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Comparison of Different Phenotypic Approaches To Screen and Detect mecC-Harboring Methicillin-Resistant Staphylococcus aureus.
J Clin Microbiol. 2018 01; 56(1)JC

Abstract

Similar to mecA, mecC confers resistance against beta-lactams, leading to the phenotype of methicillin-resistant Staphylococcus aureus (MRSA). However, mecC-harboring MRSA strains pose special difficulties in their detection. The aim of this study was to assess and compare different phenotypic systems for screening, identification, and susceptibility testing of mecC-positive MRSA isolates. A well-characterized collection of mecC-positive S. aureus isolates (n = 111) was used for evaluation. Routinely used approaches were studied to determine their suitability to correctly identify mecC-harboring MRSA, including three (semi)automated antimicrobial susceptibility testing (AST) systems and five selective chromogenic agar plates. Additionally, a cefoxitin disk diffusion test and an oxacillin broth microdilution assay were examined. All mecC-harboring MRSA isolates were able to grow on all chromogenic MRSA screening plates tested. Detection of these isolates in AST systems based on cefoxitin and/or oxacillin testing yielded overall positive agreements with the mecC genotype of 97.3% (MicroScan WalkAway; Siemens), 91.9% (Vitek 2; bioMérieux), and 64.9% (Phoenix, BD). The phenotypic resistance pattern most frequently observed by AST devices was "cefoxitin resistance/oxacillin susceptibility," ranging from 54.1% (Phoenix) and 83.8% (Vitek 2) to 92.8% (WalkAway). The cefoxitin disk diffusion and oxacillin broth microdilution assays categorized 100% and 61.3% of isolates to be MRSA, respectively. The chromogenic media tested confirmed their suitability to reliably screen for mecC-harboring MRSA. The AST systems showed false-negative results with varying numbers, misidentifying mecC-harboring MRSA as methicillin-susceptible S. aureus This study underlines cefoxitin's status as the superior surrogate mecC-positive MRSA marker.

Authors+Show Affiliations

Institute of Medical Microbiology, University Hospital Münster, Münster, Germany.Institute of Medical Microbiology, University Hospital Münster, Münster, Germany.Institute of Medical Microbiology, University Hospital Münster, Münster, Germany.Robert-Koch-Institute, Berlin, Germany.Robert-Koch-Institute, Berlin, Germany.Laboratoire de Microbiologie, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium.Royal (Dick) School of Veterinary Studies, University of Edinburgh, Midlothian, United Kingdom.Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom.Robert-Koch-Institute, Wernigerode Branch, Wernigerode, Germany.Institute of Medical Microbiology, University Hospital Münster, Münster, Germany kbecker@uni-muenster.de.

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

28978682

Citation

Kriegeskorte, André, et al. "Comparison of Different Phenotypic Approaches to Screen and Detect mecC-Harboring Methicillin-Resistant Staphylococcus Aureus." Journal of Clinical Microbiology, vol. 56, no. 1, 2018.
Kriegeskorte A, Idelevich EA, Schlattmann A, et al. Comparison of Different Phenotypic Approaches To Screen and Detect mecC-Harboring Methicillin-Resistant Staphylococcus aureus. J Clin Microbiol. 2018;56(1).
Kriegeskorte, A., Idelevich, E. A., Schlattmann, A., Layer, F., Strommenger, B., Denis, O., Paterson, G. K., Holmes, M. A., Werner, G., & Becker, K. (2018). Comparison of Different Phenotypic Approaches To Screen and Detect mecC-Harboring Methicillin-Resistant Staphylococcus aureus. Journal of Clinical Microbiology, 56(1). https://doi.org/10.1128/JCM.00826-17
Kriegeskorte A, et al. Comparison of Different Phenotypic Approaches to Screen and Detect mecC-Harboring Methicillin-Resistant Staphylococcus Aureus. J Clin Microbiol. 2018;56(1) PubMed PMID: 28978682.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of Different Phenotypic Approaches To Screen and Detect mecC-Harboring Methicillin-Resistant Staphylococcus aureus. AU - Kriegeskorte,André, AU - Idelevich,Evgeny A, AU - Schlattmann,Andreas, AU - Layer,Franziska, AU - Strommenger,Birgit, AU - Denis,Olivier, AU - Paterson,Gavin K, AU - Holmes,Mark A, AU - Werner,Guido, AU - Becker,Karsten, Y1 - 2017/12/26/ PY - 2017/05/23/received PY - 2017/09/18/accepted PY - 2017/10/6/pubmed PY - 2019/6/1/medline PY - 2017/10/6/entrez KW - MRSA KW - Staphylococcus aureus KW - broth microdilution KW - cefoxitin KW - chromogenic media KW - disk diffusion KW - mecC KW - methicillin resistance KW - oxacillin KW - susceptibility testing JF - Journal of clinical microbiology JO - J. Clin. Microbiol. VL - 56 IS - 1 N2 - Similar to mecA, mecC confers resistance against beta-lactams, leading to the phenotype of methicillin-resistant Staphylococcus aureus (MRSA). However, mecC-harboring MRSA strains pose special difficulties in their detection. The aim of this study was to assess and compare different phenotypic systems for screening, identification, and susceptibility testing of mecC-positive MRSA isolates. A well-characterized collection of mecC-positive S. aureus isolates (n = 111) was used for evaluation. Routinely used approaches were studied to determine their suitability to correctly identify mecC-harboring MRSA, including three (semi)automated antimicrobial susceptibility testing (AST) systems and five selective chromogenic agar plates. Additionally, a cefoxitin disk diffusion test and an oxacillin broth microdilution assay were examined. All mecC-harboring MRSA isolates were able to grow on all chromogenic MRSA screening plates tested. Detection of these isolates in AST systems based on cefoxitin and/or oxacillin testing yielded overall positive agreements with the mecC genotype of 97.3% (MicroScan WalkAway; Siemens), 91.9% (Vitek 2; bioMérieux), and 64.9% (Phoenix, BD). The phenotypic resistance pattern most frequently observed by AST devices was "cefoxitin resistance/oxacillin susceptibility," ranging from 54.1% (Phoenix) and 83.8% (Vitek 2) to 92.8% (WalkAway). The cefoxitin disk diffusion and oxacillin broth microdilution assays categorized 100% and 61.3% of isolates to be MRSA, respectively. The chromogenic media tested confirmed their suitability to reliably screen for mecC-harboring MRSA. The AST systems showed false-negative results with varying numbers, misidentifying mecC-harboring MRSA as methicillin-susceptible S. aureus This study underlines cefoxitin's status as the superior surrogate mecC-positive MRSA marker. SN - 1098-660X UR - https://www.unboundmedicine.com/medline/citation/28978682/Comparison_of_Different_Phenotypic_Approaches_To_Screen_and_Detect_mecC_Harboring_Methicillin_Resistant_Staphylococcus_aureus_ L2 - http://jcm.asm.org/cgi/pmidlookup?view=long&pmid=28978682 DB - PRIME DP - Unbound Medicine ER -