ArticleJournal of clinical microbiology2002
Evaluation of three techniques for detection of low-level methicillin-resistant Staphylococcus aureus (MRSA): a disk diffusion method with cefoxitin and moxalactam, the Vitek 2 system, and the MRSA-screen latex agglutination test.
Article in Journal of clinical microbiology, 2002. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 67 papers.
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67 citing papers in PubMed, 271 citations in OpenAlex.
- RPA Combined With CRISPR/Cas12a for Rapid and Ultrasensitive Detection Dual-Gene of Methicillin-Resistant Staphylococcus aureus (MRSA).Journal of molecular recognition : JMR · 2026Article
- Analysis of risk factors, pathogenic bacteria characteristics, and drug resistance of postoperative surgical site infection in adults with limb fractures.Chinese journal of traumatology = Zhonghua chuang shang za zhi · 2025Article
- Mec-A Positive Methicillin-SusceptibleReports of biochemistry & molecular biology · 2024Article
- The Clinical Characteristics and Antimicrobial Resistance ofAntibiotics (Basel, Switzerland) · 2024Article
- Prevalence and clinical characteristics of methicillin-resistantFrontiers in public health · 2023Article
- Resistance and Molecular Characteristics of Methicillin-ResistantInfection and drug resistance · 2023Article
- PMMA/ABS/CoClMolecules (Basel, Switzerland) · 2022Article
- Assessment of listing and categorisation of animal diseases within the framework of the Animal Health Law (Regulation (EU) No 2016/429): antimicrobial-resistantEFSA journal. European Food Safety Authority · 2022Article
- An Anti-MRSA Phage From Raw Fish Rinse: Stability Evaluation and Production Optimization.Frontiers in cellular and infection microbiology · 2022Article
- Emergence of Methicillin-ResistantPathogens (Basel, Switzerland) · 2021Article
- First Report of Oxacillin SusceptibleInfection and drug resistance · 2021Article
- Pathogenic and Virulence Factor Detection on Viable but Non-culturable Methicillin-ResistantFrontiers in microbiology · 2021Article
- Molecular detection of methicillin heat-resistant Staphylococcus aureus strains in pasteurized camel milk in Saudi Arabia.Bioscience reports · 2020Article
- First Report on the Rapid Detection and Identification of Methicillin-ResistantFrontiers in microbiology · 2020Article
- Association Between the Methicillin Resistance of Staphylococcus aureus Isolated from Slaughter Poultry, Their Toxin Gene Profiles and Prophage Patterns.Current microbiology · 2018Article
- Ambulance vehicles as a source of multidrug-resistant infections: a multicenter study in Assiut City, Egypt.Infection and drug resistance · 2018Article
- Bacterial pathogens associated with external ocular infections alongside eminent proportion of multidrug resistant isolates at the University of Gondar Hospital, northwest Ethiopia.BMC ophthalmology · 2017Article
- Carriage frequency, phenotypic, and genotypic characteristics of methicillin-resistant Staphylococcus aureus isolated from dental health-care personnel, patients, and environment.Scientific reports · 2017Article
- Disk Diffusion Testing for Detection of Methicillin-Resistant Staphylococci: Does Moxalactam Improve upon Cefoxitin?Journal of clinical microbiology · 2016Article
- Molecular typing of methicillin-resistant and methicillin-susceptible Staphylococcus aureus isolates from Shiraz teaching hospitals by PCR-RFLP of coagulase gene.Iranian journal of microbiology · 2014Article
7 more citing papers are in PubMed but not listed here.
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4 authors at 1 institution in 1 country.
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Abstract
Very-low-level methicillin-resistant Staphylococcus aureus (MRSA), or class 1 MRSA, is often misdiagnosed as methicillin-susceptible S. aureus (MSSA). We evaluated the performances of three methods for detection of low-level methicillin resistance: the disk diffusion method using the cephamycin antibiotics cefoxitin and moxalactam, the Vitek 2 system (bioMérieux), and the MRSA-screen test (Denka). Detection of the mecA gene by PCR was considered to be the "gold standard." We also determined the sensitivity of the oxacillin disk diffusion method with 5- and 1-microg disks and that of the Oxascreen agar assay with 6 mg of oxacillin liter(-1) for detection of MRSA. We compared the distributions of MICs of oxacillin and cefoxitin by the E-test (AB Biodisk), and those of moxalactam by dilutions in agar, for MRSA and MSSA isolates. The 152 clinical isolates of S. aureus studied were divided into 69 MSSA (mecA-negative) and 83 MRSA (mecA-positive) isolates, including 63 heterogeneous isolates and 26 class 1 isolates (low-level resistance). The cefoxitin and moxalactam disk diffusion tests detected 100% of all the MRSA classes: cefoxitin inhibition zone diameters were <27 mm, and moxalactam inhibition zone diameters were <24 mm. The Vitek 2 system and the MRSA-screen test detected 94 and 97.6% of all MRSA isolates, respectively. The sensitivities of the 5- and 1-microg oxacillin disks were 95.2 and 96.4%, respectively, whereas that of the Oxascreen agar screen assay was 94%. All of the tests except the 1-microg oxacillin disk test were 100% specific. For the class 1 MRSA isolates, the sensitivity of the Vitek 2 test was 92.3%, whereas those of the MRSA-screen test and the disk diffusion method with cefoxitin and moxalactam were 100%. Therefore, the cefoxitin and moxalactam disk diffusion methods were the best-performing tests for routine detection of all classes of MRSA.
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