Real-Time PCR Testing for mecA Reduces Vancomycin Usage and Length of Hospitalization for Patients Infected with Methicillin-Sensitive Staphylococci

Abstract

Nucleic acid amplification tests (NAATs) have revolutionized infectious disease diagnosis, allowing for the rapid and sensitive identification of pathogens in clinical specimens. Real-time PCR testing for the mecA gene (mecA PCR), which confers methicillin resistance in staphylococci, has the added potential to reduce antibiotic usage, improve clinical outcomes, lower health care costs, and avoid emergence of drug resistance. A retrospective study was performed to identify patients infected with methicillin-sensitive staphylococcal isolates who were receiving vancomycin treatment when susceptibility results became available. Vancomycin treatment and length of hospitalization were compared in these patients for a 6-month period before and after implementation of mecA PCR. Among 65 and 94 patients identified before and after mecA PCR, respectively, vancomycin usage (

Trends in Incidence and Susceptibility among Methicillin-Resistant Staphylococcus aureus Isolated from Intranasal Cultures Associated with Rhinosinusitis

“…6,7 Currently, presence of the mecA gene assists in the final identification of S. aureus as MRSA. 8 There has been a steady interval increase in the incidence of MRSA in both the community and the hospital settings. The percentage of MRSA among all S. aureus isolates from hospitals rose from 2.4% in 1975 to 29% in 1991, and to 40% in 1996.…”

“…Methicillin resistance was confirmed by cefoxitin disk during part of the study period before November 2008 and later by detection of the mecA gene using a laboratory-derived polymerase chain reaction test. 8 Within the past 20 years the introduction of polymerase chain reaction in 2008 has only improved the turnaround time of drug susceptibility testing but it has not changed the sensitivity and specificity of MRSA detection.…”

Clinical and laboratory considerations for the rapid detection of carbapenem-resistant Enterobacteriaceae

“…85 CDSSs can take many forms, including comprehensive computerized disease management systems that can integrate clinical data, medication orders, and laboratory and microbiology results to suggest anti-infective therapy and alert clinicians about potential suboptimal management of infections. [86][87][88][89] Several studies of rapid blood culture diagnostics report favorable outcomes when rapid test results are reported together with CDSSs that provide actionable guidance for clinicians through antimicrobial stewardship team oversight [90][91][92][93][94][95][96][97] or even templated comments contained within the result report. 84 Increasingly, electronic health records platforms such as Epic and Cerner are incorporating CDSSs to enhance antimicrobial stewardship.…”

Performance of the Verigene Gram-Positive Blood Culture Assay for Direct Detection of Gram-Positive Organisms and Resistance Markers in a Pediatric Hospital

“…Previous studies have been fundamental in directly correlating rapid identification of Gram-positive pathogens with improved patient outcome, decreased hospital length of stay, and decreased hospital costs (6)(7)(8)(9). Moreover, direct detection of the mecA gene in methicillin-resistant S. aureus (MRSA) has been demonstrated to be an effective tool for managing vancomycin usage as well as reducing both hospital length of stay and costs (10,11).…”