Use of molecular tests for rapid detection of bacteremia caused by methicillin-resistant Staphylococcus aureus

作者：Margat E^*

来源：Journal des Anti-Infectieux, 2012, 15(1): 9-14.

DOI：10.1016/j.antinf.2013.02.003

• Staphylococcus aureus
• Bacteremia
• Antibiotic therapy
• PCR

Staphylococcus aureus is the most prevalent pathogen isolated in bacteremia after Escherichia coli. Rapid diagnosis of bacteremia caused by S. aureus is crucial. Indeed, any delay in the initiation of antibiotic or inappropriate antibiotic in bacteremia due to methicillin-resistant Staphylococcus aureus (MRSA) may be associated with increased mortality rate. On the other hand, misuse of glycopeptides in methicillin-susceptible Staphylococcus aureus (MSSA) bacteremia has consequences in terms of adverse effects and efficacy. There are now news PCR technologies for detection of S. aureus and its methicillin resistance directly from positive blood cultures, allowing results 24 to 48 hours earlier than with conventional laboratory procedures. These methods are based on PCR amplification of genes specific for S. aureus, MRSA (SCCmec) and the mecA gene depending the test used. These techniques have a real impact in terms of time result reporting, even if there is a risk of false positives and false negatives for the detection of MRSA depending on different primers used. These novel PCR assays should allow faster initiation of appropriate antibiotic therapy. They should also reduce inadequate consumption of antibiotic, such as glycopeptides in bacteremia caused by MSSA and those due to coagulase negative staphylococci, which are often considered as contaminants. Unfortunately, studies on their clinical impact are still scarce.

• 出版日期2012-3