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Assays for rapid detection of MRSA

Assays for rapid detection of MRSA
Assay Target(s) Prevalence (%) Sensitivity (%) Specificity (%) Positive predictive value (%) Negative predictive value (%) Reference
Blood assays
BD MAX StaphSR assay – second generation SCCmec-orfX, thermostable nuclease (nuc), mecA, mecC 10.4 100 100 100 100 [1]
Xpert MRSA/SA BC – second generation Staphylococcal protein A gene (spa), SCCmec-orfX junction, mecA 7.3 100 100 100 100 [2]
Xpert MRSA/SA SSTI – second generation Staphylococcal protein A gene (spa), SCCmec-orfX junction, mecA 14 98.3 99.4 96.6 99.7 [3]
Xpert MRSA/SA BC – second generation Staphylococcal protein A gene (spa), SCCmec-orfX junction, mecA 13.3 98.1 99.6 97.2 99.7 [4]
Xpert MRSA/SA BC – second generation Staphylococcal protein A gene (spa), SCCmec-orfX junction, mecA 27.5 96.0 100 100 98.5 [5]
BioFire FilmArray BCID2 MecA/C, mec right extremity junction – 100 100 100 100 [6]
Respiratory tract assays
GeneXpert MRSA/SA SSTI spa, SCCmec, mecA 32.6 97.7 96.7 93.5 98.9 [7]
GeneXpert MRSA/SA SSTI or SA Nasal Complete spa, SCCmec, mecA 1.4 80.0 99.5 67.7 99.8 [8]
Xpert MRSA (nasal) SCCmec 25.6 100 90.6 78.6 100 [9]
GeneXpert MRSA/SA SSTI spa, SCCmec, mecA 9.3 95.7 98.2 – – [10]
Nasal swabs
LightCycler MRSA Advanced Test Insertion site SCCmec at orfX junction 16 92.2 98.9 94 98.5 [11]
Xpert MRSA NxG Different SCCmec types; mecA and mecC 11 91.8 97.2 80.8 98.9 [12]
BD Max StaphSR SCCmec-orfX junction, mecC, mecA, nuc 19.6 94.3 97.7 – – [13]
BD Max MRSAXT SCCmec-orfX junction, mecC, mecA 19.6 94.3 97.7 – – [13]
Hologic Panther Fusion (nasal, throat, and perineum) SCCmec-orfX junction, mecC, mecA – 78.0 100 – – [14]
Wound swab
Xpert MRSA/SA SSTI – second generation Staphylococcal protein A gene (spa), mecA, SCCmec-orfX junction 30 97.1 96.2 91.9 98.7 [15]
BC: blood culture; MRSA: methicillin-resistant Staphylococcus aureus; SA: S. aureus; SSTI: skin and soft tissue infection.
Data from:
  1. Ellem JA, Olma T, O'Sullivan MV. Rapid detection of methicillin-resistant Staphylococcus aureus and methicillin-susceptible S. aureus directly from positive blood cultures by use of the BD Max StaphSR assay. J Clin Microbiol 2015; 53:3900.
  2. Spencer DH, Sellenriek P, Burnham CA. Validation and implementation of the GeneXpert MRSA/SA blood culture assay in a pediatric setting. Am J Clin Pathol 2011; 136:690.
  3. Wolk DM, Struelens MJ, Pancholi P, et al. Rapid detection of Staphylococcus aureus and methicillin-resistant S. aureus (MRSA) in wound specimens and blood cultures: Multicenter preclinical evaluation of the Cepheid Xpert MRSA/SA skin and soft tissue and blood culture assays. J Clin Microbiol 2009; 47:823.
  4. Buchan BW, Allen S, Burnham CA, et al. Comparison of the next-generation Xpert MRSA/SA BC assay and the GeneOhm StaphSR assay to routine culture for identification of Staphylococcus aureus and methicillin-resistant S. aureus in positive-blood-culture broths. J Clin Microbiol 2015; 53:804.
  5. Romero-Gómez MP, Muñoz-Velez M, Gómez-Gil R, Mingorance J. Evaluation of combined use of MALDI-TOF and Xpert® MRSA/SA BC assay for the direct detection of methicillin resistance in Staphylococcus aureus from positive blood culture bottles. J Infect 2013; 67:91.
  6. Cortazzo V, D'Inzeo T, Giordano L, et al. Comparing BioFire FilmArray BCID2 and BCID panels for direct detection of bacterial pathogens and antimicrobial resistance genes from positive blood cultures. J Clin Microbiol 2021; 59:e03163.
  7. Cercenado E, Marín M, Burillo A, et al. Rapid detection of Staphylococcus aureus in lower respiratory tract secretions from patients with suspected ventilator-associated pneumonia: Evaluation of the Cepheid Xpert MRSA/SA SSTI assay. J Clin Microbiol 2012; 50:4095.
  8. Leone M, Malavieille F, Papazian L, et al. Routine use of Staphylococcus aureus rapid diagnostic test in patients with suspected ventilator-associated pneumonia. Crit Care 2013; 17:R170.
  9. Oh AC, Lee JK, Lee HN, et al. Clinical utility of the Xpert MRSA assay for early detection of methicillin-resistant Staphylococcus aureus. Mol Med Rep 2013; 7:11.
  10. Paonessa JR, Shah RD, Pickens CI, et al. Rapid detection of methicillin-resistant Staphylococcus aureus in BAL: A pilot randomized controlled trial. Chest 2019; 155:999.
  11. Peterson LR, Liesenfeld O, Woods CW, et al. Multicenter evaluation of the LightCycler methicillin-resistant Staphylococcus aureus (MRSA) advanced test as a rapid method for detection of MRSA in nasal surveillance swabs. J Clin Microbiol 2010; 48:1661.
  12. Yarbrough ML, Warren DK, Allen K, et al. Multicenter evaluation of the Xpert MRSA NxG assay for detection of methicillin-resistant Staphylococcus aureus in nasal swabs. J Clin Microbiol 2017; 56:e01381.
  13. Silbert S, Kubasek C, Galambo F, et al. Evaluation of BD Max StaphSR and BD Max MRSAXT assays using ESwab-collected specimens. J Clin Microbiol 2015; 53:2525.
  14. Bartels MD, Knudsen D, Westh H, Schønning K. Evaluation of the Hologic Panther Fusion MRSA assay for the detection of MRSA in ESwab specimens obtained from nose, throat, and perineum. Eur J Clin Microbiol Infect Dis 2021; 40:2177.
  15. Wolk DM, Marx JL, Dominguez L, et al. Comparison of MRSASelect Agar, CHROMagar methicillin-resistant Staphylococcus aureus (MRSA) medium, and Xpert MRSA PCR for detection of MRSA in nares: Diagnostic accuracy for surveillance samples with various bacterial densities. J Clin Microbiol 2009; 47:3933.
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