1. Rapid Detection of PBP2a in Staphylococci from Shortly Incubated Subcultures of Positive Blood Cultures by an Immunochromatographic Assay
- Author
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Sebastian Herren, Kim Röthlin, Natalia Kolesnik-Goldmann, Elias Bodendoerfer, Stefano Mancini, Martina Marchesi, Frank Imkamp, University of Zurich, and Mancini, Stefano
- Subjects
0301 basic medicine ,Physiology ,Staphylococcus ,Antibiotics ,MRSA ,medicine.disease_cause ,blood culture ,2726 Microbiology (medical) ,1307 Cell Biology ,PBP2a ,0302 clinical medicine ,methicillin resistance ,2400 General Immunology and Microbiology ,Blood culture ,030212 general & internal medicine ,Pathology, Molecular ,rapid tests ,Immunoassay ,Ecology ,medicine.diagnostic_test ,10179 Institute of Medical Microbiology ,Staphylococcal Infections ,QR1-502 ,Anti-Bacterial Agents ,Infectious Diseases ,Staphylococcus aureus ,Vancomycin ,medicine.drug ,Research Article ,Microbiology (medical) ,medicine.drug_class ,030106 microbiology ,610 Medicine & health ,Staphylococcal infections ,Rapid detection ,Microbiology ,03 medical and health sciences ,Antibiotic resistance ,1311 Genetics ,Bacterial Proteins ,Genetics ,medicine ,Humans ,Penicillin-Binding Proteins ,General Immunology and Microbiology ,business.industry ,SCCmec ,Cell Biology ,1314 Physiology ,2725 Infectious Diseases ,medicine.disease ,570 Life sciences ,biology ,business ,2303 Ecology - Abstract
Staphylococcus aureus, as well as coagulase-negative staphylococci (CoNS), can cause a wide range of human infections both in nosocomial and community settings. Βeta-lactams are the antibiotics of choice for the treatment of bloodstream infections (BSI) caused by these microorganisms. Resistance to virtually all β-lactams (also referred to as methicillin resistance) primarily results from the production of an alternative penicillin-binding protein (PBP2a) encoded by the mecA gene. While β-lactams are still used as first-line therapy against BSI caused by S. aureus, BSI with CoNS are usually treated with vancomycin due to the high prevalence of methicillin resistance. Rapid detection of methicillin resistance is thus critical for continuation or adjustment of the empirical therapy and therewith to improve the clinical outcome of the patients. The revised version of the immunochromatographic assay PBP2a SA culture colony test (SACCT) is a rapid, inexpensive, and easy method that enables reliable detection of PBP2a in mecA-positive staphylococcal isolates after18 to 24 h of incubation. Here, we evaluated the diagnostic performance of the SACCT using primary subcultures of spiked blood cultures after short incubation (4 to 6 h) and established a modified procedure with an equal analytical performance to that of longer-grown cultures. With the proposed method the SACCT can be employed for PBP2a detection from shortly incubated subcultures of clinically relevant staphylococcal isolates, thereby allowing more rapid and effective management of BSI caused by these organisms. IMPORTANCE Antibiotic resistance poses a major threat to health and incurs high economic costs worldwide. Rapid detection of resistance mechanisms can contribute to improving patient care and preventing the dissemination of antimicrobial resistance. Here, we describe a rapid method to detect the most important beta-lactam resistance mechanism (the plasmid-encoded alternative transpeptidase PBP2a) in staphylococcal isolates causing BSI. We show that, using a modified procedure, PBP2a can be reliably detected from primary subcultures of spiked blood cultures after short incubation (4 to 6 h) with a rapid, inexpensive, and simple immunochromatographic test (SACCT). We provide an accurate, inexpensive, and rapid method to facilitate appropriate management and control of infections in patients suffering from invasive staphylococcal infections.
- Published
- 2021