Utility of the Etest GRD for detecting Staphylococcus aureus with reduced susceptibility to glycopeptides in cystic fibrosis patients |
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| Authors: | A. Filleron R. Chiron M.-E. Reverdy H. Jean-Pierre O. Dumitrescu L. Aleyrangues F. Counil E. Jumas-Bilak H. Marchandin |
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| Affiliation: | (1) H?pital Arnaud de Villeneuve, Service de P?diatrie G?n?rale, Maladies Infectieuses, Immunologie Clinique, Centre Hospitalier R?gional Universitaire de Montpellier, 371, Avenue du Doyen Gaston Giraud, 34295 Montpellier Cedex 5, France;(2) H?pital Arnaud de Villeneuve, Centre de Ressources et de Comp?tences pour la Mucoviscidose, Service de P?diatrie 1 et des Maladies Respiratoires, Centre Hospitalier R?gional Universitaire de Montpellier, 371, Avenue du Doyen Gaston Giraud, 34295 Montpellier Cedex 5, France;(3) Facult? de M?decine Laennec, Centre National de R?f?rence des Staphylocoques, INSERM E0230, 7 rue Guillaume Paradin, 69008 Lyon, France;(4) H?pital Arnaud de Villeneuve, Laboratoire de Bact?riologie, Centre Hospitalier R?gional Universitaire de Montpellier, 371, Avenue du Doyen Gaston Giraud, 34295 Montpellier Cedex 5, France;(5) Equipe Pathog?nes et Environnements, U.F.R. des Sciences Pharmaceutiques et Biologiques, Universit? Montpellier 1, UMR 5119, 15, Avenue Charles Flahault, BP 14491, 34093 Montpellier Cedex 5, France;(6) Laboratoire d’Hygi?ne Hospitali?re, Centre Hospitalier R?gional Universitaire de Montpellier, 778, Rue de la Croix Verte, 34000 Montpellier, France;(7) Equipe Pathog?nes et Environnements, U.F.R. des Sciences Pharmaceutiques et Biologiques, Universit? Montpellier 1, UMR 5119, 15, avenue Charles Flahault BP 14491, 34093 Montpellier Cedex 5, France; |
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| Abstract: | Glycopeptide-intermediate S. aureus (GISA), particularly heterogeneous GISA (hGISA), remain difficult to detect in the routine practice of medical microbiology. Novel tools have been evaluated comparatively to the population analysis profile-area under the curve (PAP-AUC) reference method for detecting GISA/hGISA. Among them, the Etest GRD showed relatively high specificity (85.8–97%) and negative predictive value (97%) but lower sensibility (57–95%) and positive predictive value (30.8%). We investigated the utility of the Etest GRD for detecting GISA/hGISA among 180 strains isolated from 106 cystic fibrosis (CF) patients. Etest GRD was performed on all isolates, and those exhibiting a GISA/hGISA phenotype were further tested by PAP-AUC and other agar routine assays for GISA/hGISA detection. The Etest GRD allowed the detection of 15 GISA/hGISA strains, of which eight were confirmed by the reference method. Despite the 3.9% level of false positive results, the Etest GRD constitutes a useful routine tool for detecting GISA/hGISA overlooked by other routine assays, two strains being detected by the Etest GRD only. GISA/hGISA represented 7.7% of MRSA and 2.1% of MSSA, and were found in 4.7% of CF patients colonized/infected by S. aureus, which is the highest rate reported to date in this population. |
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