1887

Abstract

Meticillin-resistant (MRSA) has been recognized as one of the major pathogens in hospital as well as community settings. In India, the mean isolation rate of MRSA is 20–40 % and many studies have suggested an escalating rate of infections caused by this organism. Despite pharmaceutical and technological advancement, infections caused by MRSA still remain difficult to diagnose. The present study was undertaken to compare five phenotypic methods for the detection of MRSA. This involved examining 200 isolates of by oxacillin disc diffusion, cefoxitin disc diffusion, oxacillin screen agar test, the latex agglutination test and growth on CHROMagar. PCR for gene detection was taken as the gold standard. It was found that 35 % of all infections were caused by MRSA. The cefoxitin disc diffusion method, as recommended by the Clinical and Laboratory Standards Institute, was found to be a reliable method for MRSA detection but it should be supplemented with some other method like latex agglutination, CHROMagar or oxacillin screen agar testing so that no MRSA is missed. We recommend that along with cefoxitin disc diffusion, another method, preferably latex agglutination, should be routinely used in all hospitals to detect MRSA.

Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.032219-0
2011-11-01
2019-12-07
Loading full text...

Full text loading...

/deliver/fulltext/jmm/60/11/1613.html?itemId=/content/journal/jmm/10.1099/jmm.0.032219-0&mimeType=html&fmt=ahah

References

  1. Anupurba S. , Sen M. R. , Nath G. , Sharma B. M. , Gulati A. K. , Mohapatra T. M. . ( 2003; ). Prevalence of methicillin resistant Staphylococcus aureus in a tertiary referral hospital in eastern Uttar Pradesh. . Indian J Med Microbiol 21:, 49–51.[PubMed]
    [Google Scholar]
  2. Baird D. . ( 2006; ). Staphylococcus: cluster forming Gram positive cocci. . In Mackie and McCartney: Practical Medical Microbiology, , 14th edn., pp. 245–258. Edited by Collee J. G. , Fraser A. G. , Marmion B. P. , Simmons A. . . New York:: Churchill Livingstone;.
    [Google Scholar]
  3. Boutiba-Ben Boubaker I. , Ben Abbes R. , Ben Abdallah H. , Mamlouk K. , Mahjoubi F. , Kammoun A. , Hammami A. , Ben Redjeb S. . ( 2004; ). Evaluation of a cefoxitin disk diffusion test for the routine detection of methicillin-resistant Staphylococcus aureus . . Clin Microbiol Infect 10:, 762–765. [CrossRef] [PubMed]
    [Google Scholar]
  4. Cavassini M. , Wenger A. , Jaton K. , Blanc D. S. , Bille J. . ( 1999; ). Evaluation of MRSA-Screen, a simple anti-PBP 2a slide latex agglutination kit, for rapid detection of methicillin resistance in Staphylococcus aureus . . J Clin Microbiol 37:, 1591–1594.[PubMed]
    [Google Scholar]
  5. Chambers H. F. . ( 1988; ). Methicillin-resistant staphylococci. . Clin Microbiol Rev 1:, 173–186.[PubMed]
    [Google Scholar]
  6. Chambers H. F. . ( 1997; ). Methicillin resistance in staphylococci: molecular and biochemical basis and clinical implications. . Clin Microbiol Rev 10:, 781–791.[PubMed]
    [Google Scholar]
  7. CLSI ( 2008; ). Performance Standards for Antimicrobial Susceptibility Testing, 15th informational supplement, M100-S15. . Wayne, PA:: Clinical and Laboratory Standards Institute;.
  8. Diederen B. , Van Duijn I. , Van Belkum A. , Willemse P. , Van Keulen P. , Kluytmans J. . ( 2005; ). Performance of CHROMagar MRSA medium for detection of methicillin-resistant Staphylococcus aureus . . J Clin Microbiol 43:, 1925–1927. [CrossRef] [PubMed]
    [Google Scholar]
  9. Hartman B. J. , Tomasz A. . ( 1986; ). Expression of methicillin resistance in heterogeneous strains of Staphylococcus aureus . . Antimicrob Agents Chemother 29:, 85–92.[PubMed] [CrossRef]
    [Google Scholar]
  10. Hussain Z. , Stoakes L. , Garrow S. , Longo S. , Fitzgerald V. , Lannigan R. . ( 2000; ). Rapid detection of mecA-positive and mecA-negative coagulase-negative staphylococci by an anti-penicillin binding protein 2a slide latex agglutination test. . J Clin Microbiol 38:, 2051–2054.[PubMed]
    [Google Scholar]
  11. Krishnan P. U. , Miles K. , Shetty N. . ( 2002; ). Detection of methicillin and mupirocin resistance in Staphylococcus aureus isolates using conventional and molecular methods: a descriptive study from a burns unit with high prevalence of MRSA. . J Clin Pathol 55:, 745–748. [CrossRef] [PubMed]
    [Google Scholar]
  12. Louie L. , Matsumura S. O. , Choi E. , Louie M. , Simor A. E. . ( 2000; ). Evaluation of three rapid methods for detection of methicillin resistance in Staphylococcus aureus . . J Clin Microbiol 38:, 2170–2173.[PubMed]
    [Google Scholar]
  13. Mehta A. P. , Rodrigues C. , Sheth K. , Jani S. , Hakimiyan A. , Fazalbhoy N. . ( 1998; ). Control of methicillin resistant Staphylococcus aureus in a tertiary care centre: a five year study. . Indian J Med Microbiol 16:, 31–34.
    [Google Scholar]
  14. Rohrer S. , Tschierske M. , Zbinden R. , Berger-Bächi B. . ( 2001; ). Improved methods for detection of methicillin-resistant Staphylococcus aureus . . Eur J Clin Microbiol Infect Dis 20:, 267–270. [CrossRef] [PubMed]
    [Google Scholar]
  15. Sakoulas G. , Gold H. S. , Venkataraman L. , DeGirolami P. C. , Eliopoulos G. M. , Qian Q. . ( 2001; ). Methicillin-resistant Staphylococcus aureus: comparison of susceptibility testing methods and analysis of mecA-positive susceptible strains. . J Clin Microbiol 39:, 3946–3951. [CrossRef] [PubMed]
    [Google Scholar]
  16. Skov R. , Smyth R. , Clausen M. , Larsen A. R. , Frimodt-Møller N. , Olsson-Liljequist B. , Kahlmeter G. . ( 2003; ). Evaluation of a cefoxitin 30 µg disc on Iso-Sensitest agar for detection of methicillin-resistant Staphylococcus aureus . . J Antimicrob Chemother 52:, 204–207. [CrossRef] [PubMed]
    [Google Scholar]
  17. Skulnick M. , Simor A. E. , Gregson D. , Patel M. , Small G. W. , Kreiswirth B. , Hathoway D. , Low D. E. . ( 1992; ). Evaluation of commercial and standard methodology for determination of oxacillin susceptibility in Staphylococcus aureus . . J Clin Microbiol 30:, 1985–1988.[PubMed]
    [Google Scholar]
  18. Swenson J. M. , Williams P. P. , Killgore G. , O’Hara C. M. , Tenover F. C. . ( 2001; ). Performance of eight methods, including two new rapid methods, for detection of oxacillin resistance in a challenge set of Staphylococcus aureus organisms. . J Clin Microbiol 39:, 3785–3788. [CrossRef] [PubMed]
    [Google Scholar]
  19. Udo E. E. , Mokadas E. M. , Al-Haddad A. , Mathew B. , Jacob L. E. , Sanyal S. C. . ( 2000; ). Rapid detection of methicillin resistance in staphylococci using a slide latex agglutination kit. . Int J Antimicrob Agents 15:, 19–24. [CrossRef] [PubMed]
    [Google Scholar]
  20. Van Leeuwen W. B. , Van Pelt C. , Luijendijk A. , Verbrugh H. A. , Goessens W. H. . ( 1999; ). Rapid detection of methicillin resistance in Staphylococcus aureus isolates by the MRSA-screen latex agglutination test. . J Clin Microbiol 37:, 3029–3030.[PubMed]
    [Google Scholar]
  21. Velasco D. , del Mar Tomas M. , Cartelle M. , Beceiro A. , Perez A. , Molina F. , Moure R. , Villanueva R. , Bou G. . ( 2005; ). Evaluation of different methods for detecting methicillin (oxacillin) resistance in Staphylococcus aureus . . J Antimicrob Chemother 55:, 379–382. [CrossRef] [PubMed]
    [Google Scholar]
  22. Verma S. , Joshi S. , Chitnis V. , Hemwani N. , Chitnis D. . ( 2000; ). Growing problem of methicillin resistant staphylococci – Indian scenario. . Indian J Med Sci 54:, 535–540.[PubMed]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/jmm.0.032219-0
Loading
/content/journal/jmm/10.1099/jmm.0.032219-0
Loading

Data & Media loading...

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