Grandin S, Deschamps C, Magdoud F, Zihoune N, Branger C, Eveillard M
Service de Microbiologie-Hygiène, Hôpital Louis-Mourier (AP-HP), 178 Rue des Renouillers, 92700 Colombes, France.
Pathol Biol (Paris). 2009 May;57(3):e37-42. doi: 10.1016/j.patbio.2008.03.008. Epub 2008 May 5.
MRSA-carrier screening is recommended to prevent MRSA dissemination in hospitals. Rapid and specific detection of MRSA in the laboratory is a key element in enabling control measures. Our objective was to evaluate the impact of different lengths of pre-incubation in a nutritive broth and prolonged incubation of MRSA-ID, a chromogenic agar medium, on its performances for identifying MRSA in screening samples. According to our results, short-length pre-enrichments only provided a weak increase of sensitivity as compared to the absence of pre-enrichment. On the contrary, the sensitivity increase provided by an overnight pre-enrichment was significant. The prolongation of incubation in the chromogenic agar medium (48 hours instead of 24 hours) did not provide any significant increase of sensitivity but was associated with a strong and significant loss of specificity. Therefore, it seems relevant to reject prolonged incubation of selective agar media and to make a choice between the absence of pre-enrichment (faster results) and an overnight pre-enrichment (higher sensitivity), according to local epidemiology and local practices implemented for prevention.
建议进行耐甲氧西林金黄色葡萄球菌(MRSA)携带者筛查,以防止MRSA在医院内传播。实验室中对MRSA进行快速、特异性检测是实施控制措施的关键要素。我们的目的是评估在营养肉汤中不同预孵育时间以及在显色琼脂培养基MRSA-ID上延长孵育时间对其在筛查样本中鉴定MRSA性能的影响。根据我们的结果,与不进行预富集相比,短时间预富集仅使灵敏度略有提高。相反,过夜预富集使灵敏度显著提高。在显色琼脂培养基中延长孵育时间(从24小时延长至48小时)并未使灵敏度显著提高,但却导致特异性显著降低。因此,根据当地流行病学情况和实施的预防措施,似乎有必要摒弃选择性琼脂培养基的延长孵育,在不进行预富集(结果更快)和过夜预富集(灵敏度更高)之间做出选择。