Department of Medical Microbiology, Vaccine & Infectious Disease Institute, Universiteit Antwerpen, Antwerp, Belgium.
Eur J Clin Microbiol Infect Dis. 2012 Aug;31(8):1765-70. doi: 10.1007/s10096-011-1499-0. Epub 2011 Dec 11.
Twenty-three hospital laboratories from Europe and Israel participated in an external quality assessment (EQA) of the culture-based detection of methicillin-resistant Staphylococcus aureus (MRSA). Participants also reported the MRSA prevalence in clinical cultures and patient screening specimens, as well as the MRSA screening practices employed at their hospitals. An EQA panel of 18 samples consisting of two MRSA harbouring SCCmec IV and I, and one strain each of methicillin-resistant coagulase-negative S. epidermidis, methicillin-sensitive S. aureus and Escherichia coli as pure strains or in mixtures at 10(7)-1 cfu absolute loads was analysed by the 23 participants. Seventeen (74%) participants identified 17 or more samples correctly. Of these, 15 (88%) utilised a chromogenic medium alone (ChromID, bioMérieux; BBL CHROMagar, BD Diagnostics; MRSA Select, Bio-Rad Laboratories) or combined with a conventional medium and up to three confirmatory tests. Proportions of MRSA among S. aureus isolated from clinical cultures varied widely, even among hospitals within countries, ranging from 11-20% to 61-70%. MRSA carriage rates were less variable (0-20%) between countries. Almost all participants (n=22, 96%) screened patients for MRSA carriage during 2009-2010, of which 15 (68%) screened intensive care unit (ICU) patients alone or combined with other targeted high-risk groups, and 10 (45%) combined nasal screening with another body site.
23 家来自欧洲和以色列的医院实验室参与了耐甲氧西林金黄色葡萄球菌 (MRSA) 基于培养的检测的外部质量评估 (EQA)。参与者还报告了临床培养物和患者筛查标本中的 MRSA 流行率，以及他们所在医院使用的 MRSA 筛查实践。由 23 名参与者分析了由 18 个样本组成的 EQA 小组，其中包括两个携带 SCCmec IV 和 I 的 MRSA，以及一个耐甲氧西林凝固酶阴性葡萄球菌、甲氧西林敏感金黄色葡萄球菌和大肠埃希菌的纯菌株或在 10(7)-1 cfu 绝对负荷下的混合物菌株。17 名（74%）参与者正确识别了 17 个或更多样本。其中，15 名（88%）单独使用显色培养基（生物梅里埃的 ChromID；BD 诊断的 BBL CHROMagar；Bio-Rad Laboratories 的 MRSA Select）或与常规培养基结合使用，并进行了多达三种确认试验。从临床培养物中分离的金黄色葡萄球菌中 MRSA 的比例差异很大，即使在国家内的医院之间也是如此，范围从 11-20%到 61-70%。MRSA 携带率在国家之间的差异较小（0-20%）。几乎所有参与者（n=22，96%）在 2009-2010 年期间对患者进行了 MRSA 携带筛查，其中 15 名（68%）单独或与其他目标高危人群一起筛查重症监护病房（ICU）患者，10 名（45%）将鼻腔筛查与另一个身体部位结合起来。
