Comparative Evaluation of Three Chromogenic Media Combined with Broth Enrichment and the Real-Time PCR-Based Xpert MRSA Assay for Screening of Methicillin-Resistant Staphylococcus aureus in Nasal Swabs.
10.3343/alm.2013.33.4.255
- Author:
Seungok LEE
1
;
Yeon Joon PARK
;
Kang Gyun PARK
;
Dong Wook JEKARL
;
Hyojin CHAE
;
Jin Kyung YOO
;
Sin Won SEO
;
Jung Eun CHOI
;
Jung Hye LIM
;
Seon Mi HEO
;
Ju Hee SEO
Author Information
1. Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea. yjpk@catholic.ac.kr
- Publication Type:Original Article ; Comparative Study
- Keywords:
Chromogenic agars;
Xpert MRSA assay;
Methicillin-resistant Staphylococcus aureus
- MeSH:
Bacterial Proteins/genetics;
Bacterial Typing Techniques/*methods;
Chromogenic Compounds/chemistry/*metabolism;
Culture Media/chemistry;
DNA, Bacterial/analysis;
Humans;
Methicillin-Resistant Staphylococcus aureus/*genetics/growth & development/*isolation & purification/metabolism;
Nasal Cavity/*microbiology;
Reagent Kits, Diagnostic;
*Real-Time Polymerase Chain Reaction;
*Staphylococcal Infections/diagnosis/microbiology
- From:Annals of Laboratory Medicine
2013;33(4):255-260
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: We evaluated the performance of three chromogenic media (Brilliance agar I [Oxoid, UK], Brilliance agar II [Oxoid], and ChromID MRSA [Biomerieux, France]) combined with broth enrichment and the Xpert MRSA assay for screening of methicillin-resistant Staphylococcus aureus (MRSA). METHODS: We obtained 401 pairs of duplicate nasal swabs from 321 patients. One swab was suspended overnight in tryptic soy broth; 50-microL aliquots of suspension were inoculated on the three chromogenic media. Brilliance agar I and II were examined after 24 hr, and ChromID MRSA, after 24 and 48 hr. The paired swab was processed directly using real-time PCR-based Xpert MRSA assay. RESULTS: True positives, designated as MRSA growth in any of the culture media, were detected with the prevalence of 17% in our institution. We report the sensitivity, specificity, positive predictive value, and negative predictive value of MRSA growth as follows: 92.3%, 94.0%, 75.9%, and 98.4% in Brilliance agar I (24 hr); 92.7%, 97.9%, 90.0%, and 98.5% in Brilliance agar II (24 hr); 95.6%, 95.8%, 82.3%, and 99.1% in ChromID MRSA (24 hr); 100%, 92.5%, 73.1%, and 100% in ChromID MRSA (48 hr); 92.6%, 96.7%, 85.1%, and 98.5% in Xpert MRSA assay. The agreement between the enriched culture and Xpert MRSA assay was 96.0%. CONCLUSIONS: Three chromogenic culture media combined with enrichment and Xpert MRSA assay demonstrated similar capabilities in MRSA detection. The Xpert MRSA assay yielded results comparable to those of culture methods, saving 48-72 hr, thus facilitating earlier detection of MRSA in healthcare settings.
