An analysis of Staphylococcus aureus infections at a military medical center using the PLEX-ID combined polymerase chain reaction-mass spectrometry system

Staphylococcus aureus (S. aureus) is a major cause of morbidity in the military health care setting. Culture-based methods are the most common means of identifying infections caused by this agent. However, culture-based methods lack sensitivity and specificity. The Abbott PLEX-ID instrument uses a combination of the polymerase chain reaction and mass spectrometry for the identification of bacterial isolates. We investigated whether the Abbott PLEX-ID system could identify S. aureus in clinical material and facilitate the epidemiological analysis of individual isolates. The PLEX-ID system positively identified 100% of isolates previously found to be methicillin resistant S. aureus by culture. In addition, analysis using the PLEX-ID software revealed that the majority of S. aureus isolates at Tripler Army Medical Center derive from clonal complex 8 and nearly 100% of these strains express the R-variant of the Panton-Valentine leukocidin virulence factor. These results demonstrate the utility of the PLEX-ID system in identifying clinical isolates and reveal an unexpected level of homogeneity among clinical S. aureus isolates recovered at Tripler Army Medical Center. These results also demonstrate the utility of the PLEX-ID system in identifying the resistance patterns, predicting the virulence properties, and tracking the migration of bacterial pathogens in the clinical setting.