Original Article. Evaluation of Rapid Detection of Nasopharyngeal Colonization with MRSA by Real-Time PCR

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Abstract

Objective To investigate the clinical application of Real-Time PCR for rapid detection of methicillin-resistant Staphylococcus aureus (MRSA) directly from nasopharyngeal swab specimens.

Methods We collected the nasal and throat swab specimens from patients or medical staffs in 3 intensive care units, blood laminar flow ward and respiratory ward in Beijing Hospital, Ministry of Health from December 2010 to April 2011. Each sample was tested by RT-PCR and conventional culture-based method for the presence of MRSA.

Results The total number of the specimens was 206. Compared with the conventional culture-based method, we demonstrated the diagnostic values for Real-Time PCR were 96.4% sensitivity, 96.6% specificity, 81.8% positive predictive rate, and 99.4% negative predictive rate. And the limit of detection was 102CFU/ml.

Conclusions This Real-Time PCR is a simple, rapid, sensitive and specific method. With the high negative predictive value, it can be used for the exclusion of MRSA colonization or infection. However, the application of its low positive predictive value should be further evaluated.

1 Klein E, Smith DL, Laxminarayan R. Hospitalizations and deaths caused by methicillin- resistant Staphylococcus aureus, United States,1999-2005. Emerg Infect Dis 2007;13:1840-1846.

2 Klevens RM, Nadle J, Petit S, Petit S, Gershman K, Ray S, et al. Invasive methicillin-resistant Staphylococcus aureus infections in the United States. JAMA 2007;298:1763-1771.

3 Maree CL, Matayoshi K, Miller LG, Matayoshi K, Miller LG. Community-associated methicillin-resistant Staphylococcus aureus isolates causing healthcare-associated infections. Emerg Infect Dis 2007;1:236-242.

4 Yamamoto T, Ito T, Lijima M, Nonoyama M, Ishii M, Baranovich T, et al. Pediatric pneumonia death caused by community-acquired methicillin-resistant Staphylococcus aureus. Emerg Infect Dis 2008;14:1312-1314.

5 Leclercq R. Epidemiological and resistance issues in multidrugresistant staphylococci and enterococci. Clin Microbiol Infect 2009;15:224-231.

6 Rohr U, Kaminski A, Wilhelm M, Jurzik L, Gatermann S, Muhr G. Colonization of patients and contamination of the patients’ environment by MRSA under conditions of single-room isolation. Int J Hyg Environ Health 2009;212:209-215.

7 Coello R, Gaspar C, Fereres J, Picazo JJ, Fereres J. Risk factors for developing clinical infection with methicillin-resistant Staphylococcus aureus (MRSA) amongst hospital patients initially only colonized with MRSA. J Hosp Infect 1997;37:39-46.

8 Harbarth S. Control of endemic methicillin-resistant Staphylococcus aureus-recent advances and future challenges. Clin Microbiol Infect 2006;12:1154-1162.

9 Boucher HW, Corey GR. Epidemiology of methicillin-resistant Staphylococcus aureus. Clin Infect Dis 2008;46:s344-s349.

10 Coia JE, Duckworth GJ, Farrington M, Farrington M, Fry C, Humphreys H, et al. Guidelines for the control and prevention of meticillin-resistant Staphylococcus aureus (MRSA) in healthcare facilities. J Hosp Infect 2006;63:s1-s44.

11 Nathwani D, Morgan M, Masterton RG, Dryden M, Cookson BD, French G, et al. Guidelines for UK practice for the diagnosis and management of methicillin-resistant Staphylococcus aureus (MRSA) infections presenting in the community. J Antimicrob Chemother 2008;61:976-994.

12 Weber SG, Huang SS, Oriola S, W. Huskins C, Noskin GA, Harriman K, et al. Legislative mandates for use of active surveillance cultures to screen for methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci: position statement from the Joint SHEA and APIC Task Force. Am J Infect Control 2007;35:73-85.

13 Cunningham R, Jenks P, Northwood J, Wallis M, Ferguson S, Hunt S. Effect on MRSA transmission of rapid PCR testing of patients admitted to critical care. J Hosp Infect 2007;65:24-28.

14 Bootsma MC, Diekmann O, Bonten MJ. Controlling methicillinresistant Staphylococcus aureus: quantifying the effects of interventions and rapid diagnostic testing. Proc Nat Acad Sci USA 2006;103:5620-5625.

15 Rossney AS, Herra CM, Morgan PM, Morgan PM, O’Connell B. Evaluation of the Xpert methicillin-resistant Staphylococcus aureus (MRSA) assay using the genexpert Real-Time PCR platform for rapid detection of mrsa from screening specimens. J Clin Microbil 2008;46:3285-3290.

16 Elsayed S, Chow BL, Hamilton NL, Gregson DB, Pitout JD, Church DL, et al. Development and validation of a molecular beacon probe-based Real-Time polymerase chain reaction assay for rapid detection of methicillin resistance in Staphylococcus aureus. Arch Pathol Lab Med 2003;127:845-849.

17 Kipp F, Becker K, Peters G, von Eiff C. Evaluation of different methods to detect methicillin resistance in small-conoy variants of staphylococcus aureus. J Clin Microbiol 2004;42:1277-1279.

18 Nulens E, Descheemaeker P, Deurenberg RH, Stobberingh EE, Gordts B. Contribution of two molecular assays as compared to selective culture for MRSA screening in a low MRSA prevalence population. Infection 2010;38:98-101.

19 Paule S. M, Mehta M, Robicsek A, Gonzalzles TM, Robicsek A, Peterson LR. Chromogenic media versus Real-Time PCR for nasal surveillance of methicillin-resistant Staphylococcus aureus: impact on detection of MRSA- positive persons. Am J Clin Pathol 2009;131:532-539.

20 San ND, Denis O, Gasasira MF, Mendonça RD, Nonhoff C, Struelens MJ. Controlled evaluation of the IDI-MRSA assay for detection of colonization by methicillin-resistant Staphylococcus aureus in diverse mucocutaneous specimens. J Clin Microbiol 2007;45:1098-1101.

21. Francois P, Bento M, Renzi G, Harbarth S, Pittet D, Schrenzel J. Evaluation of three molecular assays for rapid identification of methicillin-resistant Staphylococcus aureus. J Clin Microbiol 2007;45:2011-2013.

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