耐甲氧西林金黄色葡萄球菌（MRSA）检测：两种分子方法（IDI-MRSA PCR检测法和GenoType MRSA直接PCR检测法）与三种用于感染控制拭子的选择性MRSA琼脂（MRSA ID、MRSASelect和CHROMagar MRSA）的比较。
Methicillin-resistant Staphylococcus aureus (MRSA) detection: comparison of two molecular methods (IDI-MRSA PCR assay and GenoType MRSA Direct PCR assay) with three selective MRSA agars (MRSA ID, MRSASelect, and CHROMagar MRSA) for use with infection-control swabs.
作者信息
van Hal S J, Stark D, Lockwood B, Marriott D, Harkness J
机构信息
Department of Microbiology, St. Vincent's Hospital, Darlinghurst 2010 NSW, Australia.
出版信息
J Clin Microbiol. 2007 Aug;45(8):2486-90. doi: 10.1128/JCM.00139-07. Epub 2007 May 30.
Methicillin-resistant Staphylococcus aureus (MRSA) is an increasing problem. Rapid detection of MRSA-colonized patients has the potential to limit spread of the organism. We evaluated the sensitivities and specificities of MRSA detection by two molecular methods (IDI-MRSA PCR assay and GenoType MRSA Direct PCR assay) and three selective MRSA agars (MRSA ID, MRSASelect, and CHROMagar MRSA), using 205 (101 nasal, 52 groin, and 52 axillary samples) samples from consecutive known MRSA-infected and/or -colonized patients. All detection methods had higher MRSA detection rates for nasal swabs than for axillary and groin swabs. Detection of MRSA by IDI-MRSA was the most sensitive method, independent of the site (94% for nasal samples, 80% for nonnasal samples, and 90% overall). The sensitivities of the GenoType MRSA Direct assay and the MRSA ID, MRSASelect, and CHROMagar MRSA agars with nasal swabs were 70%, 72%, 68%, and 75%, respectively. All detection methods had high specificities (95 to 99%), independent of the swab site. Extended incubation for a further 24 h with selective MRSA agars increased the detection of MRSA, with a corresponding decline in specificity secondary to a significant increase in false-positive results. There was a noticeable difference in test performance of the GenoType MRSA Direct assay in detection of MRSA (28/38 samples [74%]) compared with detection of nonmultiresistant MRSA (17/31 samples [55%]) (susceptible to two or more non-beta-lactam antibiotics). This was not observed with selective MRSA agar plates or IDI-MRSA. Although it is more expensive, in addition to rapid turnaround times of 2 to 4 h, IDI-MRSA offers greater detection of MRSA colonization, independent of the swab site, than do conventional selective agars and GenoType MRSA Direct.
耐甲氧西林金黄色葡萄球菌（MRSA）问题日益严重。快速检测出MRSA定植患者有可能限制该病菌的传播。我们使用来自连续已知MRSA感染和/或定植患者的205份样本（101份鼻拭子、52份腹股沟拭子和52份腋窝拭子），评估了两种分子方法（IDI-MRSA PCR检测法和GenoType MRSA直接PCR检测法）以及三种选择性MRSA琼脂（MRSA ID、MRSASelect和CHROMagar MRSA）检测MRSA的敏感性和特异性。所有检测方法对鼻拭子的MRSA检出率均高于腋窝和腹股沟拭子。IDI-MRSA检测MRSA是最敏感的方法，与采样部位无关（鼻样本为94%，非鼻样本为80%，总体为90%）。GenoType MRSA直接检测法以及MRSA ID、MRSASelect和CHROMagar MRSA琼脂对鼻拭子的敏感性分别为70%、72%、68%和75%。所有检测方法均具有较高的特异性（95%至99%），与拭子采样部位无关。使用选择性MRSA琼脂进一步孵育24小时可增加MRSA的检出率，但由于假阳性结果显著增加，特异性相应下降。GenoType MRSA直接检测法在检测MRSA（28/38份样本[74%]）与检测非多重耐药MRSA（17/31份样本[55%]）（对两种或更多种非β-内酰胺抗生素敏感）时，检测性能存在明显差异。选择性MRSA琼脂平板或IDI-MRSA未观察到这种情况。尽管成本更高，但除了2至4小时的快速周转时间外，IDI-MRSA与传统选择性琼脂和GenoType MRSA直接检测法相比，在检测MRSA定植方面，与拭子采样部位无关，具有更高的检出率。
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