Detection of the mecA gene and identification of Staphylococcus directly from blood culture bottles by multiplex polymerase chain reaction

Author(s)

Rocchetti, Taisa Trevizani ; Martins, Katheryne Benini ; Faccioli Martins, Patricia Yoshida ; de Oliveira, Rogerio Antonio ; Mondelli, Alessandro Lia ; Castelo Branco Fortaleza, Carlos Magno ; Ribeiro de Souza da Cunha, Maria de Lourdes

• Document type: Journal article
• Source: Brazilian Journal of Infectious Diseases; v. 22, n. 2, p. 7-pg., 2018-03-01.

Abstract

Introduction: Staphylococcus spp. - both S. aureus, including methicillin-resistant strains (MRSA) and coagulase negative staphylococci (CoNS) - are relevant agents of healthcare-associated infections. Therefore, the rapid recognition of MRSA and methicillin-resistant CoNS from blood stream infections is critically important for patient management. It is worth noting that inappropriate empiric therapy has been associated with higher in-hospital mortality. Material and methods: In this study we evaluated a multiplex polymerase chain reaction (multiplex PCR) standardized to detect Staphylococcus spp., S. aureus, and mecA gene-encoded oxacillin resistance directly from blood culture bottles. A total of 371 blood cultures with Gram-positive microorganisms confirmed by Gram-stain were analyzed. Results from multiplex PCR were compared to phenotypic characterization of isolates. Results: Staphylococcus aureus was detected in 85 (23.0%) blood cultures and CoNS in 286 (77.0%). There was 100% agreement between phenotypic and multiplex PCR identification. Forty-three (50.6%) of the 85 S. aureus carried the mecA gene and among the 286 CoNS, 225 (78.7%) were positive for the mecA gene. Conclusions: The multiplex PCR assay developed here was found to be sensitive, specific, rapid, and showed good agreement with the phenotypic results besides being less expensive. This PCR method could be used in clinical laboratories for rapid identification and initiation of specific and effective treatment, reducing patient mortality and morbidity. Furthermore, this method may reduce misuse of antimicrobial classes that are more expensive and toxic, thus contributing to the selection of antibiotic-resistant Staphylococcus spp.& nbsp; (C) 2018 Sociedade Brasileira de Infectologia. Published by Elsevier Editora Ltda. (AU)

• FAPESP's process: 10/14250-0 - Species identification of Staphylococcus spp. isolated from blood culture, mecA gene of oxacillin resistance and the genes icaA, to icaD icaC and biofilm production by multiplex PCR
• Grantee: Taisa Trevizani Rocchetti
• Support Opportunities: Scholarships in Brazil - Master