Anand K B, Agrawal P, Kumar S, Kapila K
Department of Microbiology, Armed Forces Medical College, Pune-440 040, India.
Indian J Med Microbiol. 2009 Jan-Mar;27(1):27-9.
Cefoxitin is a potent inducer of the mecA regulatory system. It is being recommended for detection of methicillin resistance in Staphylococcus aureus (MRSA) when using disk diffusion testing. The aim of our study was to evaluate the efficacy of cefoxitin disc diffusion test to characterize MRSA and compare it with oxacillin agar screening and detection of mecA gene by PCR.
Fifty strains of S. aureus isolated from clinical samples were used in the study. Routine antibiotic susceptibility testing was performed including oxacillin disk. Oxacillin screen agar plates with 4% NaCl and 6 microg/ml of oxacillin were inoculated and interpreted as per standard guidelines. Cefoxitin disc diffusion test was performed using 30 microg disc and zone sizes were measured. PCR for amplification of the mecA gene was performed.
Out of the 50 isolates, 28 were found to be methicillin resistant by oxacillin disc diffusion test, 30 were resistant by oxacillin screen agar method, and 32 were resistant with cefoxitin disc diffusion. For these 32 isolates mecA gene was positive.
Results of cefoxitin disc diffusion test is in concordance with the PCR for mecA gene. Thus, the test can be an alternative to PCR for detection of MRSA in resource constraint settings.
头孢西丁是mecA调控系统的强效诱导剂。在使用纸片扩散法检测金黄色葡萄球菌(MRSA)中的耐甲氧西林情况时,推荐使用该药物。我们研究的目的是评估头孢西丁纸片扩散试验对MRSA进行特征鉴定的有效性,并将其与苯唑西林琼脂筛选法以及通过聚合酶链反应(PCR)检测mecA基因的方法进行比较。
本研究使用了从临床样本中分离出的50株金黄色葡萄球菌。进行了常规抗生素敏感性试验,包括苯唑西林纸片试验。接种含有4%氯化钠和6微克/毫升苯唑西林的苯唑西林筛选琼脂平板,并按照标准指南进行判读。使用30微克的纸片进行头孢西丁纸片扩散试验,并测量抑菌圈大小。进行了用于扩增mecA基因的PCR。
在这50株分离株中,通过苯唑西林纸片扩散试验发现28株对甲氧西林耐药,通过苯唑西林筛选琼脂法有30株耐药,通过头孢西丁纸片扩散试验有32株耐药。对于这32株分离株,mecA基因呈阳性。
头孢西丁纸片扩散试验的结果与mecA基因的PCR结果一致。因此,在资源有限的情况下,该试验可作为检测MRSA的PCR替代方法。