Skip to main content

Advertisement

SpringerLink
Log in

MRSA screening by the Xpert MRSA PCR assay: pooling samples of the nose, throat, and groin increases the sensitivity of detection without increasing the laboratory costs

  • Article
  • Published:
European Journal of Clinical Microbiology & Infectious Diseases Aims and scope Submit manuscript

Abstract

The performance of the Xpert MRSA polymerase chain reaction (PCR) assay on pooled nose, groin, and throat swabs (three nylon flocked eSwabs into one tube) was compared to culture by analyzing 5,546 samples. The sensitivity [0.78, 95 % confidence interval (CI) 0.73–0.82] and specificity (0.99, 95 % CI 0.98–0.99) were similar to the results from published studies on separated nose or other specimens. Thus, the performance of the Xpert MRSA assay was not affected by pooling the three specimens into one assay, allowing a higher detection rate without increasing laboratory costs, as compared to nose samples alone.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Senn L, Basset P, Nahimana I, Zanetti G, Blanc DS (2012) Which anatomical sites should be sampled for screening of methicillin-resistant Staphylococcus aureus carriage by culture or by rapid PCR test? Clin Microbiol Infect 18(2):E31–E33

    Article  PubMed  CAS  Google Scholar 

  2. Batra R, Eziefula AC, Wyncoll D, Edgeworth J (2008) Throat and rectal swabs may have an important role in MRSA screening of critically ill patients. Intensive Care Med 34(9):1703–1706

    Article  PubMed  Google Scholar 

  3. Bishop EJ, Grabsch EA, Ballard SA, Mayall B, Xie S, Martin R, Grayson ML (2006) Concurrent analysis of nose and groin swab specimens by the IDI-MRSA PCR assay is comparable to analysis by individual-specimen PCR and routine culture assays for detection of colonization by methicillin-resistant Staphylococcus aureus. J Clin Microbiol 44(8):2904–2908

    Article  PubMed  CAS  Google Scholar 

  4. Eveillard M, de Lassence A, Lancien E, Barnaud G, Ricard JD, Joly-Guillou ML (2006) Evaluation of a strategy of screening multiple anatomical sites for methicillin-resistant Staphylococcus aureus at admission to a teaching hospital. Infect Control Hosp Epidemiol 27(2):181–184

    Article  PubMed  Google Scholar 

  5. Mertz D, Frei R, Jaussi B, Tietz A, Stebler C, Flückiger U, Widmer AF (2007) Throat swabs are necessary to reliably detect carriers of Staphylococcus aureus. Clin Infect Dis 45(4):475–477

    Article  PubMed  Google Scholar 

  6. Matheson A, Christie P, Stari T, Kavanagh K, Gould IM, Masterton R, Reilly JS (2012) Nasal swab screening for methicillin-resistant Staphylococcus aureus—how well does it perform? A cross-sectional study. Infect Control Hosp Epidemiol 33(8):803–808

    Article  PubMed  Google Scholar 

  7. Nulens E, Descheemaeker P, Deurenberg RH, Stobberingh EE, Gordts B (2010) Contribution of two molecular assays as compared to selective culture for MRSA screening in a low MRSA prevalence population. Infection 38(2):98–101

    Article  PubMed  CAS  Google Scholar 

  8. Wassenberg MW, Kluytmans JA, Bosboom RW, Buiting AG, van Elzakker EP, Melchers WJ, Thijsen SF, Troelstra A, Vandenbroucke-Grauls CM, Visser CE, Voss A, Wolffs PF, Wulf MW, van Zwet AA, de Wit GA, Bonten MJ (2011) Rapid diagnostic testing of methicillin-resistant Staphylococcus aureus carriage at different anatomical sites: costs and benefits of less extensive screening regimens. Clin Microbiol Infect 17(11):1704–1710

    Article  PubMed  CAS  Google Scholar 

  9. Jeyaratnam D, Gottlieb A, Ajoku U, French GL (2008) Validation of the IDI-MRSA system for use on pooled nose, axilla, and groin swabs and single swabs from other screening sites. Diagn Microbiol Infect Dis 61(1):1–5

    Article  PubMed  CAS  Google Scholar 

  10. Kelley PG, Grabsch EA, Howden BP, Gao W, Grayson ML (2009) Comparison of the Xpert methicillin-resistant Staphylococcus aureus (MRSA) assay, BD GeneOhm MRSA assay, and culture for detection of nasal and cutaneous groin colonization by MRSA. J Clin Microbiol 47(11):3769–3772

    Article  PubMed  CAS  Google Scholar 

  11. Verhoeven P, Grattard F, Carricajo A, Pozzetto B, Berthelot P (2010) Better detection of Staphylococcus aureus nasal carriage by use of nylon flocked swabs. J Clin Microbiol 48(11):4242–4244

    Article  PubMed  Google Scholar 

  12. Smismans A, Verhaegen J, Schuermans A, Frans J (2009) Evaluation of the Copan ESwab transport system for the detection of methicillin-resistant Staphylococcus aureus: a laboratory and clinical study. Diagn Microbiol Infect Dis 65(2):108–111

    Article  PubMed  Google Scholar 

  13. Saegeman V, Flamaing J, Muller J, Peetermans WE, Stuyck J, Verhaegen J (2011) Clinical evaluation of the Copan ESwab for methicillin-resistant Staphylococcus aureus detection and culture of wounds. Eur J Clin Microbiol Infect Dis 30(8):943–949

    Article  PubMed  CAS  Google Scholar 

  14. Nahimana I, Francioli P, Blanc DS (2006) Evaluation of three chromogenic media (MRSA-ID, MRSA-Select and CHROMagar MRSA) and ORSAB for surveillance cultures of methicillin-resistant Staphylococcus aureus. Clin Microbiol Infect 12(12):1168–1174

    Article  PubMed  CAS  Google Scholar 

  15. Clinical and Laboratory Standards Institute (CLSI) (2009) Performance standards for antimicrobial susceptibility testing. Approved standard MS-100-S19. CLSI, Wayne, PA

  16. Marlowe EM, Miller JM, LaForga E, Amos M, Novak-Weekley SM (2009) eSwab nares specimens cultured with BioRad MRSASelect™ media are comparable to the Cepheid Xpert™ MRSA PCR for use in MRSA Surveillance. In: Proceedings of the 109th General Meeting of the American Society for Microbiology, Philadelphia, Pennsylvania, May 2009. American Society for Microbiology, Washington, DC

  17. Martens KD, De Beenhouwer H, Frans J, Van den Abeele A, Cartuyvels R, Coppens G (2009) Evaluation of eSwab for surveillance of MRSA by Xpert MRSA and culture on pooled samples. In: Proceedings of the 19th European Congress of Clinical Microbiology and Infectious Diseases, Helsinki, Finland, 15(S4):S199, P797

  18. Rossney AS, Herra CM, Brennan GI, Morgan PM, O’Connell B (2008) Evaluation of the Xpert methicillin-resistant Staphylococcus aureus (MRSA) assay using the GeneXpert real-time PCR platform for rapid detection of MRSA from screening specimens. J Clin Microbiol 46(10):3285–3290

    Article  PubMed  CAS  Google Scholar 

  19. Hombach M, Pfyffer GE, Roos M, Lucke K (2010) Detection of methicillin-resistant Staphylococcus aureus (MRSA) in specimens from various body sites: performance characteristics of the BD GeneOhm MRSA assay, the Xpert MRSA assay, and broth-enriched culture in an area with a low prevalence of MRSA infections. J Clin Microbiol 48(11):3882–3887

    Article  PubMed  Google Scholar 

  20. Laurent C, Bogaerts P, Schoevaerdts D, Denis O, Deplano A, Swine C, Struelens MJ, Glupczynski Y (2010) Evaluation of the Xpert MRSA assay for rapid detection of methicillin-resistant Staphylococcus aureus from nares swabs of geriatric hospitalized patients and failure to detect a specific SCCmec type IV variant. Eur J Clin Microbiol Infect Dis 29(8):995–1002

    Article  PubMed  CAS  Google Scholar 

  21. Wolk DM, Picton E, Johnson D, Davis T, Pancholi P, Ginocchio CC, Finegold S, Welch DF, de Boer M, Fuller D, Solomon MC, Rogers B, Mehta MS, Peterson LR (2009) Multicenter evaluation of the Cepheid Xpert methicillin-resistant Staphylococcus aureus (MRSA) test as a rapid screening method for detection of MRSA in nares. J Clin Microbiol 47(3):758–764

    Article  PubMed  CAS  Google Scholar 

  22. Blanc DS, Basset P, Nahimana-Tessemo I, Jaton K, Greub G, Zanetti G (2011) High proportion of wrongly identified methicillin-resistant Staphylococcus aureus carriers by use of a rapid commercial PCR assay due to presence of staphylococcal cassette chromosome element lacking the mecA gene. J Clin Microbiol 49(2):722–724

    Article  PubMed  Google Scholar 

  23. Roisin S, Laurent C, Nonhoff C, Deplano A, Hallin M, Byl B, Struelens MJ, Denis O (2012) Positive predictive value of the Xpert MRSA assay diagnostic for universal patient screening at hospital admission: influence of the local ecology. Eur J Clin Microbiol Infect Dis 31(5):873–880

    Article  PubMed  CAS  Google Scholar 

  24. García-Álvarez L, Holden MT, Lindsay H, Webb CR, Brown DF, Curran MD, Walpole E, Brooks K, Pickard DJ, Teale C, Parkhill J, Bentley SD, Edwards GF, Girvan EK, Kearns AM, Pichon B, Hill RL, Larsen AR, Skov RL, Peacock SJ, Maskell DJ, Holmes MA (2011) Meticillin-resistant Staphylococcus aureus with a novel mecA homologue in human and bovine populations in the UK and Denmark: a descriptive study. Lancet Infect Dis 11(8):595–603

    Article  PubMed  Google Scholar 

  25. Basset P, Senn L, Prod’hom G, Bille J, Francioli P, Zanetti G, Blanc DS (2010) Usefulness of double locus sequence typing (DLST) for regional and international epidemiological surveillance of methicilin-resistant Staphylococcus aureus. Clin Microbiol Infect 16(8):1289–1296

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

We thank Patrick Basset for reviewing the manuscript.

Conflict of interest

All authors declare no conflicts of interest.

Author information

Authors and Affiliations

  1. Service of Hospital Preventive Medicine, Lausanne University Hospital, Rue du Bugnon 46, 1011, Lausanne, Switzerland

    D. S. Blanc, I. Nahimana & G. Zanetti

  2. Institute of Microbiology, Lausanne University Hospital, Lausanne, Switzerland

    D. S. Blanc & G. Greub

Authors
  1. D. S. Blanc
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. I. Nahimana
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. G. Zanetti
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. G. Greub
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to D. S. Blanc.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Blanc, D.S., Nahimana, I., Zanetti, G. et al. MRSA screening by the Xpert MRSA PCR assay: pooling samples of the nose, throat, and groin increases the sensitivity of detection without increasing the laboratory costs. Eur J Clin Microbiol Infect Dis 32, 565–568 (2013). https://doi.org/10.1007/s10096-012-1775-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10096-012-1775-7

Keywords

Search

Navigation