Evaluation of different phenotypic methods for the detection of methicillin resistant Staphylococcus aureus and antimicrobial susceptibility pattern of MRSA

Authors

  • Sheetal Sharma Department of Microbiology, National Institute of Medical Sciences and Research, Jaipur, Rajasthan, India
  • Preeti Srivastava Department of Microbiology, National Institute of Medical Sciences and Research, Jaipur, Rajasthan, India
  • Anjali Kulshrestha Department of Microbiology, National Institute of Medical Sciences and Research, Jaipur, Rajasthan, India
  • Ameer Abbas Department of Microbiology, National Institute of Medical Sciences and Research, Jaipur, Rajasthan, India

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20173832

Keywords:

Oxacillin resistant S. aureus, Cefoxitin resistant S. aureus, Oxacillin ezy strip, Oxacillin screen agar, MeReSa chrom agar

Abstract

Background: Rapid and accurate detection of methicillin resistant Staphylococcus aureus (MRSA) is an important role of clinical microbiology laboratories to avoid treatment failure. The aim of this study was to compare conventional methods against the cefoxitin disc diffusion method to determine the best phenotypic method.

Methods: Study was carried out in the Department of Microbiology, National Institute of Medical Sciences & Research, Jaipur (India), between July 2016 – December 2016. The methods included were Oxacillin E-test MIC, Oxacillin screen agar, Oxacillin disk diffusion, Cefoxitin disk diffusion and CHROMagar- MRSA methods. Antimicrobial susceptibility performed as per CLSI guidelines.

Results: Out of 142 isolates of S. aureus, fifty three (37.32%) strains of MRSA were isolated from clinical specimen. E-MIC test was selected as gold standard method. The sensitivity and specificity of Oxacillin screen agar and CHROMagar-MRSA were same 98.07% and 97.80%, respectively. The sensitivity and specificity of oxacillin disk diffusion were 94.23% and 98.89%. Fifty three strains of S. aureus were MRSA by cefoxitin disk diffusion method and Oxacillin Ezy MIC test. The sensitivity and specificity of cefoxitin disk diffusion method and Oxacillin Ezy MIC method was 100% and 100% respectively. All isolates including MRSA were susceptible to Vancomycin and Linezolid.

Conclusions: All phenotypic methods had high sensitivity and specificity for detection of MRSA. However, cefoxitin disk diffusion method in comparison to other methods had higher sensitivity and specificity. 

References

Aghazadeh M, Rahbar M, Kabeh MM, Savaheli MF. Sensitivity Pattern of Methicillin Resistant and Methicillin Sensitive Staphylococcus Aureus Isolates against Several Antibiotics Including Tigecyline in Iran. Pak J Med Sci. 2009;25:443-6.

Bratu S, Eramo A, Kopec R, Coughlin E, Ghitan M, Yost R, et al. Community-associated methicillin resistant Staphylococcus aureus in hospital nursery and maternity units. Emerg Infect Dis. 2005;11(6):808-13.

Vidhani S, Mehndiratta PL, Mathur MD. Study of methicillin resistant S. aureus (MRSA) isolates from high risk patients. Indian J Med Microbiol. 2001;19(2):13-6.

Bukhari M, Iqbal A, Khatoon N, Iqbal N, Naeem S, Naeem S, et al. A Laboratory Study of susceptibility of Methicillin Resistant Staphylococcus Aureus (MRSA). Pak J Med Sci. 2004;(20):229-33.

Brown DF, Edwards DI, Hawkey PM, Morrison D, Ridgway GL, Towner KJ, et al. Guidelines for the laboratory diagnosis and susceptibility testing of methicillin-resistant Staphylococcus aureus (MRSA). J Antimicrob Chemother. 2005;56(6):1000-18.

Rahbar M, Yaghoobi M, Fattahi A. Fattahi A. Comparison of different laboratory methods for detection of Methicillin Resistant Staphylococcus Aureus. Pak J Med Sci. 2006;22(4):442-5.

Mimica MJ, Berezin EN, Carvalho RL, Mimica IM, Mimica LM, Safadi MA, et al. Detection of methicillin resistance in Staphylococcus aureus isolated from pediatric patients: is the cefoxitin disk diffusion test accurate enough? Braz J Infect Dis. 2007;11(4):415-7.

Brown DF. Detection of methicillin/oxacillin resistance in staphylococci. J Antimicrob Chemother. 2001;48:65-70.

Tiemersma EW, Bronzwaer SL, Lyytikainen O, Degener JE, Schrijnemakers P, Bruinsma N, et al. Methicillin-resistant Staphylococcus aureus in Europe, 1999-2002. Emerg Infect Dis. 2004;10(9):34-7.

Velasco D, del Mar TM, Cartelle M, Beceiro A, Perez A, Molina F, et al. Evaluation of different methods for detecting methicillin (oxacillin) resistance in Staphylococcus aureus. J Antimicrob Chemother. 2005;55(3):379-82.

Clinical and Laboratory standards institute (CLSI). Performance standard for antimicrobial susceptibility testing, 25th ed. Wayne, USA: CLSI; 2015.

Datta P, Gulati N, Singla N, Vasdeva HR, Bala K. Evaluation of various methods for the detection of meticillin-resistant Staphylococcus aureus strains and susceptibility patterns. Department of Microbiology, Government Medical College Hospital, Chandigarh, India. J Med Microbiol. 2011;60:1613–6.

Himedia Technical Data. MRSA Detection EZY MIC Strip, OXA: 0.064 – 8.0 mcg/ml EM063.

Himedia Technical Data. Oxacillin Resistance Screening Agar Base M1454.

Himedia Technical Data. HiCrome MeReSa base agar M1674.

Pourmand MR, Hassanzadeh S, Mashhadi R, Askari E. Comparison of four diagnostic methods for detection of methicillin resistant Staphylococcus aureus, Iranian J Microbiol. 2014;6(5):341-4.

Anand KB, Agrawal P, Kumar S, Kapila K. Comparison of cefoxitin disc diffusion test, oxacillin screen agar, and PCR for mecA gene for detection of MRSA. Indian J Med Microbiol. 2009;27(1):27-9.

Karami S, Rahbar M, Yousefi JV. The present study was undertaken to compare five phenotypic methods for the detection of MRSA. This involved 294 isolates of Staph. aureus, one hundred and six (36%) strains of MRSA were isolated from clinical specimen and 100% sensitivity and specificity of E-test, Iranian J Pathol. 2011;6(1):27–31.

Anupurba S, Sen MR, Nath G, Sharma BM, Gulati AK, Mohapatra TM. Prevalence of methicillin resistant Staphylococcus aureus in a tertiary referral hospital in eastern Uttar Pradesh. Indian J Med Microbiol. 2003;21:49–51.

Downloads

Published

2017-08-23

How to Cite

Sharma, S., Srivastava, P., Kulshrestha, A., & Abbas, A. (2017). Evaluation of different phenotypic methods for the detection of methicillin resistant Staphylococcus aureus and antimicrobial susceptibility pattern of MRSA. International Journal Of Community Medicine And Public Health, 4(9), 3297–3301. https://doi.org/10.18203/2394-6040.ijcmph20173832

Issue

Section

Original Research Articles