title: Methicillin-resistant S. aureus colonization in intensive care unit patients: Early identification and molecular typing.
abstract: BACKGROUND
  Early detection of methicillin-resistant Staphylococcus aureus (MRSA) in colonized patients is very important for infection control procedures to prevent MRSA spread. We aimed to monitor MRSA carriage in intensive care unit (ICU) patients and to evaluate the speed and efficiency of conventional culture, immunological, chromogenic, and molecular methods together with genotyping.
  
  
  METHODS
  Nasal and axillar swab specimens were obtained from patients in the ICUs of the general surgery and neurosurgery wards in a tertiary hospital once a week over four weeks between December 2009 and July 2010. Oxacillin and cefoxitin disk diffusion tests, oxacillin agar screening test, latex agglutination test, chromogenic agar, and real-time polymerase chain reaction (PCR) tests were used for isolation and identification of MRSA. MRSA isolates were typed using ribotyping and pulsed-field gel electrophoresis (PFGE) typing.
  
  
  RESULTS
  MRSA colonization was detected in 48 of 306 patients by real-time PCR. The MRSA colonization rate was 6.2%, 15.5%, and 38.5% at admission and in the first and second weeks, respectively. Sensitivity, specificity, positive and negative predictive values for all phenotypic tests were 98%, 99.6%, 98%, and 99.6%, respectively. The shortest handle time was observed in PCR. A total of three banding patterns were obtained from MRSA isolates by ribotyping, and PFGE analyses revealed 17 different pulsotypes varying from 11 to 18 distinct bands, showing high genetic diversity among the samples.
  
  
  CONCLUSIONS
  Phenotypic MRSA screening tests in our study exhibited similar performances. The superiority of real-time PCR is its short turnaround time.
authors.affiliation: Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkey. gdurmaz@ogu.edu.tr.
authors.forename: Gul
authors.initials: G
authors.lastname: Durmaz
authors.forename: Ozlem
authors.initials: O
authors.lastname: Sanci
authors.forename: Yasemin
authors.initials: Y
authors.lastname: Oz
authors.forename: Kiymet
authors.initials: K
authors.lastname: Guven
authors.forename: Abdurrahman
authors.initials: A
authors.lastname: Kiremitci
authors.forename: Filiz
authors.initials: F
authors.lastname: Aksit
mesh_terms: D001431:Bacteriological Techniques; D002353:Carrier State / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D016521:Electrophoresis, Gel, Pulsed-Field; D005260:Female; D005838:Genotype; D006801:Humans; D007118:Immunoassay; D007362:Intensive Care Units; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification*; D058889:Molecular Typing; D010641:Phenotype; D060888:Real-Time Polymerase Chain Reaction; D012680:Sensitivity and Specificity; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D062606:Tertiary Care Centers; D013997:Time Factors