國家衛生研究院 NHRI:Item 3990099045/6297
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    題名: mecA-positive staphylococcus aureus with low-level oxacillin mic in Taiwan
    作者: Chen, FJ;Huang, IW;Wang, CH;Chen, PC;Wang, HY;Lai, JF;Shiau, YR;Lauderdale, TL
    貢獻者: Division of Infectious Diseases
    摘要: Although the presence of mecA is the genotypic determinant of methicillin-resistant Staphylococcus aureus (MRSA), certain MRSA, especially community-associated MRSA (C-MRSA), can display oxacillin MIC in the CLSI susceptible breakpoint range (</= 2 mug/mL). Among 91 and 180 isolates thought to be methicillin-susceptible S. aureus (MSSA) with oxacillin MIC 2 and 1 mug/mL by Sensititre broth microdilution (BMD) test initially, 52 (57.1%) and 6 (3.3%), respectively, were mecA-positive. These mecA-positive low-oxacillin MIC isolates belong to the dominant Taiwan C-MRSA clone [clonal complex (CC) 59], 56 of which carried SCCmec type V and were pvl-positive, and 43 belonged to spa CC t437. All 271 isolates were retested by Sensititre as well as by Vitek II and disk diffusion (DD). By oxacillin results, the sensitivity of Sensititre, Vitek II, and DD was 48.3% (28/58), 46.6% (27/58), and 89.6% (52/58), respectively. Although cefoxitin was better at detecting these isolates, 12.1%, 10.4%, and 5.2% of these isolates were still misidentified as MSSA by Sensititre, Vitek II, and DD, respectively. These results highlight the difficulty in accurate identification of MRSA with borderline oxacillin MICs in the CC59:SCCmec V clone, which likely has contributed to its spread in the health care and community settings. Since this clone has now been detected in other countries, and since other C-MRSA lineages have also been found to have low-level beta-lactam resistance, the findings of this study may be relevant to other regions. Further studies are warranted to determine the extent and clinical impact of such misidentification.
    日期: 2012-05
    關聯: Journal of Clinical Microbiology. 2012 May;50(5):1679-1683.
    Link to: http://dx.doi.org/10.1128/jcm.06711-11
    JIF/Ranking 2023: http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=NHRI&SrcApp=NHRI_IR&KeyISSN=0095-1137&DestApp=IC2JCR
    Cited Times(WOS): https://www.webofscience.com/wos/woscc/full-record/WOS:000302900500028
    Cited Times(Scopus): http://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=84859992865
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