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JAC Advance Access published online on March 2, 2005
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dki052
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JAC © The British Society for Antimicrobial Chemotherapy 2005; all rights reserved
Received November 15, 2004
Revised January 6, 2005
Accepted January 7, 2005

Original article

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

Clarence J. Fernandes 1, Lorna A. Fernandes 1, Peter Collignon 2*, and 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, Australia
2 Department of Microbiology and Infectious Diseases, The Canberra Hospital, Canberra, ACT 2606, Australia

* To whom correspondence should be addressed.
Peter Collignon, E-mail: peter.collignon{at}act.gov.au


  Abstract

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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