The Use of Cefoxitin for the Determination of Methicillin Resistance.pptVIP

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2016-10-07 发布于重庆
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The Use of Cefoxitin for the Determination of Methicillin Resistance.ppt

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The Use of Cefoxitin for the Determination of Methicillin Resistance

The Use of Cefoxitin for the Determination of Methicillin Resistance in Staphylococci John D. Perry Microbiology Department Freeman Hospital Newcastle upon Tyne BSAC Working Party recommendations for detection of methicillin resistance (2004): Inoculum: Semi confluent Medium: Columbia agar plus 2 % salt. Incubation conditions: 30°C Discs: Oxacillin 1 μg or methicillin 5 μg BSAC Working Party recommendations for detection of methicillin resistance (2004) Disadvantages: A separate medium (at a different temperature) is required to that used for testing other anti-staphylococcal agents. False resistance may be encountered due to hyper-production of ?-lactamase False susceptibility may be encountered with strains that are highly sensitive to salt. Felten et al: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.J Clin Microbiol. 2002 Aug;40(8):2766-71. Felten et al. examined: 69 mecA-negative S. aureus strains and 83 mecA positive S. aureus strains (MRSA) including 69 with heterogeneous resistance. Susceptibility to cefoxitin 30 μg discs was determined on Mueller-Hinton agar at 37°C using high and low inocula. Oxacillin disc testing was performed in parallel using CLSI and CASFM methodologies. Felten et al. (continued): Results: The cefoxitin 30 μg disc test showed 100 % specificity and 100 % sensitivity for detection of MRSA. Interpretive criteria were: Zone diameter 27 mm = MRSA. Disc testing using oxacillin showed a sensitivity of 95.2 – 96.4 % depending on the inoculum used. Specificity was 100 %. Significance of the study by Felten et al. The results suggested that cefoxitin was potentially more sensitive that oxacillin for detection of methicillin resistance. Also: Reliable results were obtained at 37°C, without the addition of salt, without a specialised medium