1887

Abstract

Meticillin-resistant (MRSA) bloodstream infection is responsible for significant morbidity, with mortality rates as high as 60 % if not treated appropriately. We describe a rapid method to detect MRSA in blood cultures using a combined three-hour short-incubation BRUKER matrix-assisted laser desorption/ionization time-of-flight MS BioTyper protocol and a qualitative immunochromatographic assay, the Alere Culture Colony Test PBP2a detection test. We compared this combined method with a molecular method detecting the and genes currently performed in our laboratory. One hundred and seventeen blood cultures were tested of which 35 were MRSA and 82 were meticillin-sensitive (MSSA). The rapid combined test correctly identified 100 % (82/82) of the MSSA and 85.7 % (30/35) of the MRSA after 3 h. There were five false negative results where the isolates were correctly identified as , but PBP2a was not detected by the Culture Colony Test. The combined method has a sensitivity of 87.5 %, specificity of 100 %, a positive predictive value of 100 % and a negative predictive value of 94.3 % with the prevalence of MRSA in our blood cultures. The combined rapid method offers a significant benefit to early detection of MRSA in positive blood cultures.

Keyword(s): Bacteremia , MALDI-ToF , MRSA , PBP2a and Rapid
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2016-07-01
2024-03-28
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References

  1. Al-Talib H., Yean C. Y., Al-Khateeb A., Hassan H., Singh K. K., Al-Jashamy K., Ravichandran M. 2009; A pentaplex PCR assay for the rapid detection of methicillin-resistant Staphylococcus aureus and Panton-Valentine Leucocidin. BMC Microbiol 9:113 [View Article][PubMed]
    [Google Scholar]
  2. Anantha R. V., Jegatheswaran J., Pepe D. L., Priestap F., Delport J., Haeryfar S. M., McCormick J. K., Mele T. 2014; Risk factors for mortality among patients with Staphylococcus aureus bacteremia: a single-centre retrospective cohort study. CMAJ Open 2:E352E359 [View Article][PubMed]
    [Google Scholar]
  3. Brakstad O. G., Aasbakk K., Maeland J. A. 1992; Detection of Staphylococcus aureus by polymerase chain reaction amplification of the nuc gene. J Clin Microbiol 30:1654–1660[PubMed]
    [Google Scholar]
  4. Cavassini M., Wenger A., Jaton K., Blanc D. S., Bille J. 1999; Evaluation of MRSA-Screen, a simple anti-PBP 2a slide latex agglutination kit, for rapid detection of methicillin resistance in Staphylococcus aureus . J Clin Microbiol 37:1591–1594[PubMed]
    [Google Scholar]
  5. Cluff L. E., Reynolds R. C., Page D. L., Breckenridge J. L. 1968; Staphylococcal bacteremia and altered host resistance. Ann Intern Med 69:859–873 [View Article][PubMed]
    [Google Scholar]
  6. Cosgrove S. E., Sakoulas G., Perencevich E. N., Schwaber M. J., Karchmer A. W., Carmeli Y. 2003; Comparison of mortality associated with methicillin-resistant and methicillin-susceptible Staphylococcus aureus bacteremia: a meta-analysis. Clin Infect Dis 36:53–59 [View Article][PubMed]
    [Google Scholar]
  7. Davis T. E., Fuller D. D. 1991; Direct identification of bacterial isolates in blood cultures by using a DNA probe. J Clin Microbiol 29:2193–2196[PubMed]
    [Google Scholar]
  8. Ellem J. A., Olma T., O'Sullivan M. V. 2015; Rapid detection of methicillin-resistant Staphylococcus aureus and methicillin-susceptible S . aureus directly from positive blood cultures by use of the BD Max StaphSR assay. J Clin Microbiol 53:3900–3904 [View Article][PubMed]
    [Google Scholar]
  9. Fowler V. G Jr, Olsen M. K., Corey G. R., Woods C. W., Cabell C. H., Reller L. B., Cheng A. C., Dudley T., Oddone E. Z. 2003; Clinical identifiers of complicated Staphylococcus aureus bacteremia. Arch Intern Med 163:2066–2072 [View Article][PubMed]
    [Google Scholar]
  10. Hussain Z., Stoakes L., Massey V., Diagre D., Fitzgerald V., El Sayed S., Lannigan R. 2000; Correlation of oxacillin MIC with mecA gene carriage in coagulase-negative staphylococci. J Clin Microbiol 38:752–754[PubMed]
    [Google Scholar]
  11. Ippolito G., Leone S., Lauria F. N., Nicastri E., Wenzel R. P. 2010; Methicillin-resistant Staphylococcus aureus : the superbug. Int J Infect Dis 14:S7–S11 [View Article][PubMed]
    [Google Scholar]
  12. Julander I. 1985; Unfavourable prognostic factors in Staphylococcus aureus septicemia and endocarditis. Scand J Infect Dis 17:179–187 [View Article][PubMed]
    [Google Scholar]
  13. Kim S. H., Kim K. H., Kim H. B., Kim N. J., Kim E. C., Oh M. D., Choe K. W. 2008; Outcome of vancomycin treatment in patients with methicillin-susceptible Staphylococcus aureus bacteremia. Antimicrobial Agents Chemother 52:192–197 [View Article]
    [Google Scholar]
  14. Klevens R. M., Edwards J. R., Tenover F. C., McDonald L. C., Horan T., Gaynes R. National Nosocomial Infections Surveillance System 2006; Changes in the epidemiology of methicillin-resistant Staphylococcus aureus in intensive care units in US hospitals, 1992–2003. Clin Infect Dis 42:389–391 [View Article]
    [Google Scholar]
  15. Laupland K. B., Ross T., Gregson D. B. 2008; Staphylococcus aureus bloodstream infections: risk factors, outcomes, and the influence of methicillin resistance in Calgary, Canada, 2000–2006. J Infect Dis 198:336–343 [View Article][PubMed]
    [Google Scholar]
  16. Layton M. C., Hierholzer W. J., Patterson J. E. 1995; The evolving epidemiology of methicillin-resistant Staphylococcus aureus at a university hospital. Infect Control Hosp Epidemiol 16:12–17 [View Article][PubMed]
    [Google Scholar]
  17. Li M., Diep B. A., Villaruz A. E., Braughton K. R., Jiang X., DeLeo F. R., Chambers H. F., Lu Y., Otto M. 2009; Evolution of virulence in epidemic community-associated methicillin-resistant Staphylococcus aureus . Proc Natl Acad Sci U S A 106:5883–5888 [View Article][PubMed]
    [Google Scholar]
  18. Lodise T. P., McKinnon P. S., Rybak M. 2003; Prediction model to identify patients with Staphylococcus aureus bacteremia at risk for methicillin resistance. Infect Control Hosp Epidemiol 24:655–661 [View Article][PubMed]
    [Google Scholar]
  19. Lodise T. P., McKinnon P. S., Levine D. P., Rybak M. J. 2007; Impact of empirical-therapy selection on outcomes of intravenous drug users with infective endocarditis caused by methicillin-susceptible Staphylococcus aureus . Antimicrob Agents Chemother 51:3731–3733 [View Article]
    [Google Scholar]
  20. Lowy F. D. 1998; Staphylococcus aureus infections. N Engl J Med 339:520–532 [View Article][PubMed]
    [Google Scholar]
  21. McConeghy K. W., Bleasdale S. C., Rodvold K. A. 2013; The empirical combination of vancomycin and a β -lactam for staphylococcal bacteremia. Clin Infect Dis 57:1760–1765 [View Article][PubMed]
    [Google Scholar]
  22. Melzer M., Eykyn S. J., Gransden W. R., Chinn S. 2003; Is methicillin-resistant Staphylococcus aureus more virulent than methicillin-susceptible S . aureus ? A comparative cohort study of British patients with nosocomial infection and bacteremia. Clin Infect Dis 37:1453–1460 [View Article][PubMed]
    [Google Scholar]
  23. Mitchell D. H., Howden B. P. 2005; Diagnosis and management of Staphylococcus aureus bacteraemia. Intern Med J 35:S17–S24 [View Article][PubMed]
    [Google Scholar]
  24. Mongkolrattanothai K., Aldag J. C., Mankin P., Gray B. M. 2009; Epidemiology of community-onset Staphylococcus aureus infections in pediatric patients: an experience at a Children's Hospital in central Illinois. BMC Infect Dis 9:112 [View Article][PubMed]
    [Google Scholar]
  25. NNIS System 1999; National Nosocomial Infections Surveillance (NNIS) System Report, Data Summary from January 1990-May 1999, issued June 1999. A report from the NNIS System. Am J Infect Control 27:520–532 [View Article][PubMed]
    [Google Scholar]
  26. Paul M., Kariv G., Goldberg E., Raskin M., Shaked H., Hazzan R., Samra Z., Paghis D., Bishara J. et al. 2010; Importance of appropriate empirical antibiotic therapy for methicillin-resistant Staphylococcus aureus bacteraemia. J Antimicrob Chemother 65:2658–2665 [View Article][PubMed]
    [Google Scholar]
  27. Peters R. P., van Agtmael M. A., Gierveld S., Danner S. A., Groeneveld A. B., Vandenbroucke-Grauls C. M., Savelkoul P. H. 2007; Quantitative detection of Staphylococcus aureus and Enterococcus faecalis DNA in blood to diagnose bacteremia in patients in the intensive care unit. J Clin Microbiol 45:3641–3646 [View Article][PubMed]
    [Google Scholar]
  28. Simor A. E., Gilbert N. L., Gravel D., Mulvey M. R., Bryce E., Loeb M., Matlow A., McGeer A., Louie L. et al. 2010; Methicillin-resistant Staphylococcus aureus colonization or infection in Canada: National Surveillance and Changing Epidemiology 1995-2007. Infect Control Hosp Epidemiol 31:348––356 [Crossref]
    [Google Scholar]
  29. Thompson R. L., Cabezudo I., Wenzel R. P. 1982; Epidemiology of nosocomial infections caused by methicillin-resistant Staphylococcus aureus . Ann Intern Med 97:309–317 [View Article][PubMed]
    [Google Scholar]
  30. van Hal S. J., Jensen S. O., Vaska V. L., Espedido B. A., Paterson D. L., Gosbell I. B. 2012; Predictors of mortality in Staphylococcus aureus bacteremia. Clin Microbiol Rev 25:362–386 [View Article][PubMed]
    [Google Scholar]
  31. Vannuffel P., Gigi J., Ezzedine H., Vandercam B., Delmee M., Wauters G., Gala J. L. 1995; Specific detection of methicillin-resistant Staphylococcus species by multiplex PCR. J Clin Microbiol 33:2864–2867[PubMed]
    [Google Scholar]
  32. Whitby M., McLaws M. L., Berry G. 2001; Risk of death from methicillin-resistant Staphylococcus aureus bacteraemia: a meta-analysis. Med J Aust 175:264–267[PubMed]
    [Google Scholar]
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