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Methicillin-resistant Staphylococcus aureus: how reliable is laboratory reporting?

D W Fleming, S D Helgerson, B L Mallery

    Infection Control : IC
    |March 1, 1986
    PubMed
    Summary

    A 1981 survey revealed high methicillin-resistant Staphylococcus aureus (MRSA) reporting in Oregon labs, with some misidentification. A 1982 follow-up showed significantly lower MRSA reporting after labs were informed.

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    Area of Science:

    • Medical Microbiology
    • Clinical Diagnostics
    • Infectious Diseases

    Background:

    • Methicillin-resistant Staphylococcus aureus (MRSA) poses a significant public health threat.
    • Accurate reporting of MRSA is crucial for effective patient treatment and infection control.
    • Previous data on MRSA reporting rates in clinical laboratories were limited.

    Purpose of the Study:

    • To assess the frequency of methicillin-resistant Staphylococcus aureus (MRSA) reporting by microbiology laboratories in Oregon.
    • To identify factors influencing MRSA reporting rates, including laboratory size and testing protocols.
    • To evaluate the impact of notifying laboratories about potential misidentification on subsequent reporting.

    Main Methods:

    • A statewide survey of microbiology laboratories in Oregon was conducted in 1981.

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  • Data collected included the percentage of Staphylococcus aureus isolates reported as methicillin-resistant.
  • A follow-up survey was performed in 1982 after laboratories were informed of initial findings and potential misidentification issues.

    • Main Results:

    • In 1981, the mean reported MRSA rate was 8.3%, with an inverse correlation between reporting and laboratory size.
    • Laboratories that retested initially resistant isolates reported significantly less MRSA (3.3%) compared to those accepting initial results (20%).
    • Following notification, the mean reported MRSA rate decreased to 3.4% in 1982, indicating improved accuracy.

    Conclusions:

    • A significant portion of MRSA reporting in Oregon laboratories in 1981 was likely due to misidentification.
    • Laboratory practices, such as retesting, play a critical role in accurate MRSA detection.
    • Improved diagnostic practices and awareness can lead to a substantial reduction in the overreporting of MRSA, ensuring appropriate clinical management.