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Related Experiment Videos

Isolate removal methods and methicillin-resistant Staphylococcus aureus surveillance.

Fenfang Li1, Tracy L Ayers, Sarah Y Park

  • 1University of Hawaii School of Medicine, Honolulu, Hawaii, USA. fenfang@hawaii.edu

Emerging Infectious Diseases
|December 2, 2005
PubMed
Summary

Duplicate isolate removal strategies impact Staphylococcus aureus oxacillin susceptibility estimates. Using the first isolate per patient is recommended for accurate S. aureus oxacillin susceptibility reporting.

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Area of Science:

  • Clinical Microbiology
  • Infectious Diseases
  • Antimicrobial Resistance

Background:

  • Accurate antimicrobial susceptibility testing is crucial for effective treatment of Staphylococcal aureus infections.
  • Duplicate isolate removal strategies can influence reported susceptibility rates, potentially impacting clinical decisions.
  • Statewide surveillance data provides a robust basis for evaluating these strategies.

Purpose of the Study:

  • To compare the impact of different duplicate isolate removal strategies on oxacillin susceptibility estimates for Staphylococcus aureus.
  • To determine the most effective and practical method for managing duplicate isolates in surveillance data.
  • To provide recommendations for optimizing susceptibility reporting.

Main Methods:

  • Analysis of 14,595 Staphylococcus aureus isolates from Hawaii statewide surveillance in 2002.

Related Experiment Videos

  • Comparison of 'no removal' strategy against 'most resistant', 'most susceptible', NCCLS, and Cerner algorithms.
  • Evaluation across multiple analysis periods (3, 10, 30, 90, and 365 days).

    • Main Results:

    • The 'no removal' strategy yielded the lowest susceptibility estimates.
    • NCCLS and Cerner algorithms showed less than 2% difference in estimates for the same analysis period.
    • The impact of duplicate removal was more pronounced in inpatient settings compared to outpatient settings.

    Conclusions:

    • The 'no removal' strategy may underestimate Staphylococcus aureus susceptibility to oxacillin.
    • Using the first isolate of a species per patient is a recommended, easily implemented strategy for calculating susceptibility frequencies.
    • Standardized duplicate isolate management is essential for reliable antimicrobial resistance surveillance.