Feasibility study of a real-time PCR test for meticillin-resistant Staphylococcus aureus in a point of care setting
Feasibility study of a real-time PCR test for meticillin-resistant Staphylococcus aureus in a point of care setting
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DOI：
10.1016/j.jhin.2009.09.007
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发表时间：
2010-03-01
影响因子：
6.9
通讯作者：
Oppenheim, B.
中科院分区：
文献类型：
--
作者：
Brenwald, N. P.;Baker, N.;Oppenheim, B.
我们研究了商业实时聚合酶链反应检测耐甲氧西林金黄色葡萄球菌（MRSA）是否可以作为护理点检测。运行Xpert MRSA测试的GeneXpert系统安装在桑德威尔和西伯明翰医院NHS信托的四个病房以及主要的微生物实验室中。使用双头拭子从四个研究病房的新入院患者中收集鼻腔样本。一个拭子由非实验室工作人员在病房使用Xpert MRSA测试进行测试，另一个拭子由微生物实验室进行测试。从930名患者（2008年3月至2008年6月）共收集了988份鼻拭子。其中，947个处理过的拭子在实验室和各自的病房均给出了有效的结果（MRSA阳性或阴性），病房和实验室的结果有97.5%的一致性（850个MRSA阴性，73个MRSA阳性）。24个拭子的结果显示病房和实验室的结果存在差异。病房MRSA检测与实验室比较，敏感性为83.9，特异性为98.8，阳性预测值为88.0，阴性预测值为98.4。平均而言，病房的结果要比实验室快10小时。无论是在病房里还是在实验室里，专家MRSA测试的效果都一样好。MRSA护理点检测的主要好处是与实验室相比，获得结果的时间大大减少。(C) 2009年医院感染学会。Elsevier Ltd.出版。版权所有。
We investigated whether a commercial real-time polymerase chain reaction test for meticillin-resistant Staphylococcus aureus (MRSA) could be used as a point of care test. GeneXpert systems, on which the Xpert MRSA test is run, were installed on four wards within the Sandwell and West Birmingham Hospitals NHS Trust and in the main microbiology laboratory. Nasal samples were collected using double-headed swabs from newly admitted patients onto the four study wards. One swab was tested using the Xpert MRSA test on the ward by non-laboratory staff, the other was tested by the microbiology laboratory. In total, 988 nasal swabs were collected from 930 patients (March 2008 to June 2008). Of these, 947 processed swabs gave a valid result (MRSA positive or negative) both in the laboratory and respective ward, and there was 97.5% agreement between results obtained from the ward and from the laboratory (850 MRSA negative; 73 MRSA positive). Results for 24 swabs showed a discrepancy between the results from the ward and laboratory. MRSA testing carried out on the wards showed a sensitivity, specificity, positive predictive value and negative predictive value of 83.9, 98.8, 88.0 and 98.4, respectively, compared with the laboratory. On average the time to result for the wards was >10 h quicker than the laboratory. The Xpert MRSA test performed equally well, whether carried out on the wards or by the laboratory. The major benefit of MRSA point of care testing was the large reduction in the time to obtain a result compared with the laboratory. (C) 2009 The Hospital Infection Society. Published by Elsevier Ltd. All rights reserved.