MRSA与糖肽类抗生素耐药的肠球菌实验室快速诊断现状和进展

David

Journal of Clinical Microbiology, May 2008, p. 1577-1587, Vol. 46, No. 5

MINIREVIEW


Current Trends in Rapid Diagnostics for Methicillin-Resistant Staphylococcus aureus and Glycopeptide-Resistant Enterococcus Species
MRSA与糖肽类抗生素耐药的肠球菌实验室快速诊断现状和进展
Surbhi Malhotra-Kumar,1* Kelly Haccuria,1 Mindy Michiels,2 Margareta Ieven,1,2 Claire Poyart,3 Waleria Hryniewicz,4 Herman Goossens,1,2 on behalf of the MOSAR WP2 Study Team
Department of Medical Microbiology, Vaccine and Infectious Disease Institute, Universiteit Antwerpen,1 University Hospital Antwerp, Antwerp, Belgium,2 Institut National de la Santé et de la Recherche Médicale, Paris, France,3 National Medicines Institute, Warsaw, Poland4

    INTRODUCTION  

Hospital-acquired (HA) infections are an increasing global problem. Methicillin-resistant Staphylococcus aureus (MRSA) and glycopeptide-resistant Enterococcus (GRE) are multidrug-resistant organisms and are particularly frequent causes of HA infections that often prove difficult and expensive to treat. Major sources of MRSA and GRE causing infections are either the patient's own floras (endogenous infection), those acquired from another person (cross-infection), or those from substances recently contaminated by a human source (environmental infection). Active surveillance cultures from patients for carriage of MRSA and GRE facilitate an early contact isolation (and even treatment), thus preventing spread in the hospital and reducing costs (42). However, the time to result with conventional cultures is 2 to 3 days, which allows these organisms a sizeable time window for potential spread prior to the institution of contact precautions. Recently, several "rapid" diagnostic tests have been introduced that would be very beneficial in decreasing the time to detection, therefore reducing the risk of nosocomial transmission and infections, especially in high-risk patients. This review discusses the current state of the art on rapid and direct detection methods for MRSA and GRE from patient material and hopes to facilitate the infectious disease specialist or microbiologist in choosing an appropriate diagnostic test.