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Evaluation of different disk diffusion/media combinations for detection of methicillin resistance in Staphylococcus aureus and coagulase-negative staphylococci

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Abstract:

Skov R, Larsen AR, Frimodt-Møller N, Espersen F. Evaluation of different disk diffusion/media combinations for detection of methicillin resistance in Staphylococcus aureus and coagulase-negative staphylococci. APMIS 2003;111:905–14.

In order to find a disk diffusion method with both high sensitivity and specificity for determination of methicillin resistance primarily for S. aureus but also for coagulase-negative staphylococci we screened several methodological variants using a material of 66 S. aureus comprising of 11 methicillin-susceptible, 18 borderline-resistant, and 37 methicillin-resistant strains. Only four of the combinations studied performed with both high sensitivity and specificity. Two of these, the Columbia agar +4.5% NaCl and Mueller Hinton agar +2% NaCl combined with a 5 μg oxacillin disk, confluent inoculum and 24 h incubation at 35 °C were further evaluated using 105 MRSA and 91 mecA-negative S. aureus and 193 clinical isolates of coagulase-negative staphylococci. The Columbia agar +4.5% NaCl performed excellently for both S. aureus and coagulase-negative staphylococci. For Columbia agar +4.5% NaCl using a 5 μg oxacillin disk we suggest an interpretive zone diameter of R≤15 mm and S≥16 mm for S. aureus and R≤24 mm and S≥26 mm for coagulase-negative staphylococci. The Mueller Hinton agar +2% NaCl performed well for coagulase-negative staphylococci but for S. aureus at least three (3%) very major errors were found, making this method less attractive.

Keywords: S. aureus; columbia agar; methicillin resistance; susceptibility testing

Document Type: Research Article

DOI: http://dx.doi.org/10.1034/j.1600-0463.2003.1110909.x

Affiliations: Sector for Microbiology, Statens Serum Institut, Copenhagen, Denmark

Publication date: September 1, 2003

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