Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, New York, USA.
Children's Healthcare of Atlanta, Atlanta, Georgia, USA.
J Clin Microbiol. 2019 Mar 28;57(4). doi: 10.1128/JCM.01417-18. Print 2019 Apr.
Non- staphylococcal species (non-SASS) are important pathogens in both animal and human populations. The development of β-lactam resistance in non-SASS through acquisition and expression of penicillin-binding protein 2a (PBP2a) represents a significant clinical and public health threat. Here, we evaluated the diagnostic performance of two versions of a PBP2a immunochromatographic assay with non-SASS. Our data show that the revised version of the assay, the PBP2a SA culture colony test, has superior diagnostic sensitivity compared to the previous version of the assay, the PBP2a culture colony test, 100% (95% confidence interval [CI], 93.3 to 100%) versus 67.9% (95% CI, 53.7 to 80.1%), respectively, while both assays display a specificity of 100% (95% CI, 92.5 to 100%). Therefore, the PBP2a SA culture colony test offers a rapid, accurate, and relatively inexpensive method for detecting PBP2a-mediated β-lactam resistance in clinically relevant non-SASS for the management of infections due to these organisms and for antimicrobial stewardship.
非葡萄球菌物种（非 SASS）是动物和人类群体中重要的病原体。非 SASS 通过获得和表达青霉素结合蛋白 2a（PBP2a）而产生的β-内酰胺耐药性是一个重大的临床和公共卫生威胁。在这里，我们评估了两种版本的 PBP2a 免疫层析检测法在非 SASS 中的诊断性能。我们的数据表明，与之前的检测方法（PBP2a 培养菌落检测法）相比，该检测方法的修订版本，即 PBP2a SA 培养菌落检测法，具有更高的诊断灵敏度，分别为 100%（95%置信区间 [CI]，93.3 至 100%）和 67.9%（95% CI，53.7 至 80.1%），而两种检测方法的特异性均为 100%（95% CI，92.5 至 100%）。因此，PBP2a SA 培养菌落检测法为检测临床相关非 SASS 中 PBP2a 介导的β-内酰胺耐药性提供了一种快速、准确且相对廉价的方法，可用于管理这些生物体引起的感染和抗菌药物管理。
