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Detection and Identification of Methicillin-resistant Staphylococcus aureus (MRSA) by Polymerase Chain Reaction (PCR)

MRSA presents both clinical and infection control challenges. Because of the increasing incidence of MRSA strains, empiric treatment for serious staph infections is usually vancomycin in the hospital setting. Although PNA-FISH can identify Staphyloccocus aureus more rapidly, it cannot yet differentiate MRSA from methicillin-susceptible S. aureus (MSSA) strains. Early differentiation of MRSA from non-MRSA strains could allow for adjustment from broad spectrum antimicrobial therapy, and reduced risk of development of resistance.

Hospital acquired infections have garnered increasing attention from many quarters; MRSA is one of several drug resistant organisms that are of concern. Many institutions have implemented active surveillance culture (ASC) protocols to identify carriers of MRSA, both upon admission, and throughout the hospital stay. Identified carriers are placed under precaution protocols, to minimize risk of transmission to other patients during the hospital stay. MRSA status is also an important consideration for those patients who are being discharged to another facility (long term care or rehabilitation centers).

Identifying carriers sooner rather than later can reduce the risk of transmission by earlier implementation of precaution protocols and reduce delays in discharge (and length of hospital stay) in situations where carrier status is needed prior to discharge. PCR methodologies offer the prospect of providing screening results 24 to 40 hours sooner than culture methodologies, depending on the culture medium employed.