An epidemic CC1-MRSA-IV clone yields false-negative test results in molecular MRSA identification assays: a note of caution, Austria, Germany, Ireland, 2020

Stefan Monecke; Elisabeth König; Megan R Earls; Eva Leitner; Elke Müller; Gabriel E Wagner; David M Poitz; Lutz Jatzwauk; Teodora Vremerǎ; Olivia S Dorneanu; Alexandra Simbeck; Andreas Ambrosch; Ines Zollner-Schwetz; Robert Krause; Werner Ruppitsch; Wulf Schneider-Brachert; David C Coleman; Ivo Steinmetz; Ralf Ehricht

doi:10.2807/1560-7917.ES.2020.25.25.2000929

An epidemic CC1-MRSA-IV clone yields false-negative test results in molecular MRSA identification assays: a note of caution, Austria, Germany, Ireland, 2020

Euro Surveill. 2020 Jun;25(25):2000929. doi: 10.2807/1560-7917.ES.2020.25.25.2000929.

Authors

Stefan Monecke^{1

2

3

4}, Elisabeth König^{4

5}, Megan R Earls^{4

6}, Eva Leitner⁵, Elke Müller^{1

3}, Gabriel E Wagner⁵, David M Poitz⁷, Lutz Jatzwauk⁸, Teodora Vremerǎ⁹, Olivia S Dorneanu⁹, Alexandra Simbeck¹⁰, Andreas Ambrosch¹¹, Ines Zollner-Schwetz¹², Robert Krause¹², Werner Ruppitsch¹³, Wulf Schneider-Brachert¹⁰, David C Coleman⁶, Ivo Steinmetz⁵, Ralf Ehricht^{1

14

3}

Affiliations

¹ Leibniz Institute of Photonic Technology (IPHT), Jena, Germany.
² Institute for Medical Microbiology and Hygiene, Medical Faculty 'Carl Gustav Carus', Technische Universität Dresden, Dresden, Germany.
³ InfectoGnostics Research Campus Jena, Jena, Germany.
⁴ These authors contributed equally.
⁵ Diagnostic and Research Institute for Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria.
⁶ Microbiology Research Unit, Division of Oral Biosciences, Dublin Dental University Hospital, Trinity College, University of Dublin, Dublin, Ireland.
⁷ Institute of Clinical Chemistry and Laboratory Medicine, University Hospital 'Carl Gustav Carus', Technische Universität Dresden, Dresden, Germany.
⁸ Department of Hospital Infection Control, University Hospital 'Carl Gustav Carus', Technische Universität Dresden, Dresden, Germany.
⁹ Microbiology Unit, Department of Preventive and Interdisciplinary Medicine, University of Medicine and Pharmacy 'Grigore T Popa', Iaşi, Romania.
¹⁰ Department of Infection Control and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany.
¹¹ Institute of Laboratory Medicine, Microbiology and Hygiene, Barmherzige Brüder Hospital, Regensburg, Germany.
¹² Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Austria.
¹³ Institute of Medical Microbiology and Hygiene, Austrian Agency for Health and Food Safety, Vienna, Austria.
¹⁴ Friedrich- Schiller University; Institute of Physical Chemistry, Jena, Germany.

PMID: 32613938
PMCID: PMC7331142
DOI: 10.2807/1560-7917.ES.2020.25.25.2000929

Abstract

We investigated why a clinical meticillin-resistant Staphylococcus aureus (MRSA) isolate yielded false-negative results with some commercial PCR tests for MRSA detection. We found that an epidemic European CC1-MRSA-IV clone generally exhibits this behaviour. The failure of the assays was attributable to a large insertion in the orfX/SCCmec integration site. To ensure the reliability of molecular MRSA tests, it is vital to monitor emergence of new SCCmec types and junction sites.

Keywords: BD MAX, next generation sequencing; CC1-MRSA-IV; Cepheid GenXpert; Staphylococci; Staphylococcus aureus; commercial PCR.

Publication types

Case Reports

MeSH terms

Austria / epidemiology
False Negative Reactions
Female
Germany / epidemiology
Humans
Ireland / epidemiology
Methicillin-Resistant Staphylococcus aureus / genetics
Methicillin-Resistant Staphylococcus aureus / isolation & purification*
Middle Aged
Staphylococcal Infections / diagnosis*
Staphylococcal Infections / epidemiology