Multicenter Evaluation of MRSASelect II Chromogenic Agar for Identification of Methicillin-Resistant Staphylococcus aureus from Wound and Nasal Specimens

J Clin Microbiol. 2016 Feb;54(2):305-11. doi: 10.1128/JCM.02410-15. Epub 2015 Nov 18.

Abstract

Hospitals strive to reduce methicillin-resistant Staphylococcus aureus (MRSA) prevalence via active surveillance of inpatient populations. Rapid and inexpensive screening methods are utilized when molecular methods are not operationally feasible. In this multisite clinical trial, the utility of Bio-Rad's MRSASelect II was evaluated for MRSA identification from remnant nares and wound swabs. The prevalence of MRSA was 11.1% (n = 1,384) from nares samples and 18.1% (n = 842) from wound samples. MRSASelect II had an overall concordance of 95.4% (confidence interval [CI] = 94.5% to 96.2%) compared to a broth-enriched reference standard. Comparisons between results, stratified by examination times, exhibited a nonsignificant trend toward increased positivity at prolonged incubation times. Cefoxitin screening of colonies directly from MRSASelect II was 96.7% (95.8% to 97.3%) concordant compared to testing of colonies following broth enrichment. A comparison of MRSASelect and MRSASelect II revealed no statistical differences; however, the latter exhibited earlier positivity, greater selectivity, and more intense indicator staining, which resulted in facilitated differentiation of positive results. MRSASelect II agar is a simple, rapid, and robust method to routinely screen patients for MRSA colonization without the need for additional testing.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents / pharmacology
  • Chromogenic Compounds
  • Disk Diffusion Antimicrobial Tests
  • Humans
  • Methicillin-Resistant Staphylococcus aureus / isolation & purification*
  • Microbial Sensitivity Tests / methods*
  • Microbial Sensitivity Tests / standards
  • Nasal Cavity / microbiology*
  • Phenotype
  • Prevalence
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Staphylococcal Infections / diagnosis*
  • Staphylococcal Infections / epidemiology
  • Staphylococcal Infections / microbiology*
  • Workflow
  • Wounds and Injuries / microbiology*

Substances

  • Anti-Bacterial Agents
  • Chromogenic Compounds

Grants and funding

Bio-Rad Laboratories, Inc., provided funding as part of the FDA submission for IVD approval of the MRSASelect II agar.