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Journal of Clinical Microbiology, April 1998, p. 1032-1034, Vol. 36, No. 4
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.
Evaluation of Four Methods for Rapid Identification
of Staphylococcus aureus from Blood Cultures
David J.
Speers,*
Thomas R.
Olma, and
Gwendolyn
L.
Gilbert
Center for Infectious Diseases and
Microbiology Laboratory Services, Institute of Clinical Pathology
and Medical Research, Westmead Hospital, Westmead, NSW 2145, Australia
Received 1 October 1997/Returned for modification 12 November
1997/Accepted 5 December 1997
The identification of Staphylococcus aureus directly
from blood cultures is clinically relevant, but it requires a test that is both rapid and reliable. Previously, biochemical, immunological, tube coagulase, and thermostable-endonuclease methods have shown variable sensitivity and specificity. Testing directly from blood culture broth has not been described for the latex kit Staphaurex Plus
(Murex Diagnostics Ltd.), and the modified conventional tests have not
been used with the newer, continuously monitored blood culture systems.
In addition, the commercial RAPIDEC staph kit (bioMerieux Vitek, Inc.)
has been used to detect S. aureus directly from the Vital
blood culture system (bioMerieux, Marcy l'Etoile, France), but its
performance has not been evaluated with other continuously monitored
systems. A total of 201 clinical blood cultures (BACTEC 9240 culture
system; Johnston Laboratories, Inc.) in which a Gram stain showed
gram-positive cocci resembling staphylococci were evaluated
prospectively. The Staphaurex Plus kit, the tube coagulase test, the
thermostable-endonuclease test, and the RAPIDEC staph kit were
compared. The sensitivities were 23, 92, 85, and 98% and the
specificities were 99, 100, 93, and 100%, respectively. The RAPIDEC
staph kit was the most reliable test, with a diagnostic accuracy
comparable to that of the best published results for any of the rapid
tests. However, it was the most expensive of the tests and relatively
labor-intensive. The tube coagulase test was also sensitive, the
simplest to perform, and inexpensive.
*
Corresponding author. Phone: (61) 2 9845 6238. Fax:
(61) 2 9893 8659. E-mail:
lyng{at}cidm.wh.su.edu.au.
Journal of Clinical Microbiology, April 1998, p. 1032-1034, Vol. 36, No. 4
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.
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