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JAC Advance Access originally published online on March 2, 2005
Journal of Antimicrobial Chemotherapy 2005 55(4):506-510; doi:10.1093/jac/dki052
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© The Author 2005. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions{at}oupjournals.org

Cefoxitin resistance as a surrogate marker for the detection of methicillin-resistant Staphylococcus aureus

Clarence J. Fernandes1, Lorna A. Fernandes1, Peter Collignon2,* on behalf of the Australian Group on Antimicrobial Resistance (AGAR)

1 Department of Microbiology, Pacific Laboratory Medicine Services, Royal North Shore Hospital, St Leonards 2065; 2 Department of Microbiology and Infectious Diseases, The Canberra Hospital, Canberra, ACT 2606, Australia

* Corresponding author. Tel: +61-2-6244-2105; Fax: +61-2-6281-0349; Email: peter.collignon{at}act.gov.au

Objectives: To evaluate the usefulness of cefoxitin when used as a surrogate marker for the detection of methicillin resistance.

Patients and methods: Eight hundred and seventy-one strains of Staphylococcus aureus, collected from eight tertiary referral centres serving diverse socio-economic populations, were included in the study using NCCLS disc diffusion and the agar dilution methods.

Results: Using cefoxitin and NCCLS criteria for disc diffusion, the sensitivity and specificity for recognizing methicillin resistance were both 100%. Similar results were obtained when the strains were tested by the agar dilution method. The cefoxitin MICs for methicillin-susceptible strains were ≤ 4 mg/L.

Conclusions: Testing with cefoxitin as a surrogate marker for the detection of methicillin resistance was very accurate with both disc diffusion and agar dilution methods. Such testing clearly distinguished methicillin-resistant strains of S. aureus from methicillin-susceptible strains.

Keywords: community-onset MRSA infections , hospital-acquired infections , non-multiresistant Staphylococcus aureus , oxacillin resistance


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