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Journal of Clinical Microbiology, December 2004, p. 5578-5581, Vol. 42, No. 12
0095-1137/04/$08.00+0     DOI: 10.1128/JCM.42.12.5578-5581.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.

Detection of Methicillin-Resistant Staphylococcus aureus Directly from Nasal Swab Specimens by a Real-Time PCR Assay

David K. Warren,1* Robert S. Liao,2 Liana R. Merz,1 Michael Eveland,3 and W. Michael Dunne Jr.2

Division of Infectious Diseases, Department of Medicine,1 Division of Laboratory Medicine, Department of Pathology and Immunology, Washington University School of Medicine,2 Barnes-Jewish Hospital, Saint Louis, Missouri3

Received 23 April 2004/ Returned for modification 22 June 2004/ Accepted 3 August 2004

Screening for colonization with methicillin-resistant Staphylococcus aureus (MRSA) is a key aspect of infection control to limit the nosocomial spread of this organism. Current methods for the detection of MRSA in clinical microbiology laboratories, including molecularly based techniques, require a culture step and the isolation of pure colonies that result in a minimum of 20 to 24 h until a result is known. We describe a qualitative in vitro diagnostic test for the rapid detection of MRSA directly from nasal swab specimens (IDI-MRSA; Infectio Diagnostic, Inc., Sainte-Foy, Québec, Canada), based upon a real-time PCR and direct detection of MRSA via amplicon hybridization with a fluorogenic target-specific molecular beacon probe. Samples from 288 patients were analyzed for the presence of MRSA with the IDI-MRSA assay, compared to detection by either direct plating or enrichment broth selective culture methods. The diagnostic values for this MRSA screening method were 91.7% sensitivity, 93.5% specificity, 82.5% positive predictive value, and 97.1% negative predictive value when compared to culture-based methods. The time from the start of processing of specimen to result was approximately 1.5 h. In our hands, the IDI-MRSA assay is a sensitive and specific test for detection of nasal colonization with MRSA and providing for same-day results, allowing more efficient and effective use of infection control resources to control MRSA in health care facilities.

* Corresponding author. Mailing address: Division of Infectious Diseases, Washington University School of Medicine, Campus Box 8051, 660 S. Euclid Ave., Saint Louis, MO 63110. Phone: (314) 454-8225. Fax: (314) 454-5392. E-mail: dwarren{at}wustl.edu.

Journal of Clinical Microbiology, December 2004, p. 5578-5581, Vol. 42, No. 12
0095-1137/04/$08.00+0     DOI: 10.1128/JCM.42.12.5578-5581.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.



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