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Journal of Clinical Microbiology, October 2008, p. 3285-3290, Vol. 46, No. 10
0095-1137/08/$08.00+0     doi:10.1128/JCM.02487-07
Copyright © 2008, American Society for Microbiology. All Rights Reserved.

Evaluation of the Xpert Methicillin-Resistant Staphylococcus aureus (MRSA) Assay Using the GeneXpert Real-Time PCR Platform for Rapid Detection of MRSA from Screening Specimens {triangledown}

Angela S. Rossney,1,2* Celine M. Herra,3 Gráinne I. Brennan,4 Pamela M. Morgan,1 and Brian O'Connell1,2,4

National MRSA Reference Laboratory, St. James's Hospital, James's St., Dublin 8, Ireland,1 Department of Clinical Microbiology, University of Dublin, Trinity College, St. James's Hospital, James's St., Dublin 8, Ireland,2 School of Biological Sciences, Dublin Institute of Technology, Kevin St., Dublin 8, Ireland,3 Department of Microbiology, St. James's Hospital, James's St., Dublin 8, Ireland4

Received 28 December 2007/ Returned for modification 9 April 2008/ Accepted 27 July 2008

The need for rapid methods to accurately detect methicillin-resistant Staphylococcus aureus (MRSA) is widely acknowledged, and a number of molecular assays are commercially available. This study evaluated the Xpert MRSA assay, which is run on the GeneXpert real-time PCR platform (Cepheid) for use in a clinical laboratory. The following parameters were investigated: (i) the limits of detection (LoDs) for four MRSA strains; (ii) the ability to detect isolates of MRSA from a collection representative of MRSA in Ireland since 1974 (n = 114) and the ability to detect control strains with staphylococcal cassette chromosome mec types IVa (IV.1.1.1), IVb (IV.2.1.1), IVc (IV.3.1.1), IVd (IV.4.1.1), V (V.1.1.1), VT, and VI; and (iii) performance in a clinical trial with swabs from nose, throat, and groin/perineum sites from 204 patients, where results were compared with those obtained by direct and enrichment cultures. The average LoD of the four test strains was 610 CFU/ml (equivalent to 58 CFU/swab). All 114 MRSA isolates and 7 control strains tested were detected. Sensitivity, specificity, and positive and negative predictive values for clinical specimens from all sites investigated were 90%, 97%, 86%, and 98%, respectively, but throat specimens yielded poor sensitivity (75%). Sensitivity, specificity, and positive and negative predictive values for nasal specimens were 95%, 98%, 90%, and 99%, respectively. Overall, the assay was rapid and easy to perform, but performance might be enhanced by the inclusion of an equivocal interpretive category based on analysis of all available amplification data.

* Corresponding author. Mailing address: National MRSA Reference Laboratory, St. James's Hospital, James's St., Dublin 8, Ireland. Phone: 353 1 410 3662. Fax: 353 1 410 3666. E-mail: arossney{at}stjames.ie

{triangledown} Published ahead of print on 6 August 2008.

Journal of Clinical Microbiology, October 2008, p. 3285-3290, Vol. 46, No. 10
0095-1137/08/$08.00+0     doi:10.1128/JCM.02487-07
Copyright © 2008, American Society for Microbiology. All Rights Reserved.



This article has been cited by other articles:

  • Kelley, P. G., Grabsch, E. A., Howden, B. P., Gao, W., Grayson, M. L. (2009). Comparison of the Xpert Methicillin-Resistant Staphylococcus aureus (MRSA) Assay, BD GeneOhm MRSA Assay, and Culture for Detection of Nasal and Cutaneous Groin Colonization by MRSA. J. Clin. Microbiol. 47: 3769-3772 [Abstract] [Full Text]  
  • Wolk, D. M., Picton, E., Johnson, D., Davis, T., Pancholi, P., Ginocchio, C. C., Finegold, S., Welch, D. F., de Boer, M., Fuller, D., Solomon, M. C., Rogers, B., Mehta, M. S., Peterson, L. R. (2009). Multicenter Evaluation of the Cepheid Xpert Methicillin-Resistant Staphylococcus aureus (MRSA) Test as a Rapid Screening Method for Detection of MRSA in Nares. J. Clin. Microbiol. 47: 758-764 [Abstract] [Full Text]  
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