Value of Xpert MRSA/SA blood culture assay on the Gene Xpert® Dx System for rapid detection of Staphylococcus aureus and coagulase-negative staphylococci in patients with staphylococcal bacteremia

Diagn Microbiol Infect Dis. 2013 Feb;75(2):139-43. doi: 10.1016/j.diagmicrobio.2012.11.005. Epub 2012 Dec 27.

Abstract

The Xpert MRSA/SA BC assay was examined prospectively in patients with staphylococcal bacteremia including 6 patients with blood culture bottles inoculated with biological fluid (synovial fluid in 4 cases and peritoneal fluid in 2 cases). Among the 56 Staphylococci species isolated, 80.3% were coagulase-negative staphylococci (CoNS) and 19.7% were S. aureus. Methicillin susceptibility test results showed that 77.8% of isolates were methicillin-resistant CoNS (MRCoNS) and 22.2% of isolates were methicillin-susceptible CoNS (MSCoNS). Of 11 S. aureus isolates, 63.7% were methicillin-susceptible S. aureus (MSSA) and 36.3% were methicillin-resistant S. aureus (MRSA). Xpert MRSA/SA BC results showed that genotypic results were in concordance with phenotypic results in 94.6% of cases versus 5.4% of discordant cases. Of these 3 discordant cases, 1 S. aureus isolate had an MRSA phenotype and an SPA(+)mec(+)SCCmec(-) genotype and another S. aureus isolate was phenotypically MSSA and genotypically SPA(+)mec(+)SCCmec(-), and 1 S. epidermidis isolate was phenotypically MSCoNS and genotypically SPA(-)mec(+)SCCmec(-).

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Ascitic Fluid / microbiology
  • Bacteremia / diagnosis
  • Bacteremia / microbiology*
  • Bacteriological Techniques / methods*
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Methicillin-Resistant Staphylococcus aureus / genetics
  • Methicillin-Resistant Staphylococcus aureus / isolation & purification
  • Middle Aged
  • Molecular Typing / methods*
  • Phenotype
  • Prospective Studies
  • Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization
  • Staphylococcal Infections / diagnosis
  • Staphylococcal Infections / microbiology*
  • Staphylococcus aureus / genetics*
  • Staphylococcus aureus / isolation & purification*
  • Synovial Fluid / microbiology