Can the use of a rapid polymerase chain screening method decrease the incidence of nosocomial meticillin-resistant Staphylococcus aureus?

Aldeyab, Mamoon A.; Kearney, Mary P.; Hughes, Carmel; Scott, Michael; Tunney, Michael; Gilpin, D.F.; Devine, Michael J.; Watson, J.D.; Gardiner, Angela; Funston, Chris; Savage, Kimberley A.; McElnay, James

doi:10.1016/j.jhin.2008.10.011

Cited by 33 publications

(32 citation statements)

References 13 publications

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“…Batch PCR is rapid on paper but presents one major issue. Indeed, several studies have demonstrated that as samples are awaited in order to run the assay, results are generally available in a minimum of one working day (compared to 2 to 4 working days for culture) (2,9,21,25).…”

Section: Discussionmentioning

confidence: 99%

Direct Detection of Staphylococcus Osteoarticular Infections by Use of Xpert MRSA/SA SSTI Real-Time PCR

et al. 2011

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We evaluated the Xpert MRSA/SA SSTI real-time PCR assay (Cepheid, Sunnyvale, CA) directly on perioperative bone and joint samples. The sensitivity and specificity for detection of methicillin-susceptible Staphylococcus aureus (MSSA), methicillin-resistant Staphylococcus aureus (MRSA), and methicillin-resistant coagulase-negative Staphylococcus were, respectively, 100% and 98.3%, 100% and 100%, and 100% and 95.3%. The median total test turnaround time was 72 min for PCR versus 79 h for culture. Using these rapid results, appropriate antibiotic treatment could be rapidly initiated.

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Section: Discussionmentioning

confidence: 99%

Direct Detection of Staphylococcus Osteoarticular Infections by Use of Xpert MRSA/SA SSTI Real-Time PCR

et al. 2011

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“…Nasal colonization is now commonly being determined by PCR-based testing (1,8,9) due to its ease of implementation, reliability, and rapid results. An additional advantage of PCR-based tests is an easily obtained measure of quantification in the C T .…”

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confidence: 99%

Cepheid Xpert MRSA Cycle Threshold in Discordant Colonization Results and as a Quantitative Measure of Nasal Colonization Burden

et al. 2012

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We analyzed the cycle threshold (C T ) of PCR surveillance MRSA swabs obtained from veterans. Lower C T on admission was associated with a positive culture from nasal swabs at discharge. Compared to PCR, direct plating of nasal swabs performed poorly, especially for patients with an elevated C T . The C T is strongly correlated with quantitative nasal cultures. Clinical and infection control applications of the C T have yet to be defined and warrant further evaluation.

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“…PCR-based MRSA screening assays have the potential to provide a result in 2 to 3 h of laboratory time and have a total turnaround time from specimen collection to ward report of approximately 20 h (1,16,21). The BD GeneOhm MRSA assay (previously known as IDI-MRSA; BD Diagnostics, San Diego, CA) and the Cepheid GeneXpert MRSA assay (Cepheid, Sunnyvale, CA) are two such PCR tests that detect the presence of characteristic MRSA DNA sequences bridging the SCCmec resistance cassette and the S. aureus-specific orfX open reading frame gene (18).…”

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confidence: 99%

Clinical Application of Real-Time PCR to Screening Critically Ill and Emergency-Care Surgical Patients for Methicillin-Resistant Staphylococcus aureus : a Quantitative Analytical Study

et al. 2009

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The clinical utility of real-time PCR screening assays for methicillin (meticillin)-resistant Staphylococcus aureus (MRSA) colonization is constrained by the predictive values of their results: as MRSA prevalence falls, the assay's positive predictive value (PPV) drops, and a rising proportion of positive PCR assays will not be confirmed by culture. We provide a quantitative analysis of universal PCR screening of critical care and emergency surgical patients using the BD GeneOhm MRSA PCR system, involving 3,294 assays over six months. A total of 248 PCR assays (7.7%) were positive; however, 88 failed to be confirmed by culture, giving a PPV of 65%.

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Can the use of a rapid polymerase chain screening method decrease the incidence of nosocomial meticillin-resistant Staphylococcus aureus?

Cited by 33 publications

References 13 publications

Direct Detection of Staphylococcus Osteoarticular Infections by Use of Xpert MRSA/SA SSTI Real-Time PCR

Direct Detection of Staphylococcus Osteoarticular Infections by Use of Xpert MRSA/SA SSTI Real-Time PCR

Cepheid Xpert MRSA Cycle Threshold in Discordant Colonization Results and as a Quantitative Measure of Nasal Colonization Burden

Clinical Application of Real-Time PCR to Screening Critically Ill and Emergency-Care Surgical Patients for Methicillin-Resistant Staphylococcus aureus : a Quantitative Analytical Study

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