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

Verkade, Erwin; Ferket, Marianne; Kluytmans, Jan

doi:10.1099/jmm.0.021964-0

Cited by 14 publications

(14 citation statements)

References 15 publications

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“…It should be noted that the study size limits the detection of small differences in sensitivity. The most striking finding of this study is that almost half of all MRSA isolates remained undetected when using direct culture only, an observation which confirms previous reports that broth enrichment is essential for detection of MRSA (1,(3)(4)(5).…”

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confidence: 78%

“…Several chromogenic selective media have been developed to facilitate such screening. We previously compared the diagnostic performances of two of these media, Brilliance MRSA agar (Thermo Fisher Scientific) and MRSA-ID (bioMérieux, France), for the detection of MRSA in nose and throat samples taken from veterinarians and their household members (1). Although sensitivities were high and similar for both media, the specificity of the Brilliance MRSA agar (88.7%) was substantially less than that of MRSA-ID (98.5%).…”

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confidence: 99%

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Evaluation of Brilliance MRSA 2 Agar for Detection of Methicillin-Resistant Staphylococcus aureus in Clinical Samples

et al. 2013

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We compared 2 chromogenic media (Oxoid Brilliance MRSA 2 agar [Thermo Fisher Scientific] and MRSA-ID [bioMérieux]) for the detection of methicillin-resistant Staphylococcus aureus (MRSA) in 1,368 hospital samples. For both media, broth enrichment was essential to obtain satisfactory diagnostic performance. Although with direct cultures only, the diagnostic performance (particularly sensitivity) of Brilliance MRSA 2 agar appears better than that of MRSA-ID, no difference in sensitivity or specificity between the media was detected after inclusion of an enrichment step. R apid and accurate screening of patients for methicillin-resistant Staphylococcus aureus (MRSA) is essential to control MRSA in hospitals. Several chromogenic selective media have been developed to facilitate such screening. We previously compared the diagnostic performances of two of these media, Brilliance MRSA agar (Thermo Fisher Scientific) and MRSA-ID (bioMérieux, France), for the detection of MRSA in nose and throat samples taken from veterinarians and their household members (1). Although sensitivities were high and similar for both media, the specificity of the Brilliance MRSA agar (88.7%) was substantially less than that of MRSA-ID (98.5%). Since then, the manufacturer of the Brilliance MRSA agar has redeveloped the medium to improve its accuracy, particularly the specificity, which would reduce the number of confirmatory tests required. In the current study, we compared the performances of the new Brilliance MRSA 2 agar and MRSA-ID for the detection of MRSA.The study was conducted in the Laboratory for Microbiology and Infection Control in Amphia Hospital, Breda, The Netherlands. In this laboratory, the MRSA-ID medium was used for the routine screening for MRSA, and the Brilliance MRSA 2 agar was included as a comparator for this study. The composition of each chromogenic medium is proprietary. The selective mixture inhibits the growth of methicillin-sensitive staphylococci and most other bacteria and yeasts. Contrary to MRSA-ID medium, the performance of Brilliance MRSA 2 agar is not affected by light exposure, which is a practical advantage in its use. On Brilliance MRSA 2 agar, MRSA forms distinctive blue colonies, while such colonies on the MRSA-ID medium are green.Rectal, throat, and nose swabs were collected between December 2011 and July 2012 using the ESwab transport medium (Copan Diagnostics). ESwab containers were vortexed, and swabs were used to inoculate both MRSA-ID agar and Brilliance MRSA 2 agar plates and a Columbia agar plate with 5% sheep blood (SBA growth control). The order in which samples were inoculated on the 2 chromogenic media was alternated weekly. The fluid remaining from the ESwab container (500 to 1,000 l) was inoculated in Mueller-Hinton broth (6.5% NaCl) that was subcultured after 18 to 24 h of incubation at 36 to 37°C in normal atmosphere on both chromogenic media and on a Columbia agar plate with 5% sheep blood (SBA). The latter was included as a backup to detect the presence of MRSA strains that would r...

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Evaluation of Brilliance MRSA 2 Agar for Detection of Methicillin-Resistant Staphylococcus aureus in Clinical Samples

et al. 2013

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“…The overnight MH broth were separately subcultured onto both chromID S. aureus and chromID MRSA agar plates. All agar plates were read after 18–24 h incubation at 35–37°C according to manufacturer's instructions [23]. All cefoxitin resistant isolates were tested using a PCR for the presence of the mec A and nuc gene [24]–[25].…”

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confidence: 99%

Transmission of Methicillin-Resistant Staphylococcus aureus CC398 from Livestock Veterinarians to Their Household Members

et al. 2014

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There are indications that livestock-associated MRSA CC398 has a reduced human-to-human transmissibility, limiting its impact on public health and justifying modified control measures. This study determined the transmissibility of MRSA CC398 from livestock veterinarians to their household members in the community as compared to MRSA non-CC398 strains. A one-year prospective cohort study was performed to determine the presence of MRSA CC398 in four-monthly nasal and oropharyngeal samples of livestock veterinarians (n = 137) and their household members (n = 389). In addition, a cross-sectional survey was performed to detect the presence of MRSA non-CC398 in hospital derived control patients (n = 20) and their household members (n = 41). Staphylococcus aureus isolates were genotyped by staphylococcal protein A (spa) typing and multiple-locus variable-number tandem repeat analysis (MLVA). Mean MRSA CC398 prevalence over the study period was 44% (range 41.6–46.0%) in veterinarians and 4.0% (range 2.8–4.7%) in their household members. The MRSA CC398 prevalence in household members of veterinarians was significantly lower than the MRSA non-CC398 prevalence in household members of control patients (PRR 6.0; 95% CI 2.4–15.5), indicating the reduced transmissibility of MRSA CC398. The impact of MRSA CC398 appears to be low at the moment. However, careful monitoring of the human-to-human transmissibility of MRSA CC398 remains important.

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“…Therefore, the targeted ESBL-E screening of clinical specimens relies on the use of selective screening agars for ESBL, several of which, with comparable high sensitivities, have been described (7)(8)(9)(10)(11)(12)(13). It has been shown that preenrichment using a broth improves the performance of selective screening agars for the detection of methicillin-resistant Staphylococcus aureus in clinical specimens (14)(15)(16)(17). However, the use of preenrichment for the detection of ESBL-E is still controversial (18) and is not common practice in clinical or research settings.…”

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Rectal Carriage of Extended-Spectrum-Beta-Lactamase-Producing Enterobacteriaceae in Hospitalized Patients: Selective Preenrichment Increases Yield of Screening

et al. 2015

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dThis study evaluated the added value of selective preenrichment for the detection of rectal carriage of extended-spectrum-betalactamase-producing Enterobacteriaceae (ESBL-E). ESBL-E rectal carriage was identified in 4.8% of hospitalized patients, and 25.9% of ESBL-E rectal carriers were identified with selective preenrichment only. The steady worldwide spread of extended-spectrum-beta-lactamase-producing Enterobacteriaceae (ESBL-E) has affected health care and community settings, as well as livestock farming (1-4). Extended-spectrum beta-lactamase (ESBL) confers resistance to the majority of beta-lactam antibiotics, including thirdgeneration cephalosporins, which limits the options for antimicrobial therapy and results in increased morbidity and mortality rates and health care costs (5, 6). Appropriate antimicrobial therapy and infection control measures depend on rapid sensitive laboratory detection methods. Unfortunately, reliable standardized methods for direct molecular detection of ESBL-E in clinical specimens are currently not available for routine use in medical microbiology. Therefore, the targeted ESBL-E screening of clinical specimens relies on the use of selective screening agars for ESBL, several of which, with comparable high sensitivities, have been described (7-13). It has been shown that preenrichment using a broth improves the performance of selective screening agars for the detection of methicillin-resistant Staphylococcus aureus in clinical specimens (14-17). However, the use of preenrichment for the detection of ESBL-E is still controversial (18) and is not common practice in clinical or research settings. Although several studies on the occurrence of ESBL-E have used nonselective or selective preenrichment (19,20), comparative data that quantify the added value of preenrichment are limited. A comparative study showed that nonselective preenrichment improved the detection of ESBL-E in throat and rectal surveillance cultures from intensive care unit (ICU) patients (21). That study was performed in a setting in which all patients received selective decontamination of the digestive tract (SDD), and the use of a nonselective medium would hardly have been hampered by overgrowth with nonresistant flora. The detection of ESBL-E in fecal or rectal samples from patients who are not receiving antibiotics, however, is complicated by the presence of nonresistant gastrointestinal flora and would benefit from the use of selective culture media. At present, no comparative data on the use of preenrichment with a selective broth for the detection of ESBL-E rectal carriage are available. This study aimed to determine the added value of selective preenrichment for the detection of rectal carriage of ESBL-E in hospitalized patients.In October 2011, an ESBL-E prevalence survey was performed in an 850-bed Dutch teaching hospital, where yearly ESBL-E prevalence surveys are part of the routine infection control policy.Rectal swabs were taken from all patients who were hospitalized on the day of the survey and were ...

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

Cited by 14 publications

References 15 publications

Evaluation of Brilliance MRSA 2 Agar for Detection of Methicillin-Resistant Staphylococcus aureus in Clinical Samples

Evaluation of Brilliance MRSA 2 Agar for Detection of Methicillin-Resistant Staphylococcus aureus in Clinical Samples

Transmission of Methicillin-Resistant Staphylococcus aureus CC398 from Livestock Veterinarians to Their Household Members

Rectal Carriage of Extended-Spectrum-Beta-Lactamase-Producing Enterobacteriaceae in Hospitalized Patients: Selective Preenrichment Increases Yield of Screening

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