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Healthcare-associated infection (HAI) - April 01, 2017

Comparison of the BD MAX™ MRSA to Cepheid™ Xpert© MRSA

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Comparison of the BD MAX™ MRSA XT to the Cepheid™ Xpert® MRSA assay for the molecular detection of methicillin-resistant Staphylococcus aureus from nasal swabs

Sanjay R Mehta 1, Jasmine Estrada 2, Juan Ybarra 2, Joshua Fierer 3

April 2017

Abstract:

Introduction: Variation in MRSA genotypes may affect the sensitivity of molecular assays to detect this organism.

Methods: We compared 2 commonly used screening assays, the Cepheid™ Xpert® MRSA and the BD MAX™ MRSA XT on consecutively obtained nasal swabs from 479 subjects. Specimens giving discordant results were subjected to additional microbiologic and molecular testing.

Results: Six hundred forty-two (97.6%) of the 658 test results were concordant. Of the 16 discordant results from 12 subjects, additional results suggested that 9 (60%) of the 15 MRSA XT assays were likely correct, and 6 (40%) of the 15 Xpert® assays were likely correct. One discordant result could not be resolved. A mecA dropout and novel mec right-extremity junction (MREJ) sites led to false-positive and negative results by Xpert®.

Conclusion: While both assays performed well, continued vigilance is needed to monitor for Staphylococcus aureus with novel MREJ sites, mecA dropouts, and mecC, leading to inaccurate results in screening assays.

Published by Elsevier Inc.

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