Comparative assessment of methicillin resistant Staphylococcus aureus diagnostic assays for use in resource-limited settings
Abstract Background The rise of methicillin-resistant Staphylococcus aureus (MRSA) is a global health concern. Paucity of data on MRSA carriage prevalence and diagnostic methods in resource-limited settings hampers efforts to define the problem and plan an appropriate response. Additionally, high va...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2019-08-01
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| Series: | BMC Microbiology |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12866-019-1566-8 |
| _version_ | 1828853247619629056 |
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| author | A. Ayebare L. M. Bebell J. Bazira S. Ttendo V. Katawera D. R. Bangsberg M. J. Siedner P. G. Firth Y. Boum II |
| author_facet | A. Ayebare L. M. Bebell J. Bazira S. Ttendo V. Katawera D. R. Bangsberg M. J. Siedner P. G. Firth Y. Boum II |
| author_sort | A. Ayebare |
| collection | DOAJ |
| description | Abstract Background The rise of methicillin-resistant Staphylococcus aureus (MRSA) is a global health concern. Paucity of data on MRSA carriage prevalence and diagnostic methods in resource-limited settings hampers efforts to define the problem and plan an appropriate response. Additionally, high variability in cost and logistical characteristics of MRSA screening methods may impede infection control efforts. We compared the performance of locally-available chromogenic agar BD CHROMagar MRSA II and two PCR-based assays (Hain GenoQuick MRSA and Cepheid Xpert SA Complete) for the detection of asymptomatic MRSA carriage in nasal swabs. Results During 2015, we enrolled 500 patients from five hospital wards at a Ugandan regional referral hospital. We found 30% prevalence of methicillin-sensitive Staphylococcus aureus (MSSA) nasal carriage, and 5.4% MRSA nasal carriage prevalence. Compared to a composite reference standard defined as a positive test result on any one of the three assays, Hain GenoQuick MRSA demonstrated the highest sensitivity (96%) followed by direct plating on CHROMagar at (70%), with the lowest sensitivity observed with Xpert SA Complete (52%). Cepheid Xpert provided the most rapid results (< 1 h) but was the most expensive (US $45–50/test). Substantially more labor was required for the Hain GenoQuick MRSA compared to Xpert SA Complete or CHROMagar tests. Conclusion MRSA nasal carriage prevalence rates were low, and high diagnostic sensitivity was achieved using Hain GenoQuick MRSA. Chromogenic media had significantly lower sensitivity, but may represent a viable local option given its lower cost compared to PCR-based assays. |
| first_indexed | 2024-12-13T00:09:51Z |
| format | Article |
| id | doaj.art-999725b366184d04883ec88bb9fc4cc0 |
| institution | Directory Open Access Journal |
| issn | 1471-2180 |
| language | English |
| last_indexed | 2024-12-13T00:09:51Z |
| publishDate | 2019-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Microbiology |
| spelling | doaj.art-999725b366184d04883ec88bb9fc4cc02022-12-22T00:06:03ZengBMCBMC Microbiology1471-21802019-08-011911610.1186/s12866-019-1566-8Comparative assessment of methicillin resistant Staphylococcus aureus diagnostic assays for use in resource-limited settingsA. Ayebare0L. M. Bebell1J. Bazira2S. Ttendo3V. Katawera4D. R. Bangsberg5M. J. Siedner6P. G. Firth7Y. Boum II8Faculty of Medicine, Mbarara University of Science and TechnologyDivision of Infectious Diseases, Massachusetts General HospitalFaculty of Medicine, Mbarara University of Science and TechnologyFaculty of Medicine, Mbarara University of Science and TechnologyWorld Health OrganizationOregon Health & Science University-Portland State University School of Public HealthFaculty of Medicine, Mbarara University of Science and TechnologyMassachusetts General Hospital Department of Anesthesia, Critical Care and Pain MedicineFaculty of Medicine, Mbarara University of Science and TechnologyAbstract Background The rise of methicillin-resistant Staphylococcus aureus (MRSA) is a global health concern. Paucity of data on MRSA carriage prevalence and diagnostic methods in resource-limited settings hampers efforts to define the problem and plan an appropriate response. Additionally, high variability in cost and logistical characteristics of MRSA screening methods may impede infection control efforts. We compared the performance of locally-available chromogenic agar BD CHROMagar MRSA II and two PCR-based assays (Hain GenoQuick MRSA and Cepheid Xpert SA Complete) for the detection of asymptomatic MRSA carriage in nasal swabs. Results During 2015, we enrolled 500 patients from five hospital wards at a Ugandan regional referral hospital. We found 30% prevalence of methicillin-sensitive Staphylococcus aureus (MSSA) nasal carriage, and 5.4% MRSA nasal carriage prevalence. Compared to a composite reference standard defined as a positive test result on any one of the three assays, Hain GenoQuick MRSA demonstrated the highest sensitivity (96%) followed by direct plating on CHROMagar at (70%), with the lowest sensitivity observed with Xpert SA Complete (52%). Cepheid Xpert provided the most rapid results (< 1 h) but was the most expensive (US $45–50/test). Substantially more labor was required for the Hain GenoQuick MRSA compared to Xpert SA Complete or CHROMagar tests. Conclusion MRSA nasal carriage prevalence rates were low, and high diagnostic sensitivity was achieved using Hain GenoQuick MRSA. Chromogenic media had significantly lower sensitivity, but may represent a viable local option given its lower cost compared to PCR-based assays.http://link.springer.com/article/10.1186/s12866-019-1566-8Methicillin-resistant Staphylococcus aureusMRSACarriageChromogenic agarPCRAfrica |
| spellingShingle | A. Ayebare L. M. Bebell J. Bazira S. Ttendo V. Katawera D. R. Bangsberg M. J. Siedner P. G. Firth Y. Boum II Comparative assessment of methicillin resistant Staphylococcus aureus diagnostic assays for use in resource-limited settings BMC Microbiology Methicillin-resistant Staphylococcus aureus MRSA Carriage Chromogenic agar PCR Africa |
| title | Comparative assessment of methicillin resistant Staphylococcus aureus diagnostic assays for use in resource-limited settings |
| title_full | Comparative assessment of methicillin resistant Staphylococcus aureus diagnostic assays for use in resource-limited settings |
| title_fullStr | Comparative assessment of methicillin resistant Staphylococcus aureus diagnostic assays for use in resource-limited settings |
| title_full_unstemmed | Comparative assessment of methicillin resistant Staphylococcus aureus diagnostic assays for use in resource-limited settings |
| title_short | Comparative assessment of methicillin resistant Staphylococcus aureus diagnostic assays for use in resource-limited settings |
| title_sort | comparative assessment of methicillin resistant staphylococcus aureus diagnostic assays for use in resource limited settings |
| topic | Methicillin-resistant Staphylococcus aureus MRSA Carriage Chromogenic agar PCR Africa |
| url | http://link.springer.com/article/10.1186/s12866-019-1566-8 |
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