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Culture-based detection of methicillin-resistant Staphylococcus aureus by a network of European laboratories: an external quality assessment study

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Abstract

Twenty-three hospital laboratories from Europe and Israel participated in an external quality assessment (EQA) of the culture-based detection of methicillin-resistant Staphylococcus aureus (MRSA). Participants also reported the MRSA prevalence in clinical cultures and patient screening specimens, as well as the MRSA screening practices employed at their hospitals. An EQA panel of 18 samples consisting of two MRSA harbouring SCCmec IV and I, and one strain each of methicillin-resistant coagulase-negative S. epidermidis, methicillin-sensitive S. aureus and Escherichia coli as pure strains or in mixtures at 107–1 cfu absolute loads was analysed by the 23 participants. Seventeen (74%) participants identified 17 or more samples correctly. Of these, 15 (88%) utilised a chromogenic medium alone (ChromID, bioMérieux; BBL CHROMagar, BD Diagnostics; MRSA Select, Bio-Rad Laboratories) or combined with a conventional medium and up to three confirmatory tests. Proportions of MRSA among S. aureus isolated from clinical cultures varied widely, even among hospitals within countries, ranging from 11–20% to 61–70%. MRSA carriage rates were less variable (0–20%) between countries. Almost all participants (n = 22, 96%) screened patients for MRSA carriage during 2009–2010, of which 15 (68%) screened intensive care unit (ICU) patients alone or combined with other targeted high-risk groups, and 10 (45%) combined nasal screening with another body site.

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Abbreviations

cfu:

Colony-forming units

MRSA:

Methicillin-resistant Staphylococcus aureus

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Acknowledgements

This work and M.G. are supported by funding from the European Community (MOSAR network contract LSHP-CT-2007-037941; InTopSens network contract FP7-ICT-2007-223932). We thank Quality Control for Molecular Diagnostics (QCMD) for the help with setting up the web-based information collection system and for the logistics, as well as the participating laboratory technicians and clinical microbiologists for their help with this survey.

Conflict of interest statement

S.M.-K. has received a speaker’s honorarium from BD Diagnostics. S.H. is a member of the speakers’ bureau and global advisory board of bioMérieux.

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Author notes

  1. A. Lee

    Present address: Department of Infectious Diseases and Microbiology, Royal Prince Alfred Hospital, Sydney, Australia

Authors and Affiliations

  1. Department of Medical Microbiology, Vaccine & Infectious Disease Institute, Universiteit Antwerpen, Antwerp, Belgium

    M. Gazin, C. Lammens, M. Ieven, H. Goossens & S. Malhotra-Kumar

  2. University of Geneva Hospitals and Medical School, Geneva, Switzerland

    A. Lee & S. Harbarth

  3. Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands

    L. Derde & M. Bonten

  4. Division of Epidemiology and Laboratory for Molecular Epidemiology and Antibiotic Research, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel

    M. Kazma & Y. Carmeli

  5. AP-HP, Groupe Henri-Mondor Albert-Chenevier, Creteil, France

    C. Brun-Buisson

  6. Department of Medical Microbiology, Campus Drie Eiken, Universiteit Antwerpen, S3, Universiteitsplein 1, 2610, Wilrijk, Belgium

    S. Malhotra-Kumar

Authors
  1. M. Gazin
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  2. A. Lee
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  3. L. Derde
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  4. M. Kazma
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  5. C. Lammens
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  6. M. Ieven
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  7. M. Bonten
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  8. Y. Carmeli
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  9. S. Harbarth
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  11. H. Goossens
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  12. S. Malhotra-Kumar
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on behalf of the MOSAR WP2 Study Team

Corresponding author

Correspondence to S. Malhotra-Kumar.

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Gazin, M., Lee, A., Derde, L. et al. Culture-based detection of methicillin-resistant Staphylococcus aureus by a network of European laboratories: an external quality assessment study. Eur J Clin Microbiol Infect Dis 31, 1765–1770 (2012). https://doi.org/10.1007/s10096-011-1499-0

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  • DOI: https://doi.org/10.1007/s10096-011-1499-0

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