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首页> 外文期刊>Journal of Clinical Microbiology >Evaluation of Three Techniques for Detection of Low-Level Methicillin-Resistant Staphylococcus aureus (MRSA): a Disk Diffusion Method with Cefoxitin and Moxalactam, the Vitek 2 System, and the MRSA-Screen Latex Agglutination Test
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Evaluation of Three Techniques for Detection of Low-Level Methicillin-Resistant Staphylococcus aureus (MRSA): a Disk Diffusion Method with Cefoxitin and Moxalactam, the Vitek 2 System, and the MRSA-Screen Latex Agglutination Test

机译：评价三种检测低水平耐甲氧西林金黄色葡萄球菌（MRSA）的技术：头孢西丁和莫拉西坦的圆盘扩散方法，Vitek 2系统和MRSA-Screen乳胶凝集试验

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Very-low-level methicillin-resistant Staphylococcus aureus (MRSA), or class 1 MRSA, is often misdiagnosed as methicillin-susceptible S. aureus (MSSA). We evaluated the performances of three methods for detection of low-level methicillin resistance: the disk diffusion method using the cephamycin antibiotics cefoxitin and moxalactam, the Vitek 2 system (bioMérieux), and the MRSA-screen test (Denka). Detection of the mecA gene by PCR was considered to be the “gold standard.” We also determined the sensitivity of the oxacillin disk diffusion method with 5- and 1-μg disks and that of the Oxascreen agar assay with 6 mg of oxacillin liter?1 for detection of MRSA. We compared the distributions of MICs of oxacillin and cefoxitin by the E-test (AB Biodisk), and those of moxalactam by dilutions in agar, for MRSA and MSSA isolates. The 152 clinical isolates of S. aureus studied were divided into 69 MSSA (mecA-negative) and 83 MRSA (mecA-positive) isolates, including 63 heterogeneous isolates and 26 class 1 isolates (low-level resistance). The cefoxitin and moxalactam disk diffusion tests detected 100% of all the MRSA classes: cefoxitin inhibition zone diameters were <27 mm, and moxalactam inhibition zone diameters were <24 mm. The Vitek 2 system and the MRSA-screen test detected 94 and 97.6% of all MRSA isolates, respectively. The sensitivities of the 5- and 1-μg oxacillin disks were 95.2 and 96.4%, respectively, whereas that of the Oxascreen agar screen assay was 94%. All of the tests except the 1-μg oxacillin disk test were 100% specific. For the class 1 MRSA isolates, the sensitivity of the Vitek 2 test was 92.3%, whereas those of the MRSA-screen test and the disk diffusion method with cefoxitin and moxalactam were 100%. Therefore, the cefoxitin and moxalactam disk diffusion methods were the best-performing tests for routine detection of all classes of MRSA.
机译：极低水平的耐甲氧西林的金黄色葡萄球菌（MRSA）或1类MRSA通常被误诊为对甲氧西林敏感的 S。金黄色（MSSA）。我们评估了三种检测低水平甲氧西林耐药性的方法的性能：使用头孢霉素抗生素头孢西丁和莫拉西坦的圆盘扩散法，Vitek 2系统（bioMérieux）和MRSA筛查法（Denka）。通过PCR检测 mecA 基因被认为是“黄金标准”。我们还确定了使用5μg和1-μg盘的奥沙西林盘扩散法和使用6 mg oxacillin升？1 的Oxascreen琼脂测定法检测MRSA的灵敏度。对于MRSA和MSSA分离物，我们通过E检验（AB Biodisk）比较了奥沙西林和头孢西丁的MIC分布，以及通过琼脂稀释对莫西内酰胺的MIC分布。 152种 S的临床分离株。研究的金黄色葡萄球菌分为69种MSSA（ mecA 阴性）和83种MRSA（ mecA 阳性）分离株，包括63种异种分离株和26种1类分离株（低级电阻）。头孢西丁和莫拉内酰胺纸片扩散测试检测到所有MRSA类型中的100％：头孢西丁抑制区直径＜27 mm，莫沙酰胺抑制区直径＜24 mm。 Vitek 2系统和MRSA筛选测试分别检测到所有MRSA分离株的94和97.6％。 5-μg和1-μg奥沙西林片的灵敏度分别为95.2％和96.4％，而Oxascreen琼脂筛查法的灵敏度为94％。除1μg奥沙西林纸片测试外，所有测试均为100％特异的。对于1类MRSA分离株，Vitek 2试验的灵敏度为92.3％，而MRSA筛选试验和头孢西丁和莫拉西坦的圆盘扩散法的灵敏度为100％。因此，头孢西丁和莫拉内酰胺纸片扩散法是常规检测所有类别的MRSA的最佳测试方法。

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