title: Isolate removal methods and methicillin-resistant Staphylococcus aureus surveillance.
abstract: The effect of duplicate isolate removal strategies on Staphylococcal aureus susceptibility to oxacillin was compared by using antimicrobial test results for 14,595 isolates from statewide surveillance in Hawaii in 2002. No removal was compared to most resistant and most susceptible methods at 365 days and to the National Committee for Clinical Laboratory Standards (NCCLS) and Cerner algorithms at 3-, 10-, 30-, 90-, and 365-day analysis periods. Overall, no removal produced the lowest estimates of susceptibility. Estimates with either NCCLS or Cerner differed by <2% when the analysis period was the same; with either method, the difference observed between a 90- and a 365-day period was <1%. The effect of duplicate isolate removal was greater for inpatient than outpatient settings. Considering the ease of implementation and comparability of results, we recommend using the first isolate of a given species per patient to calculate susceptibility frequencies for S. aureus to oxacillin.
authors.affiliation: University of Hawaii School of Medicine, Honolulu, Hawaii, USA. fenfang@hawaii.edu
authors.forename: Fenfang
authors.initials: F
authors.lastname: Li
authors.forename: Tracy L
authors.initials: TL
authors.lastname: Ayers
authors.forename: Sarah Y
authors.initials: SY
authors.lastname: Park
authors.forename: F
authors.initials: F
authors.lastname: DeWolfe Miller
authors.forename: Ralph
authors.initials: R
authors.lastname: MacFadden
authors.forename: Michele
authors.initials: M
authors.lastname: Nakata
authors.forename: Myra Ching
authors.initials: MC
authors.lastname: Lee
authors.forename: Paul V
authors.initials: PV
authors.lastname: Effler
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D006254:Hawaii / Q000453:epidemiology; D006801:Humans; D007362:Intensive Care Units; D016106:Methicillin Resistance; D008826:Microbial Sensitivity Tests; D010045:Outpatients; D011159:Population Surveillance; D013048:Specimen Handling / Q000379:methods*; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology; D013211:Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification*; D013997:Time Factors
chemical_list: D000900:Anti-Bacterial Agents