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Comparative evaluation of two fully-automated real-time PCR methods for MRSA admission screening in a tertiary-care hospital

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Abstract

We evaluated two fully-automated real-time PCR systems, the novel QIAGEN artus MRSA/SA QS-RGQ and the widely used BD MAX MRSA assay, for their diagnostic performance in MRSA admission screening in a tertiary-care university hospital. Two hundred sixteen clinical swabs were analyzed for MRSA DNA using the BD MAX MRSA assay. In parallel, the same specimens were tested with the QIAGEN artus MRSA/SA QS-RGQ. Automated steps included lysis of bacteria, DNA extraction, real-time PCR and interpretation of results. MRSA culture was additionally performed as a reference method for MRSA detection. Sensitivity values were similar for both assays (80 %), while the QIAGEN artus MRSA/SA QS-RGQ reached a slightly higher specificity (95.8 % versus 90.0 %). Positive (PPVs) and negative predictive values (NPVs) were 17.4 % and 99.4 % for the BD MAX MRSA assay and 33.3 % and 99.5 % for the QIAGEN artus MRSA/SA QS-RGQ, respectively. Total turn-around time (TAT) for 24 samples was 3.5 hours for both assays. In conclusion, both assays represent reliable diagnostic tools due to their high negative predictive values, especially for the rapid identification of MRSA negative patients in a low prevalence MRSA area.

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References

  1. Schulz M, Nonnenmacher C, Mutters R (2009) Cost-effectiveness of rapid MRSA screening in surgical patients. Eur J Clin Microbiol Infect Dis 28:1291–1296. doi:10.1007/s10096-009-0778-5

    Article  CAS  PubMed  Google Scholar 

  2. Wolkewitz M, Frank U, Philips G, Schumacher M, Davey P, Group BS (2011) Mortality associated with in-hospital bacteraemia caused by Staphylococcus aureus: a multistate analysis with follow-up beyond hospital discharge. J Antimicrob Chemother 66:381–386. doi:10.1093/jac/dkq424

    Article  CAS  PubMed  Google Scholar 

  3. Cosgrove SE, Qi Y, Kaye KS, Harbarth S, Karchmer AW, Carmeli Y (2005) The impact of methicillin resistance in Staphylococcus aureus bacteremia on patient outcomes: mortality, length of stay, and hospital charges. Infect Control Hosp Epidemiol 26:166–174. doi:10.1086/502522

    Article  PubMed  Google Scholar 

  4. Murthy A, De Angelis G, Pittet D, Schrenzel J, Uckay I, Harbarth S (2010) Cost-effectiveness of universal MRSA screening on admission to surgery. Clin Microbiol Infect 16:1747–1753. doi:10.1111/j.1469-0691.2010.03220.x

    Article  CAS  PubMed  Google Scholar 

  5. Wassenberg MW, Kluytmans JA, Box AT, Bosboom RW, Buiting AG, van Elzakker EP, Melchers WJ, van Rijen MM, Thijsen SF, Troelstra A, Vandenbroucke-Grauls CM, Visser CE, Voss A, Wolffs PF, Wulf MW, van Zwet AA, de Wit GA, Bonten MJ (2010) Rapid screening of methicillin-resistant Staphylococcus aureus using PCR and chromogenic agar: a prospective study to evaluate costs and effects. Clin Microbiol Infect 16:1754–1761. doi:10.1111/j.1469-0691.2010.03210.x

    Article  CAS  PubMed  Google Scholar 

  6. Nonhoff C, Denis O, Brenner A, Buidin P, Legros N, Thiroux C, Dramaix M, Struelens MJ (2009) Comparison of three chromogenic media and enrichment broth media for the detection of methicillin-resistant Staphylococcus aureus from mucocutaneous screening specimens: Comparison of MRSA chromogenic media. Eur J Clin Microbiol Infect Dis 28:363–369. doi:10.1007/s10096-008-0637-9

    Article  CAS  PubMed  Google Scholar 

  7. Boyce JM, Havill NL (2008) Comparison of BD GeneOhm methicillin-resistant Staphylococcus aureus (MRSA) PCR versus the CHROMagar MRSA assay for screening patients for the presence of MRSA strains. J Clin Microbiol 46:350–351. doi:10.1128/JCM.02130-07

    Article  PubMed  Google Scholar 

  8. Huletsky A, Giroux R, Rossbach V, Gagnon M, Vaillancourt M, Bernier M, Gagnon F, Truchon K, Bastien M, Picard FJ, van Belkum A, Ouellette M, Roy PH, Bergeron MG (2004) New real-time PCR assay for rapid detection of methicillin-resistant Staphylococcus aureus directly from specimens containing a mixture of staphylococci. J Clin Microbiol 42:1875–1884

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Blanc DS, Nahimana I, Zanetti G, Greub G (2013) 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. doi:10.1007/s10096-012-1775-7

    Article  CAS  PubMed  Google Scholar 

  10. Rossney AS, Herra CM, Fitzgibbon MM, Morgan PM, Lawrence MJ, O'Connell B (2007) Evaluation of the IDI-MRSA assay on the SmartCycler real-time PCR platform for rapid detection of MRSA from screening specimens. Eur J Clin Microbiol Infect Dis 26:459–466. doi:10.1007/s10096-007-0303-7

    Article  CAS  PubMed  Google Scholar 

  11. Kock R, Becker K, Cookson B, van Gemert-Pijnen JE, Harbarth S, Kluytmans J, Mielke M, Peters G, Skov RL, Struelens MJ, Tacconelli E, Witte W, Friedrich AW (2014) Systematic literature analysis and review of targeted preventive measures to limit healthcare-associated infections by meticillin-resistant Staphylococcus aureus. Euro Surveill 19

  12. Cunningham R, Jenks P, Northwood J, Wallis M, Ferguson S, Hunt S (2007) Effect on MRSA transmission of rapid PCR testing of patients admitted to critical care. J Hosp Infect 65:24–28. doi:10.1016/j.jhin.2006.09.019

    Article  CAS  PubMed  Google Scholar 

  13. Hardy K, Price C, Szczepura A, Gossain S, Davies R, Stallard N, Shabir S, McMurray C, Bradbury A, Hawkey PM (2010) Reduction in the rate of methicillin-resistant Staphylococcus aureus acquisition in surgical wards by rapid screening for colonization: a prospective, cross-over study. Clin Microbiol Infect 16:333–339. doi:10.1111/j.1469-0691.2009.02899.x

    Article  PubMed  Google Scholar 

  14. Harbarth S, Hawkey PM, Tenover F, Stefani S, Pantosti A, Struelens MJ (2011) Update on screening and clinical diagnosis of meticillin-resistant Staphylococcus aureus (MRSA). Int J Antimicrob Agents 37:110–117. doi:10.1016/j.ijantimicag.2010.10.022

    Article  CAS  PubMed  Google Scholar 

  15. Sturenburg E (2009) Rapid detection of methicillin-resistant Staphylococcus aureus directly from clinical samples: methods, effectiveness and cost considerations. Ger Med Sci 7:Doc06. doi:10.3205/000065

    PubMed  PubMed Central  Google Scholar 

  16. Mehta MS, McClure JT, Mangold K, Peterson LR (2015) Performance of 3 real-time PCR assays for direct detection of Staphylococcus aureus and MRSA from clinical samples. Diagn Microbiol Infect Dis 83:211–215. doi:10.1016/j.diagmicrobio.2014.06.005

    Article  CAS  PubMed  Google Scholar 

  17. Schaumburg F, Kock R, Mellmann A, Richter L, Hasenberg F, Kriegeskorte A, Friedrich AW, Gatermann S, Peters G, von Eiff C, Becker K, study g (2012) Population dynamics among methicillin-resistant Staphylococcus aureus isolates in Germany during a 6-year period. J Clin Microbiol 50:3186–3192. doi:10.1128/JCM.01174-12

    Article  PubMed  PubMed Central  Google Scholar 

  18. RKI (2015) Eigenschaften, Häufigkeit und Verbreitung von MRSA in Deutschland – Update 2013/2014. Epidemiologisches Bull 31

  19. Thomas L, van Hal S, O'Sullivan M, Kyme P, Iredell J (2008) Failure of the BD GeneOhm StaphS/R assay for identification of Australian methicillin-resistant Staphylococcus aureus strains: duplex assays as the “gold standard” in settings of unknown SCCmec epidemiology. J Clin Microbiol 46:4116–4117. doi:10.1128/JCM.01146-08

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Acknowledgments

N.J.H. and P.W. have received travel support from QIAGEN. G.P. has received speaker’s honoraria from BD and QIAGEN.

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Correspondence to N. J. Hos.

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The authors declare that accepted principles of ethical and professional conduct have been followed.

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QIAGEN has supported this study by providing test kits and devices, but had no influence on data evaluation or manuscript writing.

Conflict of interest

N.J.H. and P.W. have received travel support from QIAGEN. G.P. has received speaker’s honoraria from BD and QIAGEN. QIAGEN has supported this study by providing test kits and devices, but had no influence on data evaluation or manuscript writing.

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Hos, N.J., Wiegel, P., Fischer, J. et al. Comparative evaluation of two fully-automated real-time PCR methods for MRSA admission screening in a tertiary-care hospital. Eur J Clin Microbiol Infect Dis 35, 1475–1478 (2016). https://doi.org/10.1007/s10096-016-2687-8

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  • DOI: https://doi.org/10.1007/s10096-016-2687-8

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