ArticlePloS one2014
Recombinations in staphylococcal cassette chromosome mec elements compromise the molecular detection of methicillin resistance in Staphylococcus aureus.
Article in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers.
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Who cites it
29 citing papers in PubMed, 66 citations in OpenAlex.
- Development of a Point-of-Care Recombinase Polymerase Amplification Assay for Detection of Neisseria gonorrhoeae and Ceftriaxone-Resistance Associated penA Allele 60.001.Molecular diagnosis & therapy · 2026Article
- Development of a recombinase polymerase amplification isothermal assay for rapid visual and lateral flow detection of porcine parvovirus-7.Veterinary research forum : an international quarterly journal · 2026Article
- Characterization of SCCAntimicrobial agents and chemotherapy · 2022Article
- Detection of Methicillin-ResistantAntibiotics (Basel, Switzerland) · 2022Article
- Rapid and direct detection of hepatitis E virus in raw pork livers by recombinase polymerase amplification assays.Frontiers in cellular and infection microbiology · 2022Article
- Recent advances in PCR-free nucleic acid detection for SARS-COV-2.Frontiers in bioengineering and biotechnology · 2022Review
- Sensitive and semiquantitative detection of soil-transmitted helminth infection in stool using a recombinase polymerase amplification-based assay.PLoS neglected tropical diseases · 2021Article
- Characterisation of S. aureus/MRSA CC1153 and review of mobile genetic elements carrying the fusidic acid resistance gene fusC.Scientific reports · 2021Article
- On point identification of species origin of food animals by recombinase polymerase amplification-lateral flow (RPA-LF) assay targeting mitochondrial gene sequences.Journal of food science and technology · 2021Article
- Investigation of Plasmids Among ClinicalFrontiers in microbiology · 2021Article
- Rapid Detection and Differentiation ofFrontiers in chemistry · 2021Article
- Rapid and visual detection of milk vetch dwarf virus using recombinase polymerase amplification combined with lateral flow strips.Virology journal · 2020Article
- An epidemic CC1-MRSA-IV clone yields false-negative test results in molecular MRSA identification assays: a note of caution, Austria, Germany, Ireland, 2020.Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2020Article
- Development and Evaluation of Real-Time Reverse Transcription Recombinase Polymerase Amplification Assay for Rapid and Sensitive Detection of West Nile Virus in Human Clinical Samples.Frontiers in cellular and infection microbiology · 2020Article
- Updating Molecular Diagnostics for Detecting Methicillin-Susceptible and Methicillin-Resistant Staphylococcus aureus Isolates in Blood Culture Bottles.Journal of clinical microbiology · 2019Article
- Resistance diagnostics as a public health tool to combat antibiotic resistance: A model-based evaluation.PLoS biology · 2019Article
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- Molecular diagnosis of protozoan parasites by Recombinase Polymerase Amplification.Acta tropica · 2018Article
- Recombinase polymerase amplification: Basics, applications and recent advances.Trends in analytical chemistry : TRAC · 2018Review
Corrections and comments
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Authors and funding
9 authors at 5 institutions in 3 countries.
Funding
Abstract
Clinical laboratories are increasingly using molecular tests for methicillin-resistant Staphylococcus aureus (MRSA) screening. However, primers have to be targeted to a variable chromosomal region, the staphylococcal cassette chromosome mec (SCCmec). We initially screened 726 MRSA isolates from a single UK hospital trust by recombinase polymerase amplification (RPA), a novel, isothermal alternative to PCR. Undetected isolates were further characterised using multilocus sequence, spa typing and whole genome sequencing. 96% of our tested phenotypically MRSA isolates contained one of the six orfX-SCCmec junctions our RPA test and commercially available molecular tests target. However 30 isolates could not be detected. Sequencing of 24 of these isolates demonstrated recombinations within the SCCmec element with novel insertions that interfered with the RPA, preventing identification as MRSA. This result suggests that clinical laboratories cannot rely solely upon molecular assays to reliably detect all methicillin-resistance. The presence of significant recombinations in the SCCmec element, where the majority of assays target their primers, suggests that there will continue to be isolates that escape identification. We caution that dependence on amplification-based molecular assays will continue to result in failure to diagnose a small proportion (∼4%) of MRSA isolates, unless the true level of SCCmec natural diversity is determined by whole genome sequencing of a large collection of MRSA isolates.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.