多中心评估 LightCycler 耐甲氧西林金黄色葡萄球菌（MRSA）高级检测试验作为一种快速检测鼻拭子中 MRSA 的方法。
Multicenter evaluation of the LightCycler methicillin-resistant Staphylococcus aureus (MRSA) advanced test as a rapid method for detection of MRSA in nasal surveillance swabs.
机构信息
NorthShore University HealthSystem, Department of Pathology and Laboratory Medicine, 2650 Ridge Avenue, Walgreen Bldg., SB525, Evanston, IL 60201, USA.
出版信息
J Clin Microbiol. 2010 May;48(5):1661-6. doi: 10.1128/JCM.00003-10. Epub 2010 Mar 24.
The rate of methicillin-resistant Staphylococcus aureus (MRSA) infection continues to rise in many health care settings. Rapid detection of MRSA colonization followed by appropriate isolation can reduce transmission and infection. We compared the performance of the new Roche LightCycler MRSA advanced test to that of the BD GeneOhm MRSA test and culture. Double-headed swabs were used to collect anterior nasal specimens from each subject. For both tests, DNA was extracted and real-time PCR was performed according to manufacturer's instructions. For culture, one swab of the pair was plated directly to CHROMagar MRSA. The swab paired with the BD GeneOhm MRSA test was also placed into an enrichment broth and then plated to CHROMagar MRSA. Colonies resembling staphylococci were confirmed as S. aureus by standard methods. Discrepant specimens had further testing with additional attempts to grow MRSA as well as sample amplicon sequencing. Agreement between results for the two swabs was 99.3% for those with valid results. A total of 1,402 specimens were tested using direct culture detection of MRSA as the gold standard; 187 were culture positive for MRSA. The LightCycler MRSA advanced test had relative sensitivity and specificity of 95.2% (95% confidence interval [CI]: 91.1% to 97.8%) and 96.4% (95% CI: 95.2% to 97.4%), respectively. The BD GeneOhm assay had relative sensitivity and specificity of 95.7% (95% CI: 91.7% to 98.1%) and 91.7% (95% CI: 90.0% to 93.2%), respectively. Following discrepancy analysis, the relative sensitivities of the LightCycler MRSA advanced test and the BD GeneOhm MRSA assay were 92.2 and 93.2%, respectively; relative specificities were 98.9 and 94.2%, respectively. Specificity was significantly better (P<0.001) with the LightCycler MRSA advanced test. The sensitivity of direct culture was 80.4%. The LightCycler MRSA advanced test is a useful tool for sensitive and rapid detection of MRSA nasal colonization.
耐甲氧西林金黄色葡萄球菌（MRSA）感染率在许多医疗环境中持续上升。快速检测 MRSA 定植并进行适当的隔离可以减少传播和感染。我们比较了罗氏 LightCycler MRSA 高级检测与 BD GeneOhm MRSA 检测和培养的性能。双头拭子用于从每个受试者收集前鼻标本。对于两种检测方法，均按照制造商的说明提取 DNA 并进行实时 PCR。对于培养，一对拭子中的一个直接接种到 CHROMagar MRSA 平板上。与 BD GeneOhm MRSA 检测配套的拭子也被放入富集肉汤中，然后接种到 CHROMagar MRSA 平板上。类似于葡萄球菌的菌落通过标准方法确认为金黄色葡萄球菌。对有差异的标本进行进一步的检测，包括尝试进一步培养 MRSA 以及样本扩增子测序。对于有有效结果的两种拭子，结果的一致性为 99.3%。使用直接培养检测 MRSA 作为金标准共检测了 1402 份标本；其中 187 份标本培养出 MRSA 阳性。LightCycler MRSA 高级检测的相对灵敏度和特异性分别为 95.2%（95%置信区间[CI]：91.1%至 97.8%）和 96.4%（95% CI：95.2%至 97.4%）。BD GeneOhm 检测的相对灵敏度和特异性分别为 95.7%（95% CI：91.7%至 98.1%）和 91.7%（95% CI：90.0%至 93.2%）。在差异分析后，LightCycler MRSA 高级检测和 BD GeneOhm MRSA 检测的相对灵敏度分别为 92.2%和 93.2%；相对特异性分别为 98.9%和 94.2%。LightCycler MRSA 高级检测的特异性显著更好（P<0.001）。直接培养的灵敏度为 80.4%。LightCycler MRSA 高级检测是一种用于敏感、快速检测 MRSA 鼻腔定植的有用工具。
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