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Direct detection of methicillin-resistant in Staphylococcus spp. in positive blood culture by isothermal recombinase polymerase amplification combined with lateral flow dipstick assay

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Abstract

Methicillin-resistant staphylococci (MRS) are important antimicrobial-resistant pathogens in sepsis. Conventional blood cultures take 24–72 h. The polymerase chain reaction (PCR)-based methods give faster results (2–3 h) but need expensive thermal cyclers. We therefore developed an isothermal recombinase polymerase amplification (RPA) combined with lateral flow dipstick (LFD) assay for rapid detection of MRS in spiked blood culture samples. Fifty-six clinical isolates including 38 mecA-carrying staphylococci and 18 non-mecA-carrying organisms as confirmed by PCR methods were studied. RPA primer set and probe specific for mecA gene (encoding penicillin-binding protein 2a) were designed. RPA reaction was carried out under isothermal condition (45 °C) within 20 min and read by LFD in 5 min. The RPA-LFD provided 92.1% (35/38) sensitivity for identifying MRS in positive blood culture samples, and no cross-amplification was found (100% specificity). This test failed to detect three mecA-carrying S.sciuri isolates. The detection limits of RPA-LFD method for identifying MRS were equal to those of PCR method. The RPA-LFD is simple, fast, and user-friendly. This method could detect the mecA gene directly from the positive blood culture samples without requirement for special equipment. This method would be useful for appropriate antibiotic therapy and infection control, particularly in a low-resource setting.

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Acknowledgements

This work was supported by a scholarship under the Post-Doctoral Training Program from Khon Kaen University, Thailand (PD2562-09); a research grant from Khon Kaen University (Project Number I62-00-19-03); and the Centre for Research and Development of Medical Diagnostic Laboratories (CMDL), Faculty of Associated Medical Sciences, Khon Kaen University, Thailand. We are grateful to Firmer Co., Ltd for supporting pre-incubated aerobic culture bottles and RENDER automated blood culture system; and to staff of Clinical Microbiology Unit, Srinagarind Hospital for collecting the clinical isolates.

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  1. Centre for Research and Development of Medical Diagnostic Laboratories, Faculty of Associated Medical Sciences, Khon Kaen University, 40002, Khon Kaen, Thailand

    Arpasiri Srisrattakarn, Patcharaporn Tippayawat, Aroonwadee Chanawong, Ratree Tavichakorntrakool, Jureerut Daduang & Aroonlug Lulitanond

  2. Clinical Microbiology Unit, Srinagarind Hospital, Khon Kaen University, 40002, Khon Kaen, Thailand

    Lumyai Wonglakorn & Pirom Sooksongsoontorn

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  1. Arpasiri Srisrattakarn
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Correspondence to Aroonlug Lulitanond.

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This study was approved by the Ethics Committee of Khon Kaen University (project number HE611605).

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Srisrattakarn, A., Tippayawat, P., Chanawong, A. et al. Direct detection of methicillin-resistant in Staphylococcus spp. in positive blood culture by isothermal recombinase polymerase amplification combined with lateral flow dipstick assay. World J Microbiol Biotechnol 36, 162 (2020). https://doi.org/10.1007/s11274-020-02938-8

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