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首页> 外文期刊>Journal of Clinical Microbiology >Clinical Validation of the Molecular BD GeneOhm StaphSR Assay for Direct Detection of Staphylococcus aureus and Methicillin-Resistant Staphylococcus aureus in Positive Blood Cultures
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Clinical Validation of the Molecular BD GeneOhm StaphSR Assay for Direct Detection of Staphylococcus aureus and Methicillin-Resistant Staphylococcus aureus in Positive Blood Cultures

机译：直接检测阳性血培养中金黄色葡萄球菌和耐甲氧西林金黄色葡萄球菌的分子BD GeneOhm StaphSR分析的临床验证

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The rapid detection of Staphylococcus aureus bacteremia and a swift determination of methicillin susceptibility has serious clinical implications affecting patient mortality. This study evaluated the StaphSR assay (BD GeneOhm, San Diego, CA), a real-time PCR assay, for the identification and differentiation of methicillin-susceptible S. aureus (MSSA) and methicillin-resistant S. aureus (MRSA) from 300 positive blood cultures. The BD GeneOhm StaphSR assay was performed and interpreted according to the manufacturer's recommendations. Positive blood cultures (containing predominantly gram-positive cocci in clusters) were subcultured on 5% sheep blood agar plates. After 18 to 24 h of incubation, isolates morphologically consistent with S. aureus were presumptively identified by latex agglutination (Staphaurex Plus; Remel, Lenexa, KS). Susceptibility testing was initially performed with the Phoenix automated microbiology system (BD Diagnostics, Sparks, MD). Additional susceptibility testing of samples with discrepant results was done using BBL oxacillin screen agar (BD Diagnostics, Sparks, MD), oxacillin and cefoxitin Etests (AB Biodisk, Solna, Sweden) on Mueller-Hinton agar, an immunoassay for penicillin binding protein 2′ (Denka Seiken Co., Tokyo, Japan), and mecA PCR. The sensitivity, specificity, and positive and negative predictive values of the BD GeneOhm StaphSR assay for MSSA detection were 98.9, 96.7, 93.6, and 99.5%, respectively. For the detection of MRSA, the BD GeneOhm StaphSR assay was 100% sensitive and 98.4% specific; positive and negative predictive values for MRSA detection were 92.6 and 100%, respectively. Inhibition was seen with only one sample, and the issue was resolved upon retesting. The BD GeneOhm StaphSR assay appears to be a valuable diagnostic tool for quickly differentiating bacteremia caused by MSSA and MRSA from that caused by other gram-positive cocci.
机译：快速检测金黄色葡萄球菌菌血症和快速测定甲氧西林药敏性对患者死亡率具有严重的临床意义。这项研究评估了StaphSR测定法（BD GeneOhm，加利福尼亚州圣地亚哥），这是一种实时PCR测定法，用于甲氧西林敏感性 S的鉴定和区分。金黄色葡萄球菌（MSSA）和耐甲氧西林的 S。 300种阳性血液培养物中的金黄色葡萄球菌（MRSA）。 BD GeneOhm StaphSR测定法是根据制造商的建议进行的。将阳性血液培养物（簇中主要含有革兰氏阳性球菌）在5％羊血琼脂平板上继代培养。孵育18至24小时后，分离物在形态上与 S一致。据推测是通过乳胶凝集（Staphaurex Plus; Remel，Lenexa，KS）鉴定的。药敏试验最初是使用Phoenix自动化微生物系统（BD Diagnostics，Sparks，MD）进行的。使用BBL oxacillin筛选琼脂（BD Diagnostics，Sparks，MD），oxacillin和cefoxitin Etests（AB Biodisk，Solna，Sweden）在Mueller-Hinton琼脂上对青霉素结合蛋白2'进行的免疫测定对样品进行了其他敏感性测试。 （Denka Seiken Co.，日本东京）和 mecA PCR。 BD GeneOhm StaphSR分析对于MSSA检测的敏感性，特异性以及阳性和阴性预测值分别为98.9、96.7、93.6和99.5％。 BD GeneOhm StaphSR分析对于MRSA的检测具有100％的敏感性和98.4％的特异性; MRSA检测的阳性和阴性预测值分别为92.6和100％。仅一个样品可见抑制作用，该问题在重新测试后得以解决。 BD GeneOhm StaphSR分析看来是快速区分MSSA和MRSA引起的菌血症与其他革兰氏阳性球菌引起的菌血症的有价值的诊断工具。

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