May L, McCann C, Brooks G, Rothman R, Miller L, Jordan J
Department of Emergency Medicine, The George Washington University Medical Faculty Associates, Washington, DC; Department of Epidemiology and Biostatistics, School of Public Health and Health Services, The George Washington University, Washington, DC.
Department of Epidemiology and Biostatistics, School of Public Health and Health Services, The George Washington University, Washington, DC.
Diagn Microbiol Infect Dis. 2014 Sep;80(1):79-82. doi: 10.1016/j.diagmicrobio.2014.05.016. Epub 2014 May 20.
Extranasal sites are common reservoirs of Staphylococcus aureus colonization and may be relevant for methicillin-resistant S. aureus (MRSA) screening and infection control strategies. The objective here was to determine whether inguinal specimens could also be screened using Xpert SA Nasal Complete assay for MRSA. Results were compared to broth enrichment culture. Among 162 consented adults seeking care in the emergency department for cutaneous abscesses, inguinal specimens were found positive for MRSA more often than nares specimens, 24% and 26% by PCR or culture, respectively, compared to 19% each by PCR or culture. Overall, 6% of adults colonized with MRSA would have been missed by nares screening alone. Compared to culture, Xpert SA Nasal Complete assay demonstrated sensitivity and specificity of 89% and 97%, respectively, for detecting nares and/or inguinal MRSA colonization. In conclusion, inguinal specimens were a more common reservoir for MRSA than nares specimens in this population of patients.
鼻外部位是金黄色葡萄球菌定植的常见储存部位，可能与耐甲氧西林金黄色葡萄球菌（MRSA）筛查及感染控制策略相关。本研究的目的是确定是否也可以使用Xpert SA Nasal Complete检测法对腹股沟标本进行MRSA筛查。将结果与肉汤增菌培养法进行比较。在162名因皮肤脓肿到急诊科就诊并同意参与研究的成年人中，腹股沟标本MRSA检测呈阳性的情况比鼻腔标本更常见，PCR或培养法检测的阳性率分别为24%和26%，而鼻腔标本的PCR或培养法阳性率均为19%。总体而言，仅通过鼻腔筛查会遗漏6%携带MRSA的成年人。与培养法相比，Xpert SA Nasal Complete检测法检测鼻腔和/或腹股沟MRSA定植的灵敏度和特异度分别为89%和97%。总之，在这群患者中，腹股沟标本是比鼻腔标本更常见的MRSA储存部位。
