Evaluation of Xpert® MRSA Gen 3 and BD MAX™ MRSA XT for MRSA screening in a routine diagnostic setting in a low prevalence area.

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Evaluation of Xpert® MRSA Gen 3 and BD MAX™ MRSA XT for MRSA screening in a routine diagnostic setting in a low prevalence area.

J Med Microbiol. 2016 Dec 19;:

Authors: Nielsen XC, Madsen TV, Engberg J

Abstract
Screening and pre-emptive isolation of at-risk patients is an important aspect of the Danish approach to the prevention of MRSA infection, but screening with conventional culture can take up to th days for results to become available with attendant costs and disadvantages of prolonged isolation. We sought to evaluate the accuracy, time to availability of results, and potential economic benefits of two next generation MRSA screening assays, Xpert® MRSA Gen 3 and BD MAX™ MRSA XT, in a setting of a consolidated laboratory serving a number of hospitals with a low prevalence of MRSA, and using enrichment culture as a reference method. Four hundred and forty-seven screening samples together with 49 previously positive MRSA samples were evaluated. Xpert® MRSA Gen 3 demonstrated sensitivity, specificity, positive predictive value and negative predictive value of 88.2 %, 97.9 %, 62.5 %, 99.5 %, respectively and for BD MAX™ MRSA XT it was 88.2 %, 97.4 %, 57.7 %, 99.5 %, respectively. Hands-on-time was 8.8 and 21.6 min, respectively for the Xpert® MRSA Gen 3 and BD MAX™ MRSA XT PCR assays when five samples were handled simultaneously. The mean laboratory turn-around time was 2.9 (1-6) hours for the GX MRSA assay, 6.5 (2-46) hours for MAX MRSA, and 49.6 (42-122) hours for enriched culture. Despite laboratory costs being higher for the rapid PCR assays, when the costs of isolation are taken into account the assays offer the potential for significant cost savings.

PMID: 27995869 [PubMed - as supplied by publisher]