Methicillin resistance in staphylococci: molecular and biochemical basis and clinical implications.

Chambers, Henry F.

doi:10.1128/cmr.10.4.781-791.1997

Cited by 81 publications

(125 citation statements)

References 137 publications

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“…It is well-known that different strains of MRSA express the methicillin-resistant phenotype at different levels [14,15,28]. This largely unexplained property must be taken into account when designing selective media for MRSA, and evaluations should include appropriate relevant strains.…”

Section: Discussionmentioning

confidence: 99%

Use of broth enrichment and real-time PCR to exclude the presence of methicillin-resistant Staphylococcus aureus in clinical samples: a sensitive screening approach

Nilsson¹,

Alexandersson²,

Ripa³

2005

Clinical Microbiology and Infection

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A rapid and sensitive method for excluding the presence of methicillin-resistant Staphylococcus aureus (MRSA) in clinical samples was developed and evaluated. The method utilised an MRSA-selective enrichment broth for 16 h, followed by PCR quantification of the nuc gene. Samples below a quantitative PCR threshold were reported as MRSA-negative. Broths from PCR-positive samples were subcultured for MRSA isolation. Clinical samples (n = 334) in a constructed high prevalence population were analysed in parallel with a selective plating method. The new broth-PCR assay increased the number of positive samples by 35% (49 vs. 66), and 94% of negative samples were reported within 24 h. To reduce costs and workload, 665 clinical samples were grown separately in enrichment broth and then pooled in the PCR step. The broth-PCR assay increased the number of MRSA positive samples from 11 to 15 compared with selective plating. Most (89%) of the culture-negative samples were also PCR-negative and could be reported within 24 h. The growth of 25 European EMRSA strains was tested in the selective enrichment broth. On average, the MRSA strains showed a 300 000-fold increase in CFU, compared with 30-fold for the eight methicillin-sensitive Staphylococcus aureus strains tested.

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Section: Discussionmentioning

confidence: 99%

Use of broth enrichment and real-time PCR to exclude the presence of methicillin-resistant Staphylococcus aureus in clinical samples: a sensitive screening approach

Nilsson¹,

Alexandersson²,

Ripa³

2005

Clinical Microbiology and Infection

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“…As such, when typical phenotypic susceptibility testing is used to assess resistance, meticillin-resistant strains may seem falsely susceptible to some ␤-lactam antibiotics in vitro. 86 For this reason, direct detection of the mecA gene by PCR is more desirable. With its high detection sensitivity and specificity, mecA PCR has gained wide acceptance and is becoming the most reliable method of identifying meticillinresistant Staphylococcus aureus (MRSA).…”

Section: Antimicrobial Resistance Profilingmentioning

confidence: 99%

PCR-based diagnostics for infectious diseases: uses, limitations, and future applications in acute-care settings

Yang

Rothman

2004

The Lancet Infectious Diseases

800

545

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Molecular diagnostics are revolutionising the clinical practice of infectious disease. Their effects will be significant in acute-care settings where timely and accurate diagnostic tools are critical for patient treatment decisions and outcomes. PCR is the most well-developed molecular technique up to now, and has a wide range of already fulfilled, and potential, clinical applications, including specific or broad-spectrum pathogen detection, evaluation of emerging novel infections, surveillance, early detection of biothreat agents, and antimicrobial resistance profiling. PCR-based methods may also be cost effective relative to traditional testing procedures. Further advancement of technology is needed to improve automation, optimise detection sensitivity and specificity, and expand the capacity to detect multiple targets simultaneously (multiplexing). This review provides an up-to-date look at the general principles, diagnostic value, and limitations of the most current PCR-based platforms as they evolve from bench to bedside.

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“…The median time for reporting results was 2 h 45 min for identification and 7 h for susceptibility tests. Methicillin-resistant strains of Staphylococcus aureus (MRSA) are important pathogens causing nosocomial and community-acquired infections [1]. Some coagulase-negative staphylococci (CNS), such as Staphylococcus epidermidis and Staphylococcus haemolyticus, are also frequently methicillin-and multidrug-resistant [2] and cause bloodstream and device-related infections.…”

Section: Introductionmentioning

confidence: 99%

“…Invasive isolates of staphylococci should therefore be identified to the species level to determine their clinical relevance and to monitor their epidemiology [2]. Methicillin and b-lactam resistance in Correspondence: C. Nonhoff, Microbiology, Hô pital Erasme, Brussels, Belgium E-mail: claire.nonhoff@ulb.ac.be staphylococci is related to the production of penicillin-binding protein (PBP) 2a encoded by the mecA determinant [1]. Heterogeneous expression of mecA makes detection by phenotypic methods difficult in some resistant strains, requiring incubation for a full 24 h or the use of inducer substrates such as cefoxitin.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the Vitek 2 system for identification and antimicrobial susceptibility testing of Staphylococcus spp.

Nonhoff

Rottiers

Struelens

2005

Clinical Microbiology and Infection

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The Vitek 2 system was assessed against reference methods with 197 methicillin-resistant Staphylococcus aureus from Belgian hospitals and 121 clinically significant blood culture isolates of Staphylococcus spp. Vitek 2 identified 95% of staphylococcal isolates correctly, detected oxacillin resistance with a sensitivity/specificity of 99/96%, and showed acceptable accuracy for susceptibility testing of five of eight other evaluable antibiotics. The median time for reporting results was 2 h 45 min for identification and 7 h for susceptibility tests.

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Methicillin resistance in staphylococci: molecular and biochemical basis and clinical implications.

Cited by 81 publications

References 137 publications

Use of broth enrichment and real-time PCR to exclude the presence of methicillin-resistant Staphylococcus aureus in clinical samples: a sensitive screening approach

Use of broth enrichment and real-time PCR to exclude the presence of methicillin-resistant Staphylococcus aureus in clinical samples: a sensitive screening approach

PCR-based diagnostics for infectious diseases: uses, limitations, and future applications in acute-care settings

Evaluation of the Vitek 2 system for identification and antimicrobial susceptibility testing of Staphylococcus spp.

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