Multicenter Evaluation of the Portrait Staph ID/R Blood Culture Panel for Rapid Identification of Staphylococci and Detection of the mecA Gene

ABSTRACT Bloodstream infections are a leading cause of morbidity and mortality in the United States and are associated with increased health care costs. We evaluated the Portrait Staph ID/R blood culture panel (BCP) multiplex PCR assay (Great Basin Scientific, Salt Lake City, UT) for the rapid and simultaneous identification (ID) of Staphylococcus aureus, Staphylococcus lugdunensis, and Staphylococcus species to the genus level and the detection of the mecA gene directly from a positive blood culture bottle. A total of 765 Bactec bottles demonstrating Gram-positive cocci in singles or clusters were tested during the prospective trial at 3 clinical sites. The Portrait Staph ID/R BCP results were compared with results from conventional biochemical and cefoxitin disk methods performed at an independent laboratory. Discordant ID and mecA results were resolved by rpoB gene sequencing and mecA gene sequencing, respectively. A total of 658 Staphylococcus species isolates (S. aureus, 211 isolates; S. lugdunensis, 3 isolates; and Staphylococcus spp., 444 isolates) were recovered from monomicrobial and 33 polymicrobial blood cultures. After discrepant analysis, the overall ratios of Portrait Staph ID/R BCP positive percent agreement and negative percent agreement were 99.4%/99.9% for Staphylococcus ID and 99.7%/99.2% for mecA detection.

[1]  F. Nolte,et al.  Benefits of Adding a Rapid PCR-Based Blood Culture Identification Panel to an Established Antimicrobial Stewardship Program , 2016, Journal of Clinical Microbiology.

[2]  F. Fang,et al.  Evaluation of Three Rapid Diagnostic Methods for Direct Identification of Microorganisms in Positive Blood Cultures , 2014, Journal of Clinical Microbiology.

[3]  M. Holmes,et al.  The emergence of mecC methicillin-resistant Staphylococcus aureus , 2014, Trends in microbiology.

[4]  D. Angus,et al.  Epidemiology of severe sepsis , 2013, Virulence.

[5]  J. Myers,et al.  Staphylococcus lugdunensis Bacteremia in Adults in a Large Community Teaching Hospital. Report of 29 Episodes and Review of its Epidemiology, Microbiology, Clinical Manifestations, and Treatment , 2014 .

[6]  M. Almuhayawi,et al.  Clinical Evaluation of the FilmArray Blood Culture Identification Panel in Identification of Bacteria and Yeasts from Positive Blood Culture Bottles , 2013, Journal of Clinical Microbiology.

[7]  S. Beal,et al.  Evaluation of the Nanosphere Verigene Gram-Positive Blood Culture Assay with the VersaTREK Blood Culture System and Assessment of Possible Impact on Selected Patients , 2013, Journal of Clinical Microbiology.

[8]  R. Thomson,,et al.  Multiplex Identification of Gram-Positive Bacteria and Resistance Determinants Directly from Positive Blood Culture Broths: Evaluation of an Automated Microarray-Based Nucleic Acid Test , 2013, PLoS medicine.

[9]  M. Al-Hasan,et al.  Overall burden of bloodstream infection and nosocomial bloodstream infection in North America and Europe. , 2013, Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases.

[10]  M. Bissell An Antimicrobial Stewardship Program's Impact with Rapid Polymerase Chain Reaction Methicillin-Resistant Staphylococcus aureus/S. aureus Blood Culture Test in Patients with S. aureus Bacteremia , 2012 .

[11]  Jessina C. McGregor,et al.  Comparative effectiveness of nafcillin or cefazolin versus vancomycin in methicillin-susceptible Staphylococcus aureus bacteremia , 2011, BMC infectious diseases.

[12]  Robin Patel,et al.  Clinical Significance of a Single Staphylococcus lugdunensis-Positive Blood Culture , 2011, Journal of Clinical Microbiology.

[13]  P. Pancholi,et al.  An antimicrobial stewardship program's impact with rapid polymerase chain reaction methicillin-resistant Staphylococcus aureus/S. aureus blood culture test in patients with S. aureus bacteremia. , 2010, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[14]  E. Baron,et al.  Real-Time PCR Testing for mecA Reduces Vancomycin Usage and Length of Hospitalization for Patients Infected with Methicillin-Sensitive Staphylococci , 2010, Journal of Clinical Microbiology.

[15]  V. Georgiev,et al.  National Institute of Allergy and Infectious Diseases, NI , 2008 .

[16]  G. Forrest,et al.  Impact of rapid in situ hybridization testing on coagulase-negative staphylococci positive blood cultures. , 2006, The Journal of antimicrobial chemotherapy.

[17]  A. Mellmann,et al.  Sequencing and Staphylococci Identification , 2006, Emerging infectious diseases.

[18]  Clinical,et al.  Performance standards for antimicrobial disk susceptibility tests : approved standard , 2006 .

[19]  R. Wenzel,et al.  Nosocomial bloodstream infections in US hospitals: analysis of 24,179 cases from a prospective nationwide surveillance study. , 2004, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[20]  M. Weinstein Blood Culture Contamination: Persisting Problems and Partial Progress , 2003, Journal of Clinical Microbiology.

[21]  D. Mannino,et al.  The epidemiology of sepsis in the United States from 1979 through 2000. , 2003, The New England journal of medicine.

[22]  S. Cosgrove,et al.  Comparison of mortality associated with methicillin-resistant and methicillin-susceptible Staphylococcus aureus bacteremia: a meta-analysis. , 2003, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[23]  S. Hori,et al.  Suppression of methicillin resistance in a mecA-containing pre-methicillin-resistant Staphylococcus aureus strain is caused by the mecI-mediated repression of PBP 2' production , 1996, Antimicrobial agents and chemotherapy.