Guidelines for the laboratory diagnosis and susceptibility testing of methicillin-resistant Staphylococcus aureus (MRSA)

Abstract

These evidence-based guidelines have been produced after a literature review of the laboratory diagnosis and susceptibility testing of methicillin-resistant Staphylococcus aureus (MRSA). We have considered the detection of MRSA in screening samples and the detection of reduced susceptibility to glycopeptides in S. aureus. Recommendations are given for the identification of S. aureus and for suitable methods of susceptibility testing and screening for MRSA and for S. aureus with reduced susceptibility to glycopeptides. These guidelines indicate what tests should be used but not when the tests are applicable, as aspects of this are dealt with in guidelines on control of MRSA. There are currently several developments in screening media and molecular methods. It is likely that some of our recommendations will require modification as the new methods become available.

Prevalence of constitutive and inducible clindamycin resistance among clinical isolates of Staphylococcus aureus in a tertiary care institute in North India

“…Emergence of vancomycinintermediate S. aureus and more recently vancomycinresistant S. aureus is an additional concern. [23][24][25] Debnath et al has reported 7.22% MRSA strains resistance to linezolid. 26 Suggestions to use clindamycin, vancomycin and linezolid for MRSA as reserve drugs need to be emphasized in hospitals.…”

Phagocytosis and intracellular killing of heterogeneous vancomycin-intermediate Staphylococcus aureus strains

“…Meticillin resistance was determined by oxacillin Etest (AB Biodisk). MICs of vancomycin, teicoplanin, erythromycin, clindamycin, ciprofloxacin, gentamicin, amikacin, rifampicin, tigecycline, linezolid, daptomycin and quinupristin/dalfopristin were defined by Etest according to CLSI guidelines (Brown et al, 2005;Tó th et al, 2008;CLSI, 2009;Szabó et al, 2009). The suspected hVISA strains were examined using the macro Etest method (Tó th et al, 2008).…”

Clinical evaluation of Oxoid Brilliance MRSA Agar in comparison with bioMérieux MRSA ID medium for detection of livestock-associated meticillin-resistant Staphylococcus aureus

“…This includes both patients and healthcare workers (Muto et al, 2003). In human healthcare settings, different procedures employed for the detection of MRSA from clinical samples have variable results (Brown et al, 2005). Methods to detect MRSA in clinical samples ideally should have a high sensitivity and specificity combined with a short time to reporting of the results.…”