Detection of methicillin resistance in Staphylococcus aureus isolated from pediatric patients: Is the cefoxitin disk diffusion test accurate enough?

• Autor(a) principal: Mimica, M. J.
• Data de Publicação: 2007
• Outros Autores: Berezin, Eitan Naaman [UNIFESP], Carvalho, R. L. B., Mimica, I. M., Mimica, L. M. J., Safadi, Marco Aurelio Palazzi [UNIFESP], Schneider, E., Caiaffa-Filho, H. H.
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional da UNIFESP
• dARK ID: ark:/48912/00130000057mg
• DOI: 10.1590/S1413-86702007000400009
• Texto Completo: http://dx.doi.org/10.1590/S1413-86702007000400009; http://repositorio.unifesp.br/handle/11600/42880
• topic: MRSA; disc diffusion; cefoxitin; mecA

We evaluated the performance of several methods for the detection of methicillin resistance in Staphylococcus aureus using 101 clinical S. aureus isolates from pediatric patients in a tertiary hospital in Brazil; 50 isolates were mecA-positive and 51 were mecA-negative. The Etest and oxacillin agar screening plates were 100% sensitive and specific for mecA presence. Oxacillin and cefoxitin disks gave sensitivities of 96 and 92%, respectively, and 98% specificity. Alterations of CLSI cefoxitin breakpoints increased sensitivity to 98%, without decreasing specificity. Our results highlight the importance of a continuing evaluation of the recommended microbiological methods by different laboratories and in different settings. If necessary, laboratories should use a second test before reporting a strain as susceptible, especially when testing strains isolated from invasive or serious infections. With the new (2007) CLSI breakpoints, the cefoxitin-disk test appears to be a good option for the detection of methicillin resistance in S. aureus.