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Article: Evaluation of disc diffusion tests and agar screening for predicting mecA-mediated oxacillin resistance in Staphylococcus lugdunensis revealed a cefoxitin-susceptible, mecA-positive S. lugdunensis clonal complex 27 clone
Title | Evaluation of disc diffusion tests and agar screening for predicting mecA-mediated oxacillin resistance in Staphylococcus lugdunensis revealed a cefoxitin-susceptible, mecA-positive S. lugdunensis clonal complex 27 clone |
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Authors | |
Keywords | Oxacillin resistance SCCmec Staphylococci |
Issue Date | 2020 |
Publisher | Elsevier BV. The Journal's web site is located at http://www.elsevier.com/locate/issn/22137165 |
Citation | Journal of Global Antimicrobial Resistance, 2020, v. 20, p. 260-265 How to Cite? |
Abstract | Objectives:
This study evaluated disc diffusion tests and agar screening for detecting mecA-mediated oxacillin resistance in Staphylococcus lugdunensis (S. lugdunensis).
Methods:
Staphylococcus lugdunensis isolates (n = 179) from diverse sources in Hong Kong during 1998–2018 were investigated by disc diffusion tests (cefoxitin and oxacillin) and inoculation onto oxacillin (1 μg/mL and 2 μg/mL) and chromID methicillin-resistant Staphylococcus aureus (MRSA) agars. The results were compared with mecA PCR as the reference. Isolates with discordant results were further tested by MIC and penicillin-binding protein 2a (PBP2a) assays.
Results:
Cefoxitin and oxacillin zone diameters were not distributed in ways that allowed reliable division of the mecA-positive (n = 52) and mecA-negative (n = 127) isolates. On applying the 2019 Clinical Laboratory Standards Institute (CLSI) M100 breakpoints for cefoxitin disc results, there was 88% categorical agreement (CA) and 40% very major error (VME). Screening using 2 μg/mL oxacillin agar reliably differentiated mecA-positive and mecA-negative isolates (100% CA) without any major error (ME) or VME results. The performance of screening using 1 μg/mL oxacillin agar or ChromID MRSA agar was variable (74–89% CA, 0–38% ME and 0–37% VME). The mecA-positive isolates (n = 21) that could not be detected by the cefoxitin disc test were further characterised. The cefoxitin MIC for all 21 isolates was ≤4 μg/mL. Twenty isolates had an oxacillin MIC of 1–2 μg/mL and one had an oxacillin MIC of 4 μg/mL. All had positive PBP2a results and were typed as clonal cluster 27/SCCmec V.
Conclusions:
These findings highlight the need to evaluate phenotypic methods using mecA-positive S. lugdunensis with different oxacillin resistance phenotypes. |
Persistent Identifier | http://hdl.handle.net/10722/285097 |
ISSN | 2023 Impact Factor: 3.7 2023 SCImago Journal Rankings: 0.880 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Ho, PL | - |
dc.contributor.author | LIU, MCJ | - |
dc.contributor.author | TONG, MK | - |
dc.contributor.author | Fan, PM | - |
dc.contributor.author | Tse, CWS | - |
dc.contributor.author | Wu, AKL | - |
dc.contributor.author | Cheng, VCC | - |
dc.contributor.author | Chow, KH | - |
dc.date.accessioned | 2020-08-07T09:06:42Z | - |
dc.date.available | 2020-08-07T09:06:42Z | - |
dc.date.issued | 2020 | - |
dc.identifier.citation | Journal of Global Antimicrobial Resistance, 2020, v. 20, p. 260-265 | - |
dc.identifier.issn | 2213-7165 | - |
dc.identifier.uri | http://hdl.handle.net/10722/285097 | - |
dc.description.abstract | Objectives: This study evaluated disc diffusion tests and agar screening for detecting mecA-mediated oxacillin resistance in Staphylococcus lugdunensis (S. lugdunensis). Methods: Staphylococcus lugdunensis isolates (n = 179) from diverse sources in Hong Kong during 1998–2018 were investigated by disc diffusion tests (cefoxitin and oxacillin) and inoculation onto oxacillin (1 μg/mL and 2 μg/mL) and chromID methicillin-resistant Staphylococcus aureus (MRSA) agars. The results were compared with mecA PCR as the reference. Isolates with discordant results were further tested by MIC and penicillin-binding protein 2a (PBP2a) assays. Results: Cefoxitin and oxacillin zone diameters were not distributed in ways that allowed reliable division of the mecA-positive (n = 52) and mecA-negative (n = 127) isolates. On applying the 2019 Clinical Laboratory Standards Institute (CLSI) M100 breakpoints for cefoxitin disc results, there was 88% categorical agreement (CA) and 40% very major error (VME). Screening using 2 μg/mL oxacillin agar reliably differentiated mecA-positive and mecA-negative isolates (100% CA) without any major error (ME) or VME results. The performance of screening using 1 μg/mL oxacillin agar or ChromID MRSA agar was variable (74–89% CA, 0–38% ME and 0–37% VME). The mecA-positive isolates (n = 21) that could not be detected by the cefoxitin disc test were further characterised. The cefoxitin MIC for all 21 isolates was ≤4 μg/mL. Twenty isolates had an oxacillin MIC of 1–2 μg/mL and one had an oxacillin MIC of 4 μg/mL. All had positive PBP2a results and were typed as clonal cluster 27/SCCmec V. Conclusions: These findings highlight the need to evaluate phenotypic methods using mecA-positive S. lugdunensis with different oxacillin resistance phenotypes. | - |
dc.language | eng | - |
dc.publisher | Elsevier BV. The Journal's web site is located at http://www.elsevier.com/locate/issn/22137165 | - |
dc.relation.ispartof | Journal of Global Antimicrobial Resistance | - |
dc.rights | This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. | - |
dc.subject | Oxacillin resistance | - |
dc.subject | SCCmec | - |
dc.subject | Staphylococci | - |
dc.title | Evaluation of disc diffusion tests and agar screening for predicting mecA-mediated oxacillin resistance in Staphylococcus lugdunensis revealed a cefoxitin-susceptible, mecA-positive S. lugdunensis clonal complex 27 clone | - |
dc.type | Article | - |
dc.identifier.email | Ho, PL: plho@hku.hk | - |
dc.identifier.email | Fan, PM: fpmjoyce@hku.hk | - |
dc.identifier.email | Wu, AKL: alanklwu@hkucc.hku.hk | - |
dc.identifier.email | Cheng, VCC: vcccheng@hkucc.hku.hk | - |
dc.identifier.email | Chow, KH: khchowb@hku.hk | - |
dc.identifier.authority | Ho, PL=rp00406 | - |
dc.identifier.authority | Chow, KH=rp00370 | - |
dc.description.nature | published_or_final_version | - |
dc.identifier.doi | 10.1016/j.jgar.2019.08.021 | - |
dc.identifier.pmid | 31493529 | - |
dc.identifier.scopus | eid_2-s2.0-85079197603 | - |
dc.identifier.hkuros | 312547 | - |
dc.identifier.volume | 20 | - |
dc.identifier.spage | 260 | - |
dc.identifier.epage | 265 | - |
dc.identifier.isi | WOS:000522221800050 | - |
dc.publisher.place | Netherlands | - |
dc.identifier.issnl | 2213-7165 | - |