Evaluation of a new chromogenic medium for the detection of methicillin-resistant Staphylococcus aureus carriage on nasal and perianal specimens

Reyes, Romina C.; Stoakes, Luba; Milburn, Sue; Lennox, Gwen; Daniel, Janis; Silver, Shannon N.; Wijnker, E.; John, Michael; Hussain, Zafar

doi:10.1016/j.diagmicrobio.2007.09.011

Cited by 9 publications

(6 citation statements)

References 15 publications

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“…A study comparing CMRSA and MRSAS found that the two media gave similar results for the detection of MRSA from surveillance specimens 14. The sensitivity and specificity of the two media were similar in the present study.…”

Section: Discussionsupporting

confidence: 75%

Evaluation of Chromogenic MRSA medium, MRSASelectand Oxacillin Resistance Screening Agar for the detection of methicillin-resistantStaphylococcus aureus

et al. 2008

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Aims: An evaluation of Chromogenic MRSA medium (CMRSA), MRSASelect (MRSAS) and Oxacillin Resistance Screening Agar (ORSA) was performed to determine the optimum medium providing a rapid and sensitive method for methicillin-resistant Staphylococcus aureus (MRSA) detection. Methods: A total of 632 clinical specimens were cultured on the three media in first phase of the study, while 720 clinical specimens were cultured on CMRSA and ORSA in the second phase. Results: The sensitivity and specificity, respectively, of the media in the first phase were: CMRSA 88.9% and 98.45%; MRSAS 92.1% and 99.1%; ORSA (24 h incubation) 68.3% and 98.8%; and ORSA (48 h incubation) 85.7% and 96.3%. In the second phase the sensitivity and specificity, respectively, were CMRSA 91.2% and 98.6%; ORSA (24 h incubation) 58.9% and 98.2%; and ORSA (48 h incubation) 85.6% and 95.6%. The positive predictive values of the two chromogenic media were higher than that for ORSA. There were fewer false-positive results with the chromogenic media (1.4% for CMRSA and 0.8% for MRSAS) compared with ORSA (3.3%). Conclusions: Performing latex agglutination tests on growth from chromogenic media provides results for 93.8% of MRSA isolates within 24 h. There is a small increase in cost of chromogenic media compared with ORSA (£28 for MRSAS, and £36 for CMRSA, per 1000 specimens) and direct agglutination tests (£80 per 1000 specimens). However early availability of MRSA screening results can reduce the burden of MRSA in hospitals because of early implementation of infection control measures.

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Section: Discussionsupporting

confidence: 75%

Evaluation of Chromogenic MRSA medium, MRSASelectand Oxacillin Resistance Screening Agar for the detection of methicillin-resistantStaphylococcus aureus

et al. 2008

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“…We identified 599 publications, of which 28 met our inclusion criteria [15–42]. One additional eligible publication [43] was detected through the reference list of an enrolled publication (Fig.…”

Section: Resultsmentioning

confidence: 99%

Diagnostic accuracy of culture-based and PCR-based detection tests for methicillin-resistant Staphylococcus aureus: a meta-analysis

Luteijn

Hubben

Pechlivanoglou

et al. 2011

Clinical Microbiology and Infection

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A systematic review and meta-analysis were performed to determine and compare the sensitivity and specificity of PCR-based and culture-based diagnostic tests for methicillin-resistant Staphylococcus aureus (MRSA). Our analysis included 74 accuracy measurements from 29 publications. Nine tests were evaluated: the PCR-based Genotype MRSA Direct and IDI-MRSA, the chromogenic media CHROMagar, Chromogenic MRSA Medium, MRSA ID, MRSA Select and ORSAB, and the nonchromogenic culture media MSA-Cefoxitin and MSA-Oxacillin. For four chromogenic media, incubation periods of 18-24 and 48 h were evaluated. Considerable heterogeneity was detected in most analyses. A significantly higher sensitivity was found for the overall PCR pooled estimate (92.5; 95% CI 87.4-95.9) and the chromogenic media after 48 h of incubation (87.6; 95% CI 82.1-91.6) compared to the overall sensitivity of chromogenic media after 18-24 h (78.3; 95% CI 71.0-84.1). The specificity of chromogenic media after 18-24 h (98.6; 95% CI 97.7-99.1) was higher than the specificity of PCR (97.0; 95% CI 94.5-98.4) but declined after 48 h of incubation (94.7; 95% CI 91.6-96.8).The most sensitive chromogenic medium after 18-24 h of incubation was Chromogenic MRSA Medium (sensitivity: 89.3; 95% CI 72.8-96.3), whereas the most specific chromogenic medium after 18-24 h of incubation was MRSA Select (specificity: 99.4; 95% CI 98.6-99.7). After 48 h of incubation, MRSA Select had the highest sensitivity (93.2; 95% CI 83.5-97.0), whereas CHROMagar had the highest specificity (96.4; 95% CI 91.3-98.5). This meta-analysis showed statistically significant differences in diagnostic accuracy between several of the tests and the test methods evaluated. A reduction of the incubation time of chromogenic media (from 48 to 18-24 h) increases specificity but reduces sensitivity.

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“…Sensitivities for MRSA detection from nonnasal samples decrease either due to a larger amount of competing flora or due to lower levels of MRSA colonization at these anatomical sites. However, 2.6% to 26.9% of MRSA-colonized patients show exclusive groin, rectal, or perianal carriage and would be overlooked on nasal screening, which emphasizes the importance of screening nonnasal sites for MRSA carriage (4,33,44). van Hal et al compared the performances of ChromID, MRSA Select, and CHROMagar with nose, groin, and axilla swabs (39).…”

Section: "Rapid" Culture-based Detection Methodsmentioning

confidence: 99%

Current Trends in Rapid Diagnostics for Methicillin-Resistant Staphylococcus aureus and Glycopeptide-Resistant Enterococcus Species

et al. 2008

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Evaluation of a new chromogenic medium for the detection of methicillin-resistant Staphylococcus aureus carriage on nasal and perianal specimens

Cited by 9 publications

References 15 publications

Evaluation of Chromogenic MRSA medium, MRSASelectand Oxacillin Resistance Screening Agar for the detection of methicillin-resistantStaphylococcus aureus

Evaluation of Chromogenic MRSA medium, MRSASelectand Oxacillin Resistance Screening Agar for the detection of methicillin-resistantStaphylococcus aureus

Diagnostic accuracy of culture-based and PCR-based detection tests for methicillin-resistant Staphylococcus aureus: a meta-analysis

Current Trends in Rapid Diagnostics for Methicillin-Resistant Staphylococcus aureus and Glycopeptide-Resistant Enterococcus Species

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