JAC Advance Access originally published online on January 13, 2005
Journal of Antimicrobial Chemotherapy 2005 55(2):157-161; doi:10.1093/jac/dkh514
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JAC vol.55 no.2 © The British Society for Antimicrobial Chemotherapy 2005; all rights reserved
Evaluation of cefoxitin 5 and 10 µg discs for the detection of methicillin resistance in staphylococci
1 National Center for Antimicrobials and Infection Control, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark; 2 The Swedish External Reference Laboratory for Susceptibility Testing, Växjö, Sweden
* Corresponding author. Tel: +45-3268-8348; Fax: +45-3268-3873; Email: rsk{at}ssi.dk
Objective: To evaluate cefoxitin 5 and 10 µg discs for detection of methicillin resistance in staphylococci.
Methods: Six hundred and forty-one Staphylococcus aureus (261 mecA-negative and 380 mecA-positive) and 344 coagulase-negative staphylococci (CoNS) (132 mecA-negative and 212 mecA-positive) were investigated. The CoNS represented nine species, Staphylococcus epidermidis being the most frequent (n=231). All isolates were tested using semi-confluent growth on Iso-Sensitest agar (ISA), and Mueller–Hinton agar (MH) using a 5 and a 10 µg cefoxitin disc and overnight incubation in ambient air at 35–37°C.
Results: For S. aureus, both cefoxitin discs performed with high accuracy on both media. The sensitivity and specificity for the following proposed interpretive zone diameters were: ISA 5 µg, R < 14 mm (99.5% and 98.1%); ISA 10 µg, R < 22 mm (99.5% and 98.1%); MH 5 µg, R < 12 mm (99.7% and 98.1%); and MH 10 µg, R < 18 mm (99.5% and 98.9%), respectively. All four variants were superior to oxacillin using the former SRGA methodology. In CoNS, a substantial overlap was seen for all variants. However, by avoiding primary interpretation in the overlapping interval, highly accurate results could be obtained for 81%, 80%, 91% and 97% of the isolates, respectively.
Conclusion: For S. aureus, cefoxitin 5 and 10 µg discs performed with high accuracy on both ISA and MH using semi-confluent growth and standard incubation conditions. With the introduction of a defined interval in which primary interpretation should be avoided, the method could also be used for CoNS.
Keywords: MRSA , coagulase-negative staphylococci , susceptibility testing
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