Multicenter Evaluation of the Cepheid Xpert Methicillin-Resistant Staphylococcus aureus (MRSA) Test as a Rapid Screening Method for Detection of MRSA in Nares
| Autor: | M. C. Solomon, Sydney M. Finegold, Lance R. Peterson, Christine C. Ginocchio, Preeti Pancholi, M. de Boer, Maitry S. Mehta, Donna M. Wolk, Thomas E. Davis, DeAnna Fuller, David F. Welch, E. Picton, Desiree R. Johnson, Beverly Barton Rogers |
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| Rok vydání: | 2009 |
| Předmět: |
DNA
Bacterial Methicillin-Resistant Staphylococcus aureus Microbiology (medical) Micrococcaceae Meticillin medicine.drug_class Antibiotics Drug resistance Nose medicine.disease_cause Staphylococcal infections Polymerase Chain Reaction Sensitivity and Specificity Microbiology Humans Mass Screening Medicine Mass screening biology business.industry Bacteriology Staphylococcal Infections biochemical phenomena metabolism and nutrition bacterial infections and mycoses biology.organism_classification medicine.disease Methicillin-resistant Staphylococcus aureus United States Staphylococcus aureus Carrier State business medicine.drug |
| Zdroj: | Journal of Clinical Microbiology. 47:758-764 |
| ISSN: | 1098-660X 0095-1137 |
| DOI: | 10.1128/jcm.01714-08 |
| Popis: | The first U.S. multicenter clinical trial to assess the performance of the Cepheid Xpert MRSA assay (Xpert MRSA) was conducted. The assay is a qualitative test designed for the rapid detection of methicillin-resistant Staphylococcus aureus (MRSA) directly from nares swabs. This novel test combines integrated nucleic acid extraction and automated real-time PCR for the detection of a MRSA-specific signature sequence. A total of 1,077 nares specimens were collected from seven geographically distinct health care sites across the United States with prevalence rates ranging from 5.2% to 44%. Nares specimens were tested by (i) the Xpert MRSA assay, (ii) direct culture on CHROMagar MRSA medium (direct CM culture), and (iii) broth-enriched culture (Trypticase soy broth with 6.5% sodium chloride) followed by plating onto CHROMagar MRSA medium (broth-enriched CM culture). When direct CM culture was designated the reference method, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the Xpert MRSA assay were 94.3%, 93.2%, 73.0%, and 98.8%, respectively. When broth-enriched CM culture was used as the reference method, the clinical sensitivity, specificity, PPV, and NPV of the Xpert MRSA assay were 86.3%, 94.9%, 80.5%, and 96.6%, respectively. The BD GeneOhm MRSA (BDGO) assay was performed as a comparative molecular method. No statistical performance differences were observed between the Xpert MRSA and BDGO assays when they were compared to culture methods. From this large-scale, multicenter clinical comparison, we conclude that the Xpert MRSA assay is a simple, rapid, and accurate method for performing active surveillance for MRSA in a variety of health care populations. |
| Databáze: | OpenAIRE |
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