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Sak sak at execpc.dot.com
Tue Jan 18 18:24:18 EST 2000

On Tue, 18 Jan 2000 21:48:48 +0100, lamb
<L.A.M.Buisman at cable.A2000.nl> wrote:

>Sak wrote:
>> Yes, it's done on isolated colonies. I guess I meant to say that it
>> tests for methicillin resistance in known S. aureus colonies. I also
>> meant that we use it for isolation of patients with MRSA not isolating
>> the organism itself. Not too clear was I?
>> Being able to read the test in four hours allows us to get patients
>> into isolation a day earlier than waiting overnight for most other
>> methods that would give an MIC. They really don't care what the MIC
>> is, they just want to know if it's methicillin resistant.
>Exactly, methicillin resistance is important. Anything else is interesting for science
>and epidemiology, I suppose.Does that mean that every Staph aureus is tested with the
>B&D test?
>Is the problem really that big where you are?

Most MRSA from our patients is found by "accident" from normal
susceptibility testing of S. aureus isolated from cultures. Some
hospitals in my area routinely take rectal and nasal swabs when a
patient is admitted to screen for MRSA and VRE to get colonized
patients into isolation. It is these admission screens that we use the
test for.

I don't really have any idea of how big MRSA is here, but I suspect it
has more to do with patients with real infections of MRSA being
treated with vancomycin and picking up VRE from some health care
worker bringing it from another colonized patient. Isolation gives the
workers the protocols to minimize transmission of any bugs between
patients. If VRE trending is any indication, I would estimate I've
seen a ten-fold increase in isolation of VRE in the past five years. 

>> As far as numbers, all I know is that BD tested some 600 or so
>> isolates and claim 100% accuracy.
>I was afraid so. Does anybody have independent figures?
10 isolates were tested at BD. 39 isolates from the CDC were also
tested at BD. 559 isolates were tested at three independent labs. I
don't know of any published studies of the method.

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