spencer M, Seabrook GR, Leaper D. Is Staphylococcal Screening and Suppression an Effective Interventional Strategy for Reduction of Surgical Site Infection? Surg Infect (Larchmt) 2016; 17:158-66. [DOI: 10.1089/sur.2015.257] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Affiliation(s)
- Charles E. Edmiston
- Departments of Surgery (Vascular), Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Nathan A. Ledeboer
- Department of Pathology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Blake W. Buchan
- Department of Pathology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | | | - Gary R. Seabrook
- Departments of Surgery (Vascular), Medical College of Wisconsin, Milwaukee, Wisconsin
| | - David Leaper
- Infection Prevention Consultants, Boston, Massachusetts
- Institute of Skin Integrity and Infection Prevention, University of Huddersfield, Huddersfield, United Kingdom
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Panda RK, Mahapatra A, Mallick B, Chayani N. Evaluation of Genotypic and Phenotypic Methods for Detection of Methicillin Resistant Staphylococcus aureus in a Tertiary Care Hospital of Eastern Odisha. J Clin Diagn Res 2016; 10:DC19-21. [PMID: 27042463 DOI: 10.7860/jcdr/2016/17476.7278] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 01/12/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Methicillin resistant Staphylococcus aureus has emerged as an important pathogen in nosocomial and community acquired infections. Accurate and rapid identification of MRSA in clinical specimens is essential for timely decision of effective antimicrobial chemotherapy. AIM The present study was conducted to compare efficacy of four conventional phenotypic methods, with mec- A based polymerase chain reaction (PCR) for MRSA identification. MATERIALS AND METHODS Methicillin resistance was determined in 200 S.aureus isolates by oxacillin disc diffusion, cefoxitin disc diffusion, Oxacillin Resistance Screening Agar and E-test. The results were compared with mec-A based PCR. RESULTS Among 200 S.aureus isolates 62 (31%) were positive for mec-A gene by PCR. Cefoxitin disc diffusion, Oxacillin Resistance Screening Agar and E-test showed 100% specificity. Oxacillin disc diffusion had lowest sensitivity (82.5%) and specificity (98.5%) among all. The conventional methods take more time than PCR for diagnosing MRSA. Linezolid, Vancomycin & Dalfopristin were the highly sensitive drugs against MRSA isolates. CONCLUSION Cefoxitin disc diffusion, is rapid, simple and cheaper, hence can be used routinely as an alternative to PCR for detection of MRSA in resource constraint laboratories.
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Affiliation(s)
- Rakesh Kumar Panda
- Assistant Professor, Department of Microbiology, S.C.B Medical College , Cuttack, India
| | - Ashoka Mahapatra
- Associate Professor, Department of Microbiology, AIIMS , Bhubaneswar, India
| | - Bandana Mallick
- Professor, Department of Microbiology, Kalinga Institute of Medical Sciences , Bhubaneswar, India
| | - Nirupama Chayani
- Professor and Head, Department of Microbiology, S.C.B Medical College , Cuttack, India
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Hirvonen JJ. The use of molecular methods for the detection and identification of methicillin-resistant Staphylococcus aureus. Biomark Med 2015; 8:1115-25. [PMID: 25402581 DOI: 10.2217/bmm.14.60] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) is a major pathogen in many hospitals and long-term care facilities as well as in the community. To limit the spread of MRSA, early detection and proper treatment are essential. Because conventional culture as gold standard is time consuming, new techniques such as PCR-based and hybridization assays have emerged for the rapid detection of MRSA. This review will focus on the currently available molecular-based assays and on their utility and performance for detection of S. aureus, of its virulence factors and of the markers for acquired resistance.
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Hirvonen JJ, Kaukoranta SS. GenomEra MRSA/SA, a fully automated homogeneous PCR assay for rapid detection ofStaphylococcus aureusand the marker of methicillin resistance in various sample matrixes. Expert Rev Mol Diagn 2014; 13:655-65. [DOI: 10.1586/14737159.2013.820542] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Abstract
Antimicrobial susceptibility test methods such as disk diffusion, broth microdilution, and oxacillin screen plate require 24 h of incubation after having the organism growing in pure culture. Rapid and accurate identification of MRSA isolates is essential not only for patient care, but also for effective infection control programs to limit the spread of MRSA. In the last few years, several commercial rapid tests for detection of MRSA directly from nasal swabs and blood cultures have been developed for use in clinical laboratories. Real-time PCR and other molecular tests are gaining popularity as MRSA screening tests to identify patients who are candidates for contact precaution at the time of admission decreasing the risk for nosocomial transmission. These new methodologies have the advantage of a lower turnaround time than that of traditional culture and susceptibility testing and they are capable of detecting MRSA directly from nasal or wound swabs allowing rapid identification of colonized or infected patients. In addition, molecular methods able to detect and differentiate S. aureus and MRSA (SA/MRSA) directly from blood cultures are becoming a useful tool for rapid detection of bacteremia caused by MSSA and MRSA. This review focuses on the procedures for performing testing using rapid methods currently available for detection of MRSA directly from clinical specimens.
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Pence MA, McElvania TeKippe E, Burnham CAD. Diagnostic Assays for Identification of Microorganisms and Antimicrobial Resistance Determinants Directly from Positive Blood Culture Broth. Clin Lab Med 2013; 33:651-84. [DOI: 10.1016/j.cll.2013.03.010] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Barsoumian A, Calvano T, Markelz AE, Cassidy R, Murray CK, Beckius ML, Mende K, Akers KS. Variations of CHROMagar Acinetobacter to detect imipenem-resistant Acinetobacter baumannii–calcoaceticus complex. ACTA ACUST UNITED AC 2013; 45:446-52. [DOI: 10.3109/00365548.2013.759270] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Three-way comparison of BBL CHROMagar MRSA II, MRSASelect, and spectra MRSA for detection of methicillin-resistant Staphylococcus aureus isolates in nasal surveillance cultures. J Clin Microbiol 2012; 51:202-5. [PMID: 23135930 DOI: 10.1128/jcm.02022-12] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) is a major cause of hospital-acquired and life-threatening infections. Active surveillance programs for MRSA utilize either molecular or culture-based methods. A prospective study was performed to compare the performance of selective and differential chromogenic media, BBL CHROMagar MRSA II (CMRSA II; BD Diagnostics, Sparks, MD), MRSASelect (Bio-Rad Laboratories, Redmond, WA), and Spectra MRSA (Remel, Lenexa, KS), for the detection of MRSA in nasal swab specimens. A total of 515 compliant remnant nasal swab specimens were sequentially used to inoculate BBL Trypticase soy agar with 5% sheep blood (TSA II) and each chromogenic medium. After 24 h of incubation, colony color reactions and morphology on chromogenic media were compared to suspicious colonies on nonselective TSA II. MRSA on TSA II was confirmed by Gram staining, a coagulase test, and a cefoxitin disk test. The overall prevalence of MRSA and methicillin-susceptible S. aureus (MSSA) on TSA II was 12.4% (64/515) and 9.7% (50/515), respectively. When each chromogenic medium was compared to the standard culture method, the sensitivity and specificity, respectively, were as follows: CMRSA II, 87.7% and 98.6%; MRSASelect, 89.0% and 93.4%; and Spectra MRSA, 83.6% and 92.1%. The positive predictive values were highest for CMRSA II (91.4%), followed by MRSASelect (69.1%) and Spectra MRSA (63.5%). False-positive results on chromogenic media were mainly due to color interpretation. The negative predictive values for all three media were greater than 97%. In conclusion, CMRSA II gave the best overall results for detecting MRSA from nasal specimens.
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Evaluation of chromogenic meticillin-resistant Staphylococcus aureus media: sensitivity versus turnaround time. J Hosp Infect 2012; 81:20-4. [DOI: 10.1016/j.jhin.2012.02.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2011] [Accepted: 02/17/2012] [Indexed: 11/23/2022]
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Rapid confirmation of suspected methicillin-resistant Staphylococcus aureus colonies on chromogenic agars by a new commercial PCR assay, the GenomEra MRSA/SA Diagnose. Eur J Clin Microbiol Infect Dis 2012; 31:1961-8. [PMID: 22278292 DOI: 10.1007/s10096-011-1527-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2011] [Accepted: 12/15/2011] [Indexed: 12/21/2022]
Abstract
A new automated closed tube PCR assay, the GenomEra(™) MRSA/SA Diagnose (Abacus Diagnostica Oy, Finland) was evaluated for rapid confirmation of methicillin-resistant Staphylococcus aureus (MRSA) from cultured screening specimens. The ability of the assay to detect genotypically different MRSA strains was studied with a collection of 304 MRSA isolates covering 68 spa types. The specificity was investigated with a collection of 146 non-MRSA staphylococcus isolates. The usefulness of the assay for clinical purposes was assessed by a sequential combination of MRSA screening culture and confirmation of the colonies with the GenomEra MRSA/SA Diagnose assay. A total of 145 suspected MRSA colonies on chromogenic plates were analyzed this way. All MRSA isolates from the culture collection and from the clinical screening specimens were confirmed as MRSA with the GenomEra MRSA/SA Diagnose assay and none of the non-MRSA staphylococci caused false-positive results, which indicates both sensitivity and specificity of 100%. The combination of GenomEra MRSA/SA Diagnose with preceding culture on selective MRSA agar permitted MRSA confirmation within 24 h. This practice offers a reliable and quick detection of MRSA that is also suitable in areas where several strain types cause epidemics.
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Conventional and Molecular Methods for the Detection of Methicillin-Resistant Staphylococcus aureus. J Clin Microbiol 2011. [DOI: 10.1128/jcm.00791-11] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Van Hoecke F, Deloof N, Claeys G. Performance evaluation of a modified chromogenic medium, ChromID MRSA New, for the detection of methicillin-resistant Staphylococcus aureus from clinical specimens. Eur J Clin Microbiol Infect Dis 2011; 30:1595-8. [PMID: 21499707 DOI: 10.1007/s10096-011-1265-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2010] [Accepted: 04/02/2011] [Indexed: 11/25/2022]
Abstract
A novel chromogenic medium for the detection of methicillin-resistant Staphylococcus aureus (MRSA), ChromID MRSA New, was evaluated and compared with the original ChromID MRSA agar, using 355 consecutive screening specimens from nose (120), throat (121) and perineum (114). The specimens were collected with an E-swab and inoculated within 24 hours onto both ChromID MRSA New and on ChromID MRSA. ChromID MRSA New was more sensitive than ChromID MRSA in detecting MRSA after 24 hours of incubation (94.3% versus 81.4%; p < 0.05). With the ChromID MRSA New, processing time is reduced from 48 h to 24 h and confirmation of the resistance to methicillin is redundant.
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Affiliation(s)
- F Van Hoecke
- Department of Clinical Chemistry, Microbiology and Immunology, Ghent University Hospital, Ghent, Belgium.
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Havill NL, Boyce JM. Evaluation of a new selective medium, BD BBL CHROMagar MRSA II, for detection of methicillin-resistant Staphylococcus aureus in stool specimens. J Clin Microbiol 2010; 48:2228-30. [PMID: 20392908 PMCID: PMC2884516 DOI: 10.1128/jcm.02376-09] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2009] [Revised: 02/06/2010] [Accepted: 04/06/2010] [Indexed: 11/20/2022] Open
Abstract
We compared the recovery of methicillin-resistant Staphylococcus aureus (MRSA) on a new selective chromogenic agar, BD BBL CHROMagar MRSA II (CMRSAII), to that on traditional culture media with 293 stool specimens. The recovery of MRSA was greater on the CMRSAII agar. Screening of stool samples can identify patients who were previously unknown carriers of MRSA.
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Affiliation(s)
- Nancy L Havill
- Hospital of Saint Raphael, 1450 Chapel St., New Haven, CT 06511, USA.
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