Detection of oxacillin-resistant staphylococci by the AutoMicrobic system.

The AutoMicrobic system (Vitek Systems, Inc., Hazelwood, Mo.) is an automated instrument designed for rapid microbiological identification and susceptibility reporting in the clinical laboratory. The reliability of a rapid, automated approach to testing methicillin-resistant staphylococci was evaluated. To determine the accuracy in detecting oxacillin-methicillin resistance by the AutoMicrobic system, 746 staphylococci from seven different geographical areas were tested. Results were compared with the Bauer-Kirby agar disk diffusion technique as the reference method. Of the 304 staphylococci, 209 coagulase-positive and 95 coagulase-negative strains were resistant to oxacillin-methicillin. These organisms fell into three categories of resistance detection. The first category had resistance levels high enough for initial detection, the second category had low resistance levels requiring modified data analysis techniques for detection, and the third category had resistance levels too low for detection. Of the resistant strains tested, 21% showed a category two resistant growth pattern. Major errors, as a result of hetero-resistant growth patterns of the tested strains, were resolved by computer analysis of growth curves. These data analysis applications enabled detection of 96% of the oxacillin-methicillin-resistant organisms. Results for all resistant staphylococci tested were available in an average time of 5.5 h.