Skip to content
1887

Access Microbiology open research platform logo Access Microbiology

Volume 7, Issue 6

Culture harder: use more specimen to increase methicillin-resistant culture yield relative to PCR Open Access

Abstract

Methicillin-resistant (MRSA) causes considerable morbidity and mortality in both community-acquired and healthcare-associated infections, but detecting colonization with MRSA has been shown to improve patient outcomes in certain clinical settings. MRSA colonization detection has been carried out in a variety of ways, with molecular assays having superior sensitivity in most studies relative to culture, but culture is disadvantaged in some comparisons by utilization of low specimen volumes. We compared a commercial molecular assay to both low-volume (10 µl) and high-volume (650 µl) cultures and found that increasing the volume utilized for culture led to the detection of 25% more cases than low-volume culture.

  • Received:
  • Accepted:
  • Published Online:
Keyword(s): culture , methicillin-resistant Staphylococcus aureus (MRSA) screening and PCR
© 2025 The Authors
  • This is an open-access article distributed under the terms of the Creative Commons Attribution License. This article was made open access via a Publish and Read agreement between the Microbiology Society and the corresponding author’s institution.
Loading

Article metrics loading...

/content/journal/acmi/10.1099/acmi.0.000918.v4
2025-06-03
2025-06-17
Loading full text...

Full text loading...

/deliver/fulltext/acmi/7/6/acmi000918.v4.html?itemId=/content/journal/acmi/10.1099/acmi.0.000918.v4&mimeType=html&fmt=ahah

References

  1. Hanberger H, Walther S, Leone M, Barie PS, Rello J et al. Increased mortality associated with methicillin-resistant Staphylococcus aureus (MRSA) infection in the intensive care unit: results from the EPIC II study. Int J Antimicrob Agents 2011; 38:331–335 [View Article] [PubMed]
     [Google Scholar]
  2. Delaney JA, Schneider-Lindner V, Brassard P, Suissa S. Mortality after infection with methicillin-resistant Staphylococcus aureus (MRSA) diagnosed in the community. BMC Med 2008; 6:2 [View Article] [PubMed]
     [Google Scholar]
  3. Meng L, Pourali S, Hitchcock MM, Ha DR, Mui E et al. Discontinuation patterns and cost avoidance of a pharmacist-driven methicillin-resistant Staphylococcus aureus nasal polymerase chain reaction testing protocol for de-escalation of empiric vancomycin for suspected pneumonia. Open Forum Infect Dis 2021; 8:ofab099 [View Article] [PubMed]
     [Google Scholar]
  4. Dalpke AH, Hofko M, Stock C, Zimmermann S. Evaluation of the BD Max MRSA XT assay for use with different swab types. J Clin Microbiol 2014; 52:4343–4346 [View Article] [PubMed]
     [Google Scholar]
  5. Yarbrough ML, Warren DK, Allen K, Burkholder D, Daum R et al. Multicenter evaluation of the Xpert MRSA NxG assay for detection of methicillin-resistant Staphylococcus aureus in nasal swabs. J Clin Microbiol 2018; 56:e01381-17 [View Article] [PubMed]
     [Google Scholar]
  6. Molan A, Nulsen M, Thomas G. Methicillin-resistant Staphylococcus aureus (MRSA): isolation from nasal and throat swabs transported in liquid or semisolid media; identification by PCR compared with culture. N Z J Med Lab Sci 2013; 67:
     [Google Scholar]
  7. Perry JD. A decade of development of chromogenic culture media for clinical microbiology in an era of molecular diagnostics. Clin Microbiol Rev 2017; 30:449–479 [View Article] [PubMed]
     [Google Scholar]
  8. McElvania E, Mindel S, Lemstra J, Brands K, Patel P et al. Automated detection of methicillin-resistant Staphylococcus aureus with the MRSA CHROM imaging application on BD Kiestra total lab automation system. J Clin Microbiol 2024; 62: [View Article]
     [Google Scholar]
  9. Hiermandi N, Foster C, Purnell K, Dunn J, Campbell J et al. MRSA PCR improves sensitivity of detection of colonization in neonates. Antimicrob Steward Healthc Epidemiol 2023; 3:s58–s59 [View Article]
     [Google Scholar]
  10. Luteijn JM, Hubben GAA, Pechlivanoglou P, Bonten MJ, Postma MJ. Diagnostic accuracy of culture-based and PCR-based detection tests for methicillin-resistant Staphylococcus aureus: a meta-analysis. Clin Microbiol Infect 2011; 17:146–154 [View Article] [PubMed]
     [Google Scholar]
  11. Nielsen XC, Madsen TV, Engberg J. Evaluation of Xpert MRSA Gen 3 and BD MAX MRSA XT for meticillin-resistant Staphylococcus aureus screening in a routine diagnostic setting in a low-prevalence area. J Med Microbiol 2017; 66:90–95 [View Article] [PubMed]
     [Google Scholar]
  12. Snyder JW, Munier GK, Johnson CL. Comparison of the BD GeneOhm methicillin-resistant Staphylococcus aureus (MRSA) PCR assay to culture by use of BBL CHROMagar MRSA for detection of MRSA in nasal surveillance cultures from intensive care unit patients. J Clin Microbiol 2010; 48:1305–1309 [View Article] [PubMed]
     [Google Scholar]
  13. Tansarli GS, LeBlanc L, Auld DB, Chapin KC. Diagnostic accuracy of presurgical Staphylococcus aureus PCR assay compared with culture and post-PCR implementation surgical site infection rates. J Mol Diagn 2020; 22:1063–1069 [View Article] [PubMed]
     [Google Scholar]
  14. Wolk DM, Marx JL, Dominguez L, Driscoll D, Schifman RB. Comparison of MRSASelect agar, CHROMagar methicillin-resistant Staphylococcus aureus (MRSA) medium, and Xpert MRSA PCR for detection of MRSA in nares: diagnostic accuracy for surveillance samples with various bacterial densities. J Clin Microbiol 2009; 47:3933–3936 [View Article] [PubMed]
     [Google Scholar]
  15. Shenoy ES, Noubary F, Kim J, Rosenberg ES, Cotter JA et al. Concordance of PCR and culture from nasal swabs for detection of methicillin-resistant Staphylococcus aureus in a setting of concurrent antistaphylococcal antibiotics. J Clin Microbiol 2014; 52:1235–1237 [View Article] [PubMed]
     [Google Scholar]
  16. Peterson LR, Liesenfeld O, Woods CW, Allen SD, Pombo D et al. Multicenter evaluation of the LightCycler methicillin-resistant Staphylococcus aureus (MRSA) advanced test as a rapid method for detection of MRSA in nasal surveillance swabs. J Clin Microbiol 2010; 48:1661–1666 [View Article] [PubMed]
     [Google Scholar]
  17. Yu VL, Goetz A, Wagener M, Smith PB, Rihs JD et al. Staphylococcus aureus nasal carriage and infection in patients on hemodialysis. Efficacy of antibiotic prophylaxis. N Engl J Med 1986; 315:91–96 [View Article] [PubMed]
     [Google Scholar]
  18. Carr AL, Daley MJ, Givens Merkel K, Rose DT. Clinical utility of methicillin-resistant Staphylococcus aureus nasal screening for antimicrobial stewardship: a review of current literature. Pharmacotherapy 2018; 38:1216–1228 [View Article] [PubMed]
     [Google Scholar]
  19. Silbert S, Kubasek C, Galambo F, Vendrone E, Widen R. Evaluation of BD Max StaphSR and BD Max MRSA XT assays using ESwab-collected specimens. J Clin Microbiol 2015; 53:2525–2529 [View Article] [PubMed]
     [Google Scholar]
  20. Herrmann M, Petit C, Dawson A, Biechele J, Halfmann A et al. Methicillin-resistant Staphylococcus aureus in Saarland, Germany: a statewide admission prevalence screening study. PLoS One 2013; 8:e73876 [View Article] [PubMed]
     [Google Scholar]
  21. 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 [View Article] [PubMed]
     [Google Scholar]
  22. Cheng CWR, Ong CH, Chan DSG. Impact of BD Kiestra InoqulA streaking patterns on colony isolation and turnaround time of methicillin-resistant Staphylococcus aureus and carbapenem-resistant Enterobacterale surveillance samples. Clin Microbiol Infect 2020; 26:1201–1206 [View Article] [PubMed]
     [Google Scholar]
  23. Gammel N, Ross TL, Lewis S, Olson M, Henciak S et al. Comparison of an automated plate assessment system (APAS Independence) and artificial intelligence (AI) to manual plate reading of methicillin-resistant and methicillin-susceptible Staphylococcus aureus CHROMagar surveillance cultures. J Clin Microbiol 2021; 59:e0097121 [View Article] [PubMed]
     [Google Scholar]
  24. Turner SC, Seligson ND, Parag B, Shea KM, Hobbs ALV. Evaluation of the timing of MRSA PCR nasal screening: how long can a negative assay be used to rule out MRSA-positive respiratory cultures?. Am J Health Syst Pharm 2021; 78:S57–S61 [View Article] [PubMed]
     [Google Scholar]
/content/journal/acmi/10.1099/acmi.0.000918.v4
Loading
Culture harder: use more specimen to increase methicillin-resistant Staphylococcus aureus culture yield relative to PCR
Access Microbiology 7, 000918.v4 (2025); https://doi.org/10.1099/acmi.0.000918.v4
/content/journal/acmi/10.1099/acmi.0.000918.v4
/content/journal/acmi/10.1099/acmi.0.000918.v4
Loading

Data & Media loading...

Supplements

Supplementary material 1

EXCEL

Most cited Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error