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Annals of Clinical & Laboratory Science 37:248-250 (2007)
© 2007 Association of Clinical Scientists

Comparison of Protocols for Surveillance of Methicillin-resistant Staphylococcus aureus (MRSA): Medical Staff vs ICU Patients

Seungok Lee1, Yeon-Joon Park2, Eun-Jee Oh2, Jimin Kahng1, Jin Hong Yoo3, In-Hee Jeong4, Young-Mi Kwon5 and Kyungja Han2
1 Departments of Laboratory Medicine, 3 Internal Medicine, 4 Clinical Microbiology, and 5 Hospital Infection Control, Holy Family Hospital, Pucheon, Korea; 2 Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea

Address correspondence to Yeon-Joon Park, M.D., Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Kangnam St. Mary’s Hospital, 505 Banpo-dong, Seocho-ku, Seoul 137-701, Korea; tel 82 2 590 1604; fax 82 2 590 2547; e-mail yjpk{at}catholic.ac.kr.

To compare the sensitivity of various protocols for methicillin-resistant Staphylococcus aureus (MRSA) surveillance, active surveillance for detecting MRSA nasal colonization was performed on 97 members of the medical staff and 218 patients in the Intensive Care Unit (ICU) of a university hospital. Duplicate nasal swabs were collected from each participant. One was plated directly on a blood agar plate (D-BAP) and observed at 24 and 48 hr. Another was incubated overnight in tryptic soy broth (TSB) with 6.5% NaCl, and subcultured on both BAP (B-BAP) and mannitol salt agar with 4 mg/L of oxacillin (B-MSAOXA). The MRSA colonization rate was similar in the medical staff and patient samples (16.5% vs 11.9%, p = 0.285). Among the medical staff members, the sensitivity of MRSA detection was the same (93.8%) in D-BAP and B-BAP. In the ICU patients, which are a high-risk group, the sensitivity of MRSA detection was improved by adding a pre-enrichment step (73.1% on D-BAP vs 96.2% on B-BAP). The simple direct plating protocol was sufficiently sensitive for the medical staff members, but pre-enrichment was an essential step to increase detection of MRSA in the ICU patients.

Keywords: Staphylococcus aureus, methicillin-resistance, MRSA surveillance, pre-enrichment media




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S. Lee, Y.-J. Park, J.-H. Yoo, J. Kahng, I.-H. Jeong, Y.-M. Kwon, and K. Han
Comparison of Culture Screening Protocols for Methicillin-Resistant Staphylococcus aureus (MRSA) Using a Chromogenic Agar (MRSA-Select)
Ann. Clin. Lab. Sci., January 1, 2008; 38(3): 254 - 257.
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