We compared the performance of Staphychrom II (International Microbio, Signes, France), a rapid (2-h) chromogenic staphylocoagulase test that uses human prothrombin and protease inhibitors, with those of the reference tube coagulase test (TCT) and the latex agglutination test (LAT) Slidex Staph Plus for the rapid identification of S. aureus. Prospective evaluation with 293 fresh clinical isolates yielded sensitivities, specificities, and predictive and negative predictive values of 98.1, 100, 100, and 95.1%, respectively, for the Staphychrom II test; 98.6, 98.7, 99.6, and 96.3%, respectively, for LAT; and 97.6, 98.7, 99.5, and 93.9%, respectively, for TCT. The perfect specificity of the Staphychrom II test was confirmed by testing 193 collection strains selected because of their potential testing pitfalls. The Staphychrom II test was positive for 90% of the 215 S. aureus strains tested after only 1 h of incubation. The Staphychrom II test was as sensitive as the reference TCT and was 100% specific.Rapid identification of Staphylococcus aureus is a major priority for clinical microbiologists. The tube coagulase test (TCT) is the reference method for distinguishing S. aureus and rare coagulase-positive non-S. aureus staphylococci (e.g., S. intermedius) from coagulase-negative staphylococci. However, this test requires 18 to 24 h of incubation and is not perfectly reliable (1,13,16,18). Agglutination tests with either erythrocytes or latex particles coated with various ligands may lack sensitivity, notably, for methicillin-resistant S. aureus (MRSA), and may also lack specificity for non-S. aureus staphylococci, such as S. lugdunensis, S. schleiferi, and S. intermedius (3,8,14,15).In the present study we evaluated Staphychrom II (International Microbio, Signes, France), a rapid (2-h) chromogenic staphylocoagulase test which specifically detects S. aureus, and compared the results obtained with those obtained by a reference TCT (Becton Dickinson, Le Pont de Claix, France) and the latex agglutination test (LAT) Slidex Staph Plus (bioMérieux, Marcy l'Etoile, France). The tests were compared prospectively with 293 clinical isolates in two clinical laboratories and retrospectively with 193 typical and atypical collection strains chosen because of their potential testing pitfalls.
MATERIALS AND METHODS
Test organisms. From March 2002 to May 2002, a total of 293Staphylococcus isolates were prospectively tested at Bellevue Hospital, Saint Etienne, France (n ϭ 149) or Debrousse Hospital, Lyon, France (n ϭ 144). They comprised 215 S. aureus isolates (43 MRSA strains and 172 methicillin-susceptible strains) and 78 non-S. aureus staphylococci. The 78 non-S. aureus isolates comprised S. capitis (n ϭ 14), S. caprae (n ϭ 3), S. cohnii (n ϭ 1), S. epidermidis (n ϭ 49), S. haemolyticus (n ϭ 3), S. hominis (n ϭ 4), S. simulans (n ϭ 2), and S. warneri (n ϭ 2). The strains were isolated from the following clinical specimens: pus (n ϭ 85), respiratory tract (n ϭ 83), nose (n ϭ 32), blood (n ϭ 26), catheter (n ϭ 22), urine (n ϭ 13), sto...