%0 Journal Article %1 wolk_multicenter_2009 %A Wolk, D. M. %A Picton, E. %A Johnson, D. %A Davis, T. %A Pancholi, P. %A Ginocchio, C. C. %A Finegold, S. %A Welch, D. F. %A de Boer, M. %A Fuller, D. %A Solomon, M. C. %A Rogers, B. %A Mehta, M. S. %A Peterson, L. R. %D 2009 %J J. Clin. Microbiol. %K imported %N 3 %P 758--764 %R 10.1128/JCM.01714-08 %T Multicenter Evaluation of the Cepheid Xpert Methicillin-Resistant Staphylococcus aureus (MRSA) Test as a Rapid Screening Method for Detection of MRSA in Nares %U http://jcm.asm.org/cgi/content/abstract/47/3/758 %V 47 %X The first U.S. multicenter clinical trial to assess the performance of the Cepheid Xpert MRSA assay (Xpert MRSA) was conducted. The assay is a qualitative test designed for the rapid detection of methicillin-resistant Staphylococcus aureus (MRSA) directly from nares swabs. This novel test combines integrated nucleic acid extraction and automated real-time PCR for the detection of a MRSA-specific signature sequence. A total of 1,077 nares specimens were collected from seven geographically distinct health care sites across the United States with prevalence rates ranging from 5.2\% to 44\%. Nares specimens were tested by (i) the Xpert MRSA assay, (ii) direct culture on CHROMagar MRSA medium (direct CM culture), and (iii) broth-enriched culture (Trypticase soy broth with 6.5\% sodium chloride) followed by plating onto CHROMagar MRSA medium (broth-enriched CM culture). When direct CM culture was designated the reference method, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the Xpert MRSA assay were 94.3\%, 93.2\%, 73.0\%, and 98.8\%, respectively. When broth-enriched CM culture was used as the reference method, the clinical sensitivity, specificity, PPV, and NPV of the Xpert MRSA assay were 86.3\%, 94.9\%, 80.5\%, and 96.6\%, respectively. The BD GeneOhm MRSA (BDGO) assay was performed as a comparative molecular method. No statistical performance differences were observed between the Xpert MRSA and BDGO assays when they were compared to culture methods. From this large-scale, multicenter clinical comparison, we conclude that the Xpert MRSA assay is a simple, rapid, and accurate method for performing active surveillance for MRSA in a variety of health care populations.

@article{wolk_multicenter_2009, abstract = {The first {U.S.} multicenter clinical trial to assess the performance of the Cepheid Xpert {MRSA} assay {(Xpert} {MRSA)} was conducted. The assay is a qualitative test designed for the rapid detection of methicillin-resistant Staphylococcus aureus {(MRSA)} directly from nares swabs. This novel test combines integrated nucleic acid extraction and automated real-time {PCR} for the detection of a {MRSA-specific} signature sequence. A total of 1,077 nares specimens were collected from seven geographically distinct health care sites across the United States with prevalence rates ranging from 5.2\% to 44\%. Nares specimens were tested by (i) the Xpert {MRSA} assay, (ii) direct culture on {CHROMagar} {MRSA} medium (direct {CM} culture), and (iii) broth-enriched culture {(Trypticase} soy broth with 6.5\% sodium chloride) followed by plating onto {CHROMagar} {MRSA} medium (broth-enriched {CM} culture). When direct {CM} culture was designated the reference method, the sensitivity, specificity, positive predictive value {(PPV),} and negative predictive value {(NPV)} of the Xpert {MRSA} assay were 94.3\%, 93.2\%, 73.0\%, and 98.8\%, respectively. When broth-enriched {CM} culture was used as the reference method, the clinical sensitivity, specificity, {PPV,} and {NPV} of the Xpert {MRSA} assay were 86.3\%, 94.9\%, 80.5\%, and 96.6\%, respectively. The {BD} {GeneOhm} {MRSA} {(BDGO)} assay was performed as a comparative molecular method. No statistical performance differences were observed between the Xpert {MRSA} and {BDGO} assays when they were compared to culture methods. From this large-scale, multicenter clinical comparison, we conclude that the Xpert {MRSA} assay is a simple, rapid, and accurate method for performing active surveillance for {MRSA} in a variety of health care populations.}, added-at = {2011-03-11T10:05:34.000+0100}, author = {Wolk, D. M. and Picton, E. and Johnson, D. and Davis, T. and Pancholi, P. and Ginocchio, C. C. and Finegold, S. and Welch, D. F. and de Boer, M. and Fuller, D. and Solomon, M. C. and Rogers, B. and Mehta, M. S. and Peterson, L. R.}, biburl = {https://www.bibsonomy.org/bibtex/2da6a24a9a6a423fd1acf8f91ec38aa0a/jelias}, doi = {10.1128/JCM.01714-08}, interhash = {ff2815920844deccc71df9f77ea5af88}, intrahash = {da6a24a9a6a423fd1acf8f91ec38aa0a}, journal = {J. Clin. Microbiol.}, keywords = {imported}, month = mar, number = 3, pages = {758--764}, timestamp = {2011-03-11T10:06:14.000+0100}, title = {Multicenter Evaluation of the Cepheid Xpert {Methicillin-Resistant} Staphylococcus aureus {(MRSA)} Test as a Rapid Screening Method for Detection of {MRSA} in Nares}, url = {http://jcm.asm.org/cgi/content/abstract/47/3/758}, volume = 47, year = 2009 }