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JAC Advance Access originally published online on November 17, 2005
Journal of Antimicrobial Chemotherapy 2005 56(6):1000-1018; doi:10.1093/jac/dki372
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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@oxfordjournals.org

Review

Guidelines for the laboratory diagnosis and susceptibility testing of methicillin-resistant Staphylococcus aureus (MRSA)

Derek F. J. Brown1, David I. Edwards2, Peter M. Hawkey3,4,*, Donald Morrison5, Geoffrey L. Ridgway6, Kevin J. Towner7, Michael W. D. Wren8 on behalf of the Joint Working Party of the British Society for Antimicrobial Chemotherapy, Hospital Infection Society and Infection Control Nurses Association

1 Health Protection Agency, Addenbrooke's Hospital, Hills Road, Cambridge CB2 2QW, UK; 2 39 Wallenger Avenue, Gidea Park, Essex RM2 6EP, UK; 3 University of Birmingham, Edgbaston, Birmingham B9 2TT, UK; 4 Heartlands Hospital, Bordesley Green East, Birmingham B5 9SS, UK; 5 Scottish MRSA Reference Laboratory, Department of Microbiology, Stobhill Hospital, Glasgow G21 3UW, UK; 6 Department of Health, Wellington House, 135–155 London Road, London SE1 8UG, UK; 7 Department of Microbiology, University Hospital, Queens Medical Centre, Nottingham NG7 2UH, UK; 8 Department of Clinical Microbiology, UCL Hospitals, Windeyer Institute of Medical Sciences, London W1T 4JF, UK

* Correspondence address. Health Protection Agency, Heart of England NHS Trust, Bordesley Green East, Birmingham B9 5SS, UK. Tel: +44 121 424 1240; Fax: +44 121 772 6229; E-mail: peter.hawkey{at}heartofengland.nhs.uk

These evidence-based guidelines have been produced after a literature review of the laboratory diagnosis and susceptibility testing of methicillin-resistant Staphylococcus aureus (MRSA). We have considered the detection of MRSA in screening samples and the detection of reduced susceptibility to glycopeptides in S. aureus. Recommendations are given for the identification of S. aureus and for suitable methods of susceptibility testing and screening for MRSA and for S. aureus with reduced susceptibility to glycopeptides. These guidelines indicate what tests should be used but not when the tests are applicable, as aspects of this are dealt with in guidelines on control of MRSA. There are currently several developments in screening media and molecular methods. It is likely that some of our recommendations will require modification as the new methods become available.

Keywords: MRSA identification , MRSA susceptibility testing , MRSA screening , MRSA molecular methods , GISA , meticillin


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