Department of Laboratory Medicine, Kyung Hee University Hospital at Gangdong, 892 Dongnam-ro, Gangdong-gu, Seoul 134-727, Korea.
Yonsei Med J. 2013 Sep;54(5):1282-4. doi: 10.3349/ymj.2013.54.5.1282.
Healthcare-associated infections caused by methicillin-resistant Staphylococcus aureus (MRSA) have recently become an important issue for healthcare facilities due to high rates of infection, mortality, and high treatment costs. We investigated the frequency of MRSA in healthcare workers (HCWs) via nasal carriage and assessed the performance of the LightCycler® MRSA Advanced test. We tested nasal swabs from the anterior nares of participating HCWs at an intensive care unit. Nasal swabs were identified as S. aureus, methicillin-sensitive or methicillin-resistant coagulase-negative staphylococci (MSCoNS or MRCoNS), or MRSA by using conventional culture and the LightCycler® MRSA Advanced test. Of the 142 HCWs who participated in this study, only 11 participants (7.8%) were MRSA-positive by conventional culture and MRSA ID, and 24 (16.9%) were positive for mecA by real time polymerase chain reaction (PCR). In terms of diagnostic performance, the LightCycler® MRSA Advanced test had a sensitivity of 100%, a specificity of 90.1%, a positive predictive value of 45.8%, and a negative predictive value of 100% compared with conventional culture method. The detection limit of the LightCycler® MRSA Advanced test was 10(3) colony/mL. We concluded that real-time PCR was able to rapidly and sensitively detect MRSA in HCWs. However, MRSA must be confirmed by culture due to false positivity.
耐甲氧西林金黄色葡萄球菌（MRSA）引起的医源性感染由于感染率、死亡率和高治疗费用高，最近已成为医疗机构的一个重要问题。我们通过鼻腔携带调查了医护人员（HCW）中 MRSA 的频率，并评估了 LightCycler®MRSA 高级检测的性能。我们对重症监护病房参与的 HCW 的前鼻孔进行了鼻腔拭子检测。通过常规培养和 LightCycler®MRSA 高级检测，鼻腔拭子被鉴定为金黄色葡萄球菌、甲氧西林敏感或耐甲氧西林凝固酶阴性葡萄球菌（MSCoNS 或 MRCoNS）或 MRSA。在参与本研究的 142 名 HCW 中，仅 11 名参与者（7.8%）经常规培养和 MRSA ID 呈 MRSA 阳性，24 名（16.9%）实时聚合酶链反应（PCR）检测 mecA 阳性。就诊断性能而言，与常规培养方法相比，LightCycler®MRSA 高级检测的灵敏度为 100%，特异性为 90.1%，阳性预测值为 45.8%，阴性预测值为 100%。LightCycler®MRSA 高级检测的检测限为 10（3）cfu/ml。我们得出结论，实时 PCR 能够快速灵敏地检测 HCW 中的 MRSA。然而，由于假阳性，必须通过培养来确认 MRSA。
