JAC Advance Access published online on January 13, 2005
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkh514
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1 National Center for Antimicrobials and Infection Control, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark
* To whom correspondence should be addressed. 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.
Received June 10, 2004
Revised October 22, 2004
Accepted October 26, 2004
Original article
Evaluation of cefoxitin 5 and 10 µg discs for the detection of methicillin resistance in staphylococci
2 The Swedish External Reference Laboratory for Susceptibility Testing, Växjö, Sweden
R. Skov, E-mail: rsk{at}ssi.dk
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