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Rapid detection of methicillin-resistant Staphylococcus aureus

Authors
Joshua Freeman, MBChB, FRCPA
Arthur Morris, MD, D(ABMM), FRCPA
Section Editor
Daniel J Sexton, MD
Deputy Editor
Elinor L Baron, MD, DTMH

INTRODUCTION

Approaches to rapid detection of methicillin-resistant Staphylococcus aureus (MRSA) include rapid culture methods and molecular techniques. A number of studies have examined the role of rapid detection methods as a component of MRSA control strategies.

Molecular diagnostic methods can reduce the turnaround time for detection of MRSA colonization and detection of MRSA from positive blood cultures. Rapid MRSA detection tools can also reduce the risk of MRSA surgical site infection, by providing information to guide decisions regarding choice of perioperative antimicrobial prophylaxis and preoperative decolonization.

Laboratory tools for rapid detection will be discussed here; the microbiology of MRSA and clinical issues related to MRSA surveillance are discussed in detail separately. (See "Methicillin-resistant Staphylococcus aureus (MRSA): Microbiology" and "Methicillin-resistant Staphylococcus aureus (MRSA) in adults: Prevention and control".)

DEFINITION

By definition, all MRSA isolates carry the mecA gene or a related variant known as mecC. These genes confer resistance to all beta-lactam antibiotics, including cephalosporins and carbapenems.

ANATOMIC SAMPLING SITE(S)

For the purposes of MRSA infection control surveillance, the anterior nares are the most common site for MRSA carriage; sampling multiple anatomical sites increases sensitivity [1-3]. Lower sensitivities have been observed for non-nasal sample sites (eg, throat, axilla), perhaps due to lower colonization rates or higher quantities of competing flora at these sites. Rectal swabs may contain polymerase chain reaction inhibitors and therefore are of limited utility when molecular methods are used [4].

             
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Literature review current through: Nov 2017. | This topic last updated: Nov 20, 2017.
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