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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 Staphylococcus aureus(MRSA)

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Military Medical Research 2015年第4期3卷 213-219页

作者： Volker Micheel Benedikt Hogan Thomas Koller Philipp Warnke Sabine Crusius Rebecca Hinz Ralf Matthias Hagen Norbert Georg Schwarz Hagen Frickmann Department of Tropical Medicine at the Bernhard Nocht Institute German Armed Forces Hospital of Hamburg Department of Infectious Disease Epidemiology Bernhard Nocht Institute for Tropical Medicine Hamburg Institute for Microbiology Virology and Hygiene University Medicine Rostock

Background: 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 ***: 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 suspiciouslooking colonies was confirmed afterwards or excluded by another selective agar, chrom ID MRSA. All isolates from the selective agars with MRSA-specific colony morphology were identified by biochemical methods and mass ***: 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 chrom ID 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 chrom ID agar, 3 were methicillin-sensitive Staphylococcus aureus(MSSA, with one instance of cocolonization 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, ***: 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-s

关键词： Methicillin-resistant Staphylococcus aureus Selective agar chromogenic agar Screening Hygiene Stepwise diagnostics CHROMagar Chrom ID agar

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