Evaluation of commercial selective agars in screening for methicillin-resistant Staphylococcus aureus

To evaluate methicillin-resistant S. aureus (MRSA) detection methods, we compared (a) mannitol salt agar with cefoxitin (MSA-FX), (b) MRSASelect agar (Bio-Rad), (c) MRSA ID (bioMerieuex), and (d) CHROMagar MRSA (BD Diagnostics) as selective media for culturing nasal swab specimens collected from intensive care unit (ICU) patients and healthcare personnel. A total of 99 (17.1%) cases of MRSA were recovered from 578 specimens. Four (5.5%) cases were identified from healthcare personnel and 95 (18.8%) were from ICU patients. The sensitivity of MSA-FX, MRSASelect, MRSA ID, and CHROMagar MRSA was 83.8, 87.9, 80.8, and 84.8% after 18 hr; 92.9, 94.9, 90.9, and 91.9% after 24 hr; and 96.0, 100, 99.0, and 99.0% after 48 hr, respectively. The specificity of MSA-FX, MRSASelect, MRSA ID, and CHROMagar MRSA was 97.7, 99.0, 98.7. and 99.8% after 18 hr; 97.1, 98.5, 98.1, and 99.5% after 24 hr; and 95.2, 97.7, 97.9, and 99.0% after 48 hr, respectively. In conclusion, all four media showed good results after the 24 hr readings, but MRSA ID and CHROMagar MRSA media required readings at 48 hr due to increased sensitivity at this time point.