BACKGROUND: A rapid and sensitive surveillance culture has a pivotal role in infection control of methicillinresistant Staphylococcus aureus (MRSA). This study was aimed to compare the performance of MRSASelect (Bio-Rad, France) to that of mannitol salt agar containing 6 microgram/mL of oxacillin (MSA-OX) for detecting MRSA in surveillance cultures. METHOD: From May to June 2006, 86 nasal swabs and 21 sputum specimens were enrolled. All specimens were inoculated onto MRSASelect and MSA-OX, which were incubated for 2 days and 3 days, respectively, and colonies were read daily by a technologist. Pink colonies on MRSASelect and yellow colonies on MSA-OX were examined with Gram stain, Pastorex(R) Staph-plus (Bio-Rad) and mecA-PCR. After the final reading, both media were re-examined by a superviser. RESULTS: Of the 107 specimens cultured, 32 (29.9%) were positive for MRSA. Of these, 27 were detected by both media, one by MSA-OX only, and 4 by re-examination. The day-1 and day-2 sensitivities/specificities of MRSASelect were 78.1%/97.3% and 84.4%/97.3%, respectively, while those of MSA-OX were 53.1%/100% and 78.1%/92.1%, respectively. With MRSASelect, two more positives were detected at day 2, but their incubation was less than 18 hour at day 1. There were six false positive organisms detected: three Enterobacter spp., one Acinectobacter spp., and two coagulase-negative staphylococci (CNS). But, the two CNS grew on MSA-OX only. CONCLUSION: MRSASelect with 1-day incubation showed a sensitivity equivalent to and a specificity better than MSA-OX with 2-day incubation. MRSASelect should be a useful medium for MRSA surveillance when it is read after an incubation of 18-28 hours with the confirmatory Gram stain of screen-positives.
Agar ; Enterobacter ; Infection Control ; Mannitol ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Oxacillin ; Sensitivity and Specificity ; Sputum ; Staphylococcus aureus

Purpose: This study examined health determinants at a community level and put forward to a typology of five different forms of community health vulnerabilities. We also investigated the differences in the prevalence of chronic diseases, self-rated health, and quality of life (EQ-5D) among the five types. Methods: Latent class analysis was applied to material, social capital, and health behavior vulnerability variables across 255 regions of South Korea. The data came from 2017 & 2019 Community Health Survey. Results: We found five types of community health vulnerabilities: Type 1 group had the highest material vulnerabilities compared to Type 5. The typology was found to be significant in all the regression analysis on the prevalence of chronic diseases (hypertension and diabetes), self-rated health status, and quality of life. In the regions with high material vulnerabilities, the material vulnerability appeared the most effective to the health status of individual’s. In the other regions with less material vulnerabilities, the social capital and health behavior resources were found to be effective. Conclusion A comprehensive measure of vulnerability can be helpful to understand community health. Policy makers need to consider the level of material vulnerability when planning for a health promotion project.

BACKGROUND: We evaluated multiplex PCR for species identification and toxin typing to improve the sensitivity and turnaround time of toxigenic Clostridium difficile culture (TCDC). METHODS: We performed multiplex PCR using primers targeting the species-specific gene, tpi, and the toxin genes, tcdA and tcdB. From January to March 2008, 528 stool specimens were tested with direct toxin assay (DT) using C. difficile Tox A/B II (Techlab, Blacksburg, USA) and TCDC. For 288 specimens from early study period, toxin production by C. difficile isolates of TCDC was measured by enzyme immunoassay with culture supernatants using VIDAS C. difficile Toxin A&B (CDAB;bioMerieux, Marcy-l'Etoile, France) and multiplex PCR with isolated colonies. For 240 specimens from late period, only multiplex PCR was used to test toxin production by the isolates. RESULTS: During the early period, 29 C. difficile were isolated and their toxin-positive rates were 65.5% by PCR and 44.8% by CDAB (P<0.05). Among 528 stool specimens, the results of DT+/TCDC+, DT+/ TCDC-, and DT-/TCDC+ were 32 (6.1%), 33 (6.3%), and 10 (1.9%), respectively, when tested with PCR. 13.3% of total 75 positive specimens was detected only by TCDC. Of the 42 toxigenic C. difficile isolates, all were positive for tpi, 30 (71.4%) were tcdA+/tcdB+, and 12 (28.6%) were tcdA-/tcdB+. CONCLUSION: TCDC using multiplex PCR for species identification and toxin typing is sensitive and rapid to be used as a routine diagnostic test.
Boron Compounds ; Clostridium ; Clostridium difficile ; Diagnostic Tests, Routine ; Immunoenzyme Techniques ; Multiplex Polymerase Chain Reaction ; Polymerase Chain Reaction