JAC Advance Access published online on July 1, 2003
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkg325
© 2003 by The British Society for Antimicrobial Chemotherapy
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Original article
1 National Center for Antimicrobials
and Infection Control, Statens Serum Institut, Artillerivej 5,
DK-2300 Copenhagen S; Department
of Clinical Microbiology, Hvidovre Hospital, Copenhagen, Denmark
* Corresponding author. E-mail: rsk{at}ssi.dk.
Received 25 March 2003
; revised 9 May 2003
; accepted 9 May 2003
Objectives: To evaluate the performance
of a cefoxitin 30 µg disc on Iso-Sensitest
agar, using a semi-confluent inoculum and overnight incubation at
35-36°C, for detection of methicillin-resistant Staphylococcus aureus (MRSA). Methods: A total of 457 S. aureus,
including 190 MRSA of several defined PFGE types and a number of
low-level resistant isolates, were tested with a cefoxitin 30 µg disc on Iso-Sensitest agar, using
a semi-confluent inoculum and overnight incubation at 35-36°C. This method was compared with the
standard SRGA (Swedish Reference Group for Antibiotics) method (oxacillin
1 µg disc on Iso-Sensitest agar supplemented
with 5% defibrinated horse blood, confluent growth and
24 h incubation in ambient air at 30°C). Results: The cefoxitin method was excellent,
with a sensitivity of 100% and a specificity of 99% using
an interpretative zone diameter of S Conclusion: We suggest that the cefoxitin method
should replace that currently recommended by the SRGA for the detection
of MRSA, and that it would fit well into BSAC methodology.
Keywords: susceptibility testing, disc diffusion, MRSA,
Iso-Sensitest Agar
Evaluation of a cefoxitin 30 µg
disc on Iso-Sensitest agar for detection of methicillin-resistant Staphylococcus aureus
2 The Swedish External Reference
Laboratory for Susceptibility Testing, Växjö
3 Department
of Clinical Microbiology, Hvidovre Hospital, Copenhagen, Denmark
4 National Center for Antimicrobials
and Infection Control, Statens Serum Institut, Artillerivej 5,
DK-2300 Copenhagen S
5 The Swedish Institute for Infectious
Disease Control, Solna, Sweden
29
mm and R < 29 mm. Its performance was much better than
the SRGA method, which with this collection of difficult strains
had a sensitivity of only 78% using the current breakpoint
of S 12 mm.
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