1.Department of Tropical Medicine at the Bernhard Nocht Institute, German Armed Forces Hospital of Hamburg, Hamburg, Germany
2.Department of Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine Hamburg, Hamburg, Germany
3.Institute for Microbiology, Virology and Hygiene, University Medicine Rostock, Rostock, Germany
*: frickmann@bni-hamburg.de
纸质出版:2015-12
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Screening agars for MRSA: evaluation of a stepwise diagnostic approach with two different selective agars for the screening for methicillin-resistant
Volker Micheel, Benedikt Hogan, Thomas Köller, et al. Screening agars for MRSA: evaluation of a stepwise diagnostic approach with two different selective agars for the screening for methicillin-resistant
Screening agars for MRSA: evaluation of a stepwise diagnostic approach with two different selective agars for the screening for methicillin-resistant
Volker Micheel, Benedikt Hogan, Thomas Köller, et al. Screening agars for MRSA: evaluation of a stepwise diagnostic approach with two different selective agars for the screening for methicillin-resistant
Background:
2
Colonization with methicillin-resistant
Staphylococcus aureus
(MRSA) poses a hygiene risk that does not spare field hospitals or military medical field camps during military deployments. Diagnostic options for unambiguously identifying MRSA isolates are usually scarce in military environments. In this study
we assessed the stepwise application of two different selective agars for the specific identification of MRSA in screening analyses.
Methods:
2
Nasal swabs from 1
541 volunteers were subjected to thioglycollate broth enrichment and subsequently screened on CHROMagar MRSA selective agar for the identification of MRSA. The MRSA identity of suspicious-looking colonies was confirmed afterwards or excluded by another selective agar
chromID MRSA. All isolates from the selective agars with MRSA-specific colony morphology were identified by biochemical methods and mass spectrometry.
Results:
2
The initial CHROMagar MRSA screening identified suspicious colonies in 36 out of 1541 samples. A total of 25 of these 36 isolates showed MRSA-like growth on chromID agar. Out of these 25 isolates
24 were confirmed as MRSA
while one isolate was identified as
Staphylococcus kloosii
. From the 11 strains that did not show suspicious growth on chromID agar
3 were methicillin-sensitive
Staphylococcus aureus
(MSSA
with one instance of co-colonization with
Corynebacterium spp
.)
2 were confirmed as MRSA (with 1 instance of co-colonization with MSSA)
2 were lost during passaging and could not be re-cultured
one could not be identified by the applied approaches
and the remaining 3 strains were identified as
Staphylococcus saprophyticus
Staphylococcus hominis
(co-colonized with
Macrococcus caseolyticus
) and
Staphylococcus cohnii
respectively.
Conclusion:
2
The application of the selective agar CHROMagar MRSA alone proved to be too non-specific to allow for a reliable diagnosis of the presence of MRSA. The combined use of two selective agars in a stepwise approach reduced this non-specificity with an acceptably low loss of sensitivity. Accordingly
such a stepwise screening approach might be an option for resource-restricted military medical field camps.
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