Evaluation of methods for detection of β-lactamase production in MSSA.

Autor:	Skov R; Division of Infectious Disease Preparedness, Statens Serum Institut, Copenhagen, Denmark., Lonsway DR; Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA., Larsen J; Department of Bacteria, Parasites, and Fungi, Statens Serum Institut, Copenhagen, Denmark., Larsen AR; Department of Bacteria, Parasites, and Fungi, Statens Serum Institut, Copenhagen, Denmark., Samulioniené J; Department of Clinical Microbiology, Aalborg University Hospital, Alborg, Denmark., Limbago BM; Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Jazyk:	angličtina
Zdroj:	The Journal of antimicrobial chemotherapy [J Antimicrob Chemother] 2021 May 12; Vol. 76 (6), pp. 1487-1494.
DOI:	10.1093/jac/dkab032
Abstrakt:	Objectives: Correct determination of penicillin susceptibility is pivotal for using penicillin in the treatment of Staphylococcus aureus infections. This study examines the performance of MIC determination, disc diffusion and a range of confirmatory tests for detection of penicillin susceptibility in S. aureus. Methods: A total of 286 consecutive penicillin-susceptible S. aureus blood culture isolates as well as a challenge set of 62 MSSA isolates were investigated for the presence of the blaZ gene by PCR and subjected to penicillin-susceptibility testing using broth microdilution MIC determination, disc diffusion including reading of the zone edge, two nitrocefin tests and the cloverleaf test. Results: Using PCR-based detection of blaZ as the gold standard, both broth microdilution MIC testing and disc diffusion testing resulted in a relatively low accuracy (82%-93%) with a sensitivity ranging from 49%-93%. Among the confirmatory tests, the cloverleaf test performed with 100% accuracy, while zone edge interpretation and nitrocefin-based tests increased the sensitivity of β-lactamase detection to 96%-98% and 82%-96% when using MIC determination or disc diffusion as primary test, respectively. Conclusions: This investigation showed that reliable and accurate detection of β-lactamase production in S. aureus can be obtained by MIC determination or penicillin disc diffusion followed by interpretation of the zone edge as a confirmatory test for apparently penicillin-susceptible isolates. The more cumbersome cloverleaf test can also be used. Nitrocefin-based tests should not be used as the only test for confirmation of a presumptive β-lactamase-negative isolate. (© The Author(s) 2021. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
Databáze:	MEDLINE
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