Division of Clinical Microbiology, HUSLAB, Helsinki University Hospital, Helsinki, Finland.
APMIS. 2010 Jan;118(1):74-80. doi: 10.1111/j.1600-0463.2009.02562.x.
We analyzed the performance of a selective enrichment broth combined with Taqman-based real-time duplex nuc-mecA-PCR to expedite the screening of methicillin-resistant Staphylococcus aureus (MRSA). We found the broth to be able to select MRSA strains (oxacillin MIC range 4-256 microg/ml) from MSSA strains. A total of 31 MRSA strains were found from 1250 clinical samples screened. The nuc-mecA-PCR was positive from all enrichment broths containing MRSA. From the remaining 1219 samples negative for MRSA on culture/subculture, 138 samples were nuc+/mecA+ in PCR. The sensitivity of the test was 93.5%, specificity 88.6%, positive predictive value 17.3%, and negative predictive value 99.8% as compared to culture. Thus, with this method, the negative MRSA results can be reliably reported within 24-48 h from sampling. The method is a practical additional alternative to those already described for the same purpose.
我们分析了一种选择性增菌肉汤联合 Taqman 实时双荧光 nuc-mecA-PCR 检测方法，以加速耐甲氧西林金黄色葡萄球菌（MRSA）的筛查。我们发现该肉汤能够从甲氧西林敏感金黄色葡萄球菌（MSSA）菌株中选择出 MRSA 菌株（苯唑西林 MIC 范围为 4-256μg/ml）。从 1250 份筛查的临床样本中总共发现了 31 株 MRSA 菌株。所有含有 MRSA 的增菌肉汤的 nuc-mecA-PCR 均为阳性。在培养/传代后 MRSA 阴性的 1219 份剩余样本中，138 份样本的 nuc+/mecA+在 PCR 中。与培养相比，该检测方法的灵敏度为 93.5%，特异性为 88.6%，阳性预测值为 17.3%，阴性预测值为 99.8%。因此，使用该方法可以在采样后 24-48 小时内可靠地报告阴性 MRSA 结果。该方法是针对相同目的已经描述的方法的一种实用的补充替代方法。
