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Am J Clin Pathol. 2009 Apr;131(4):532-9. doi: 10.1309/AJCP18ONZUTDUGAQ.

Chromogenic media vs real-time PCR for nasal surveillance of methicillin-resistant Staphylococcus aureus: impact on detection of MRSA-positive persons.

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Department of Pathology and Laboratory Medicine, Division of Microbiology, NorthShore University HealthSystem, Walgreen SB525, 2650 Ridge Ave, Evanston, IL 60201, USA.


Surveillance for methicillin-resistant Staphylococcus aureus (MRSA) colonization can be an important element for infection control programs when managing a multidrug-resistant pathogen such as MRSA. The sensitivity and speed of laboratory testing affects the proportion of appropriate isolation days captured, which determines the success or failure of a MRSA control program. Chromogenic culture, CHROMagar MRSA (BBL, Becton Dickinson, Sparks, MD) and MRSASelect (Bio-Rad, Hercules, CA), with and without broth enrichment and real-time polymerase chain reaction (PCR; BD GeneOhm MRSA, BD Diagnostics, San Diego, CA), were compared and found to have a wide range of sensitivities (78.5%-98.2%), specificities (91.6%-100.0%), and turnaround times (2-72 hours). Real-time PCR provided the most rapid results and demonstrated the highest sensitivity followed by broth-enriched culture and then direct plating for MRSA detection in nasal swabs. There was no substantial difference in the labor required for any of the 3 approaches.

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